PIA National — and other insurance groups — pushed for agent and broker participation in the Affordable Care Act when it was being crafted in 2010. Those pleas fell on deaf ears. Much to the chagrin of the health insurance industry, the Obama administration and congressional Democrats pushed for the creation of “neutral” navigators to assist consumers with enrollment.
It didn’t make sense because these navigators — for the most part — aren’t insurance professionals, aren’t required to have licenses, and in many instances, background checks or errors and omissions insurance.
Plus, the taxpayer has to fork over dollars for the salaries of the assister workforce. Independent agents and brokers — who by the way, are already trained and experienced in the sale of health insurance — would not cost the taxpayer a dime.
What wasn’t lost on consumers in all of this — and as the exchanges went into operation a couple of years ago — is the value of health insurance experts to the process of enrollment. So while some are still debating whether the Affordable Care Act is actually working, we do know much of its success with consumers comes from the independent insurance agent and broker.
Or so says a Kaiser Family Foundation report titled the 2015 Kaiser Foundation Survey of Health Insurance Marketplace Assister Programs and Brokers.
In it some brokers and agents — 20% — say in this year’s open-enrollment period they helped 100 or more individuals with enrollment for healthcare coverage through the federal or state insurance exchanges — also known as marketplaces. The survey found 60% helped 50 or more enroll.
In year-one these agents and brokers also connected deeply with their clients and most opted to continue working with them in year-two. This beats what the assister programs — or the so-called navigators — have been able to do. And Kelly Fristoe — who is the president and CEO of Texas-based Financial Partners — put it in perspective.
“Every day that health insurance becomes more complicated, the value of what we do for or customers becomes more valuable. We have more dialogue with our customers. They are our source of revenue. It comes down to customer service. One of our primary goals is to make sure we take care of people,” he said.
Part of the reason health insurance agents and brokers are able to be of better service to consumers is because of their connection to the insurance company. “We as agents get that information from insurance companies, so we’re able to reach back out to our clients and have a conversation with them now, so that when we get into open enrollment, we can find something suitable for them. And we can help them learn how an HMO will work and what it will mean to them, since many of them have been consumers of a PPO for the past few years,” Fristoe added.
Agents and brokers — the survey found — are very good helping consumers compare plans and select qualified plans. They also assisted with the application of premium tax credits and resolved enrollment problems.
That said, there are areas where assisters — or navigators — were more effective than agents and brokers:
• Assister programs were better at engaging in public education outreach — 80% to 33%
• Assister programs were also more likely to help a consumer with an appeal on eligibility decisions — 58% to 39%.
On the other hand, agents and brokers are more effective — 34% to 9% — when helping small business select coverage. The survey also noted:
• 66% say it takes more time to sell a non-group policy than it did before the implementation of the marketplaces in 2014.
• 57% say revenue per policy is down.
• 40% say overall revenue is up.
• Another 40% say overall revenue is down.
• 60% — however — say they sell more non-group policies than ever.
• On average they sell one outside policy to every two marketplace policies sold.
Source links: Employee Benefit News and insurancejournal.com