All They Have to Do is Call the Marketplace One Time

[bill3173]

and your name and npn come off of the enrollment, with few exceptions. Had a lady call me the other day to let me know that she had a little problem when she went back in to review her plans, but didn't want to "bother" me. I only found out because she wanted to ask me a question about her coverage, and mentioned that she had already spoken to the marketplace.

I casually mentioned that we may need to take a look at the plan online, and I told her my name had been removed. I fixed it, with her permission, but this is really too much.

 

[TxOnline]

If your client enrolled with HealthSherpa, your NPN was embedded at the Plan Selection section, and even seems to have been embedded at the spot called Authorized Rep (something like that...where you have the right to call the govt on client's behalf).

When the client calls-in to the govt 800#, they seem to strip your NPN at the Contact Section ONLY.

I don't seem to be losing clients (at the insurance company) when they were enrolled at HealthSherpa.

I can't tell you if this is a consistent pattern or not. Just what I've observed with the ones I've checked.

 

[CHUMPS FROM OXFORD]

"When the client calls-in to the govt 800#, they seem to strip your NPN at the Contact Section ONLY."

I wonder if they are instructed to do that? Actually, they should be instructed NOT to do that.

 

[KennyWest]

Bill, TXOnline and Chumps, not to confuse further but all of you are partly right and partly wrong.

TXOnline above said "...Authorized Rep ..." which has zero to do with an agent being connected/attached/etc.in so far as their NPN and commissions are concerned. In fact, you can use the Markeptplace Access feature and set yourself as "authorized" on ANY APP, whether you were the agent of record or not. BUT, if you are not the one which NPN is attached and you simply add yourself as "authorized" you will not get paid.

Lastly, and prior to the below from our FAQ; It is true that many who call in to healthcare.gov or make changes on their own where an agents NPN was connected prior CMS is having issues and is stripping the NPN in many instances.

We find many agents think that because they are not designated as “Authorized” to view a customer’s account it means they are not attached via NPN, they are two different things.

For example, if you were to call healthcare.gov and ask if you are attached to an application which has been submitted they might say no. The reason is due to a disconnect in what healthcare.gov considers as attached to an application versus an agents NPN being assigned to a submission. Healthcare.gov employees have NO ACCESS to view whether an agents NPN is associated with an application. They can only see if someones name has been input in the field “Did someone help you with your application?” or not. A couple of examples:

1. If you were to 100% submit an application at healthcare.gov and put your name in the field where they ask “Did someone help you with your application?” and NOT input your NPN number then later called healthcare.gov and ask if you were attached to the application they would say, yes you are, even though your NPN was NOT associated with them.

2. If you were to 100% submit an application at healthcare.gov and put NOTHING in the field where they ask “Did someone help you with your application?” and DID input your NPN number then later called healthcare.gov and ask if you were attached to the application they would say, NO you are not, even though your NPN was associated with them.

The NPN you provided when you on-boarded and is listed within your profile at ACAExpress (or any other WBE if they are submitting using the agents NPN and FFM info) is sent to CMS/healthcare.gov when the final submission is completed. CMS/Healthcare.gov then send the info to the carrier. Keep in mind, some carriers are faster than others at actually associating the NPN to an application after they receive the data from CMS/healthcare.gov than others.

 

[TxOnline]

I don't see ANY "partly wrong" info in our comments above.

There are THREE spots where an agent can be added to On-X apps.
TWO of them involve NPN (which carries over to the insurance company...for commission purposes).
ONE (the Authorized Rep spot) gives YOU (the agent) the right to call the govt & make changes on behalf of your client......INCLUDING getting your NPN# added back to the app.

1 - Contact Section (near beginning of govt app)
This seems to be where agent NPN# is stripped when your client calls-in to the govt.

2 - Plan Selection section (where they pick-a-plan).
I don't think NPN# is being stripped here.....UNLESS your client asks the govt to change their plan selection.

3 - Authorized Rep (or whatever it's called) Section.
This section doesn't carry-over to the insurance company.
It simply gives you (as agent) the right to CALL the govt on client's behalf & make changes.
I initially THOUGHT that you could ONLY be designated as the Authorized Rep IF your client made a call TO the govt....to tell them to authorize you (to speak to govt on their behalf).
However, it SEEMS that my HealthSherpa enrollments automatically have me listed as Authorized Rep.
That's GOOD.....if that's the case!
I can call the govt.....IF needed.....and get my NPN number added back (after they strip me).
No need to impose upon my client to make that dreaded call.

However, last I heard, that Authorized Rep designation only lasts for 12 months. Then, client has to call-in to authorize us AGAIN.
BUT, if Sherpa is ADDING us into that Authorized Rep section with EACH new enrollment, then there's no need for clients to make that dreaded call to the govt.....IF we re-enrolled them thru Sherpa for 2016.

Can't speak for ACA-express enrollments (about the Authorized Rep assignment).

Can't even guarantee that Sherpa does that.
But, it SURE looks like they do.
I see myself as Authorized Rep on MANY of my Sherpa-enrolled clients.
And, I KNOW that I've never asked those clients to call-in to add me (as their Authorized Rep).

 

[KennyWest]

The stripping is not done manually by CMS employees, in the situations where a customer calls hc.gov, it is there is an issue CMS is having with the data feed to the carrier after a change is made as you describe.

 

[TxOnline]

Thank you for the clarification, Kenny!

If that's the case, I THINK we are only being stripped from the Contact Section....NOT from the Plan Selection Section....which is still embedded AT the insurance company.

I've found (when I go in to do a Life Change at govt site) that I'm missing at Contact Section.
But, I've been PAID for that client.....all along.....so my NPN# is still embedded SOMEWHERE......even after clients called-in to govt about problems.

Maybe that insurance company is honoring my initial enrollment with the client.....and the next insurance company is NOT.

I haven't figured this out.
But, we'll never figure it out if we don't TRY to find a pattern here.

 

[AllenChicago]

The stripping is not done manually by CMS employees, in the situations where a customer calls hc.gov, it is an issue CMS is having with the data feed to the carrier, after a change is made.

YEP, and it's been like this for 3 years running now. Carriers know that the agent has been removed from a client. But they don't complain to CMS.

WHY? Common sense says that CMS/Healthcare.gov is merely following covertly communicated instructions. Instructions from the Washington lobbyists who work for the health insurance companies.

Some companies aren't participating in this cold-hearted greed however. When a customer transaction comes arrives from the Exchange, a basic software routine is run. If Suzie-Q was the agent before the transaction, Suzie-Q will be reassigned as the post-transaction agent.
ac

 

[bill3173]

Had a long time client that called in to complete his app that was 80% done, and we couldn't move forward. I thought about doing a new sherpa app on him, but he called me back first to let me know that he called the marketplace and they were able to help him finish it, but they told him I would not be the agent on the policy. I pulled it up and my name had been removed.

 

[KennyWest]

Had a long time client that called in to complete his app that was 80% done, and we couldn't move forward. I thought about doing a new sherpa app on him, but he called me back first to let me know that he called the marketplace and they were able to help him finish it, but they told him I would not be the agent on the policy. I pulled it up and my name had been removed.

As an FYI, there is not that I am aware of anywhere you can see if your NPN is associated or as agent of record after locating using the Marketplace Access feature.

It will show if you are not listed as an authorized user but again, that has nothing to do with commissions.