Breaking News - Role of Agents, Brokers, and Web - Brokers in Health Insurance Marketplaces

[RayNY]

Dave and Ann, I came to the same conclusion as you on the web-broker definition. Did you notice this on page 9?

"After the consumer selects a QHP and the APTC amount has been determined, the web-broker will transmit the individual or family's QHP selection, including the applicable premium, APTC amount that will be applied to the premium, and broker identifier, back to the Marketplace. The Marketplace ... will convey all enrollment information to appropriate QHP issuers, including information identifying the web-broker in order to facilitate compensation by the issuer."

APTC-Advanced premium tax credit, aka the subsidy.

Does this mean subsidies will be available OUTSIDE the exchange through web-brokers, who will then get a commission? Or did I mis-translate the legalese?

 

[Ann H]

Does this mean subsidies will be available OUTSIDE the exchange through web-brokers, who will then get a commission? Or did I mis-translate the legalese?

No, it just means the web-broker can go outside the marketplace (on the web-broker's quoting model) to compare and pick a plan, but when you submit the app and premium+subsidy, it all re-routes back through the exchange/marketplace. The subsidy is only available for exchange products.

Note also, that those rules were for web-brokers. For "traditional brokers" as HHS puts it (LOL), you can submit apps to the carrier or through the marketplace. Actually, most brokers will probably be web-based through a 3rd party interface like Quotit or Norvax. I doubt that many brokers will be using the exchange to compare/pick a plan nor going to every single carrier's website to do it.

 

[dmans]

Nice... another way to waste time and not get paid. Great. Of course I have been making so much money selling individual health insurance that I can now afford to do volunteer work.

 

[RayNY]

So it means that the subsidy will be through the marketplace (not an exchange any more, trying to break that habit).

But, moral of the story, John Doe goes to Web Broker XYZ's portal and, without leaving that site, walks away with a plan and a subsidy not caring what happened in the background, correct?

 

[deathbyaca14]

Nice... another way to waste time and not get paid. Great. Of course I have been making so much money selling individual health insurance that I can now afford to do volunteer work.

Now that gets an award for best use of sarcasm and funny.

 

[cadylou]

Right now you have a number of carriers pushing back on participation in the "marketplaces" being set up, so in the end a lot of business may be occurring outside of the exchanges. The fact that they've established an annual enrollment that is at the same time as Medicare AEP will be my biggest problem, even if the individual health market remains viable. I can't possibly do both in that time frame, so Medicare business wins - more $$ than individual health.

 

[timsip]

Right now you have a number of carriers pushing back on participation in the "marketplaces" being set up, so in the end a lot of business may be occurring outside of the exchanges. The fact that they've established an annual enrollment that is at the same time as Medicare AEP will be my biggest problem, even if the individual health market remains viable. I can't possibly do both in that time frame, so Medicare business wins - more $$ than individual health.

You might need new individual contracts....

 

[cadylou]

Why would I need new individual contracts? Are you referring to me having to set up new contracts with the carriers I'm appointed with? Sorry, I don't understand the comment . . .

 

[timsip]

Why would I need new individual contracts? Are you referring to me having to set up new contracts with the carriers I'm appointed with? Sorry, I don't understand the comment . . .

I was referring to your point that you would make more money in MA than individual. On a case-by-case basis, I make more in individual health.

 

[supersupps]

let's talk money... AEP is medicare vs obamacare.. we know what medicare pays.. what do the indy policys pay?