Enroll America - Here's the Solution Folks!

[bluediamond]

Soooooo.....we are less than 7 months from the scene in "Healthy, MO where Brian Williams covers the signing of the the 1st applicant. Just a few questions:
1. When does the training start and who is going to do it?
2. Do I still have time to set up a non-profit for "distressed independent agents" and get the grant money?
3.What do the "greedy agents" make to assist enrollments.
4. Is it going to be worthwhile to help anybody since Medicare AEP is the same time?
5. Can I get a job as a Navigator and make enough to buy a Lincoln?

Training Dates: Sept 28 and 29th
If you hurry you can get in the grant business but grants under $100 are hard to come by.
Greedy agents: $5.00 per enrollee
Answer to number 4 is probably not.
You will be able to go to your local junkyard and pick the lincoln of your choice.

 

[timsip]

5. Can I get a job as a Navigator and make enough to buy a Lincoln?

Interesting story...I just returned from the sub-committee meeting regarding the bill that is to establish an exchange in Iowa for 2015 (we currently are scheduled to have the partnership version for 2014) and it appears the interpretation they were discussing is that navigators would be volunteers modeled after the SHIIP program....we weren't given the opportunity to debate without being walked out, so I forcefully bit my tongue.

 

[BobbyMcGee]

Sounds like the rest of the states are paying them:

Topic: Health Care Reform 02/05/2013 - California Healthline

http://bangordailynews.com/2013/02/...ators-a-huge-task-maine-imposes-restrictions/

 

[Yagents]

Feds: Our exchanges will work with producers | LifeHealthPro

SECTION 10. AGENTS AND BROKERS
Section 1312(e) of the Affordable Care Act and 45 C.F.R. § 155.220 permit states to allow agents and brokers to enroll qualified individuals, employers, and employees in QHPs through an Exchange. Where permitted by the state, agents and brokers (including web-brokers) may assist with the eligibility application and enrollment processes, including plan selection, as well as in applying for insurance affordability programs, including APTCs and CSRs, subject to the standards outlined in 45 C.F.R. § 155.220.
44
All agents and brokers, including web-brokers, seeking to enroll individuals through an FFE or FF-SHOP must be licensed as producers by the state and adhere to all applicable state laws. States will maintain their current roles of overseeing agents and brokers in their insurance markets, including licensure requirements, appointments with issuers, and any compensation standards.32
CMS will work with agents and brokers, including web-brokers, to facilitate enrollment in an FFE or FF-SHOP, including a State Partnership Exchange, to the extent permitted by state law. As described in the Exchange Final Rule, CMS will enter into agreements with registered agents and brokers to ensure compliance with federal regulation and Exchange privacy and security requirements.
This Exchange-specific Agent/Broker Agreement will govern agents' and brokers' access to the Exchange. CMS will monitor and oversee agents and brokers to confirm ongoing compliance with the terms of the Agent/Broker Agreement. CMS anticipates that this monitoring and oversight will be limited to the terms of the Agent/Broker Agreement not covered by state law, such as the Exchange's privacy and security requirements and standards for obtaining consumer consent. If an agent or broker violates the terms of the Agent/Broker Agreement with the FFE, CMS may suspend or terminate agent or broker access to the Exchange. We plan to release additional information on this process in the future.
CMS intends to notify the state when an agent's or broker's Exchange access has been suspended or terminated. CMS also intends to refer any identified market conduct issues (for example, failure to act in the best interest of the consumer) to states for follow-up and remediation.
Issuers must ensure that marketing actions taken on their behalf by agents and brokers, including web-brokers, participating in FFEs and FF-SHOPs comply with applicable federal and state requirements. Any marketing materials related to an issuer's QHPs and used by an agent or broker must conform to requirements in the QHP issuer's Agreement with the Exchange.
32 However, a QHP issuer participating in an FFE or FF-SHOP must pay the same commission for a QHP sold inside and outside of an Exchange.

 

[Ann H]

The article is very good. A paragraph at the end caught my eye, even though it is not about the topic of this thread, nor the reason you posted that article. However..... talk about a rate hike magnet. Read this:

In a section on stand-alone dental plans offered through the FFEs and partnership exchanges, CCIIO officials have noted that a PPACA provision banning use of annual and lifetime benefits limits applies to the pediatric dental benefits included in the PPACA-mandated "essential health benefits" (EHB) package as well as to the other EHB benefits.

To be considered, the annual limit on cost-sharing costs for the pediatric dental benefits must be $1,000 or below, officials said.​

Feds: Our exchanges will work with producers | LifeHealthPro

 

[AllenChicago]

The article is very good.

In a section on stand-alone dental plans offered through the FFEs and partnership exchanges, CCIIO officials have noted that a PPACA provision banning use of annual and lifetime benefits limits applies to the pediatric dental benefits included in the PPACA-mandated "essential health benefits" (EHB) package as well as to the other EHB benefits.​

To be considered, the annual limit on cost-sharing costs for the pediatric dental benefits must be $1,000 or below, officials said.​

Feds: Our exchanges will work with producers | LifeHealthPro

Is this $1,000 maximum out-of-pocket per child? I haven't been exposed to dental prices in recent years. Are braces still the most sought after and expensive dental care for children?

Regarding the article that YAgents posted, it seems that CMS will be monitoring broker/buyer conversations and also contacting plan purchasers (and non-purchasers) for feedback on the "experience". Is it worth 5% commission to converse with potential buyers over a monitored, recorded, voice and internet connection? And remember, we can't use the 3 words "My Advice is..." when talking to an Exchange-Marketplace shopper. Short, efficient conversations will not happen in this environment.
-ac

 

[somarco]

it seems that CMS will be monitoring broker/buyer conversations and also contacting plan purchasers (and non-purchasers) for feedback on the "experience". Is it worth 5% commission to converse with potential buyers over a monitored, recorded, voice and internet connection? And remember, we can't use the 3 words "My Advice is..." when talking to an Exchange-Marketplace shopper. Short, efficient conversations will not happen in this environment.

Reminds me of the Watergate hearings where the answers were non-commital.

Where is Rose Mary Woods when you need her?

 

[AllenChicago]

AP and the Washington Post are finally comprehending and reporting how extremely burdensome the 2014 QHP application process is going to be..15 pages of government questions to answer, even before getting to the point of choosing a health insurance policy.


Story: Will nation’s uninsured get lost in long application for Obama health care plan? - The Washington Post

-ac

 

[stuy119]

 

[Ann H]

It will be fun to watch. Here are some funny lines I selected from the article:

1) If anyone in your household is offered health insurance on the job but does not take it, be prepared for some particularly head-scratching questions. For example: "What's the name of the lowest cost self-only health plan the employee listed above could enroll in at this job?"

2) The government estimates its online application will take a half hour to complete, on average. If you need a break, or have to gather supporting documents, you can save your work and come back later. The paper application is estimated to take an average of 45 minutes.

3) Drafts of the paper application and a 60-page description of the online version... run counter to the vision of simplicity promoted by administration officials.

4) HHS estimates it will receive more than 4.3 million applications for financial assistance in 2014, with online applications accounting for about 80 percent of them. Because families can apply together, the government estimates 16 million people will be served.

Here's my answer:

Dear Government, please research PCIP enrollment where only 3 things were required: 1) be an American Citizen; 2) have a pre-existing condition for which you cannot obtain health insurance; 3) have no health insurance for the prior 6 months. The govt estimated that 4 million people were eligible, but about 5% of them would enroll. Actually, about 2.36% enrolled.