Exchanges and Agents (my Blog)

[Dave020]

California Health Insurance Blog - by David Fluker: Health Exchanges and Independent Agents

 

[somarco]

Obviously none of us know what the end result will be, but you certainly make some valid points about the value of an agent, even in a "no brainer" situation like HIPAA plans. The same can be said about Med Supps yet somehow the agent has a place in the decision process.

 

[Crabcake Johnny]

The exchanges will not be the market. Plans sold outside the exchanges will be the market.

 

[insurehound]

healthagent, what makes you say that?

 

[CHUMPS FROM OXFORD]

There will be two markets. Inside an outside the exchange. I have previously posted about the "outside the market" exchange.

Inside? We don't know details. Yet.

 

[Crabcake Johnny]

healthagent, what makes you say that?

Because the fix has been in for quite some time. Do you see the carriers going nuts over this? No, and there's a reason. That reason is "excepted" coverage which barely has one undefined paragraph in the legislation.

Yet that one paragraph allows carriers that sell plans in the exchange (you must sell plans in the exchange in order to sell plans outside of the exchange) to do basically whatever they want outside of the exchange.
- - - - - - - - - - - - - - - - - -
EXCEPTED BENEFITS COVERAGE.—Nothing in this division shall be construed as affecting the offering with BILLS104
•HR 3962
1 outside of the Health Insurance Exchange and
2 under State law of health benefits in the form of ex
cepted benefits (described in section
4 202(b)(1)(B)(ii)) if such benefits are offered under
5 a separate policy, contract, or certificate of insurance.



And this:

EXEMPTION FOR CERTAIN POLICIES.—The term 'specified health insurance policy' does not include any insurance if substantially all of its coverage is of excepted benefits described in section 9832(c).