Exchanges and Vesting of Commissions

[pahealthquotes]

lets say you have someone who enrolls in a plan and wants to change. Will they only be able to change 10/1 thru 12/31?

what if you have someone who wants a plan outside 10/1/ thru 12/31 but has no special qualifying event.No Loss of job with coverage , No move from service area etc. Will this peron be able to buy? I'm assuming yes but they will not have pre-existing conditions covered.

Any early rumblings about commission? Will they pay the entire year up front? I actually prefer montly rather than all at once. I wonder if they will let the producer decide.

No medical underwriting but I see a paperwork nightmare.

 

[AllenChicago]

What if you have someone who wants a plan outside 10/1/ thru 12/31 but has no special qualifying event.No Loss of job with coverage , No move from service area etc. Will this peron be able to buy? I'm assuming yes, but they will not have pre-existing conditions covered.

Since the IRS Penalty-Tax is calculated on how many months a person goes without having qualified health coverage in any given year, let's hope that those without q.h.c. can buy it whenever they want. But then again... insurance companies wouldn't like that. But then again, HHS is calling the shots .

For all the thousands of pages of legislation, rules and regulations related to the Affordable Care Act, the most important specifics for the public, insurers...and agents, have still not been decided. Twelve months left before liftoff of the most complicated benefits program ever designed and our government is still figuring out the basics. No wonder the California exchange website says that 1/1/14 is the EARLIEST that they will be up and running.

 

[Ann H]

Ann, are we talking about Small Group or Individual or both? So come 10/13, every health insurance broker's income (regardless if they are small group or individual) will go away?

Everyone better have a "Plan B" that is active NOW!

I was talking about both Small Group and IFP. But it's just a worry. And like my Mama said, "Don't worry about your worries, because they may not happen." In GI states, when there were only one or two carriers left standing they saw no need for the agent. But it took a few years for the GI state to get to the place where all the business was under 1 or 2 carriers. That's the point at which they cancelled the broker contracts. Could that happen in the fall of this year? Yes, but it's not likely. What is more likely for us, as brokers, is to be surprised by a carrier who is leaving the health insurance marketplace and sends the client (and us) a 30 day notice. Then we're left without commission, while we are trying to figure out what to do with those clients even before 1/1/2014. But a grand scale broker contract cancellation is not likely.

 

[somarco]

In GI states, when there were only one or two carriers left standing they saw no need for the agent. But it took a few years for the GI state to get to the place where all the business was under 1 or 2 carriers.

Different time. Different circumstances.

Now we have federal govt oversight, dictating coverage, MLR (including rebates), federal rate regulation, federal govt in competition with the free market, price supports for consumers.

I don't think it is going to take as long to unravel as it did on a state level. This assumes the 2014 projected start date actually happens complete with exchanges and subsidies.

 

[ctg]

If they are non-grandfathered, they won't have a choice. No current NGF IFP plan conforms to the PPACA standard and, according to our carriers, all will be replaced.

Just for my own clarification, plans sold now are NGF but PPACA compliant-at least according to the carriers I deal with. So those won't have to be replaced.

The plans that will be replaced are the somewhat older policies that are NGF but not PPACA compliant. Is that about right?

 

[russelltw]

I have read that all NGF plans will have to switch to a ACA plan effective 1/1/14. If this is the case, I would expect sales of IFP to slow to a crawl after 6/1/13.

I have also read where those who purchase plans now (in 2013), would have to change their plans on the anniversary date that falls in 2014. If this is the case and premiums for ACA plans are high, that would potentially cause some to consider getting coverage before 1/1/14 in an attempt to hold out at least another year.
Time will tell.

 

[Dave020]

Two things from both Anthem and Blue Shield out here:

1. No NGF IFP plan currently sold conforms to the exchange metal requirements in or out and new plans have to be developed for new enrollments and to replace existing NGF IFP plans

2. From one Blue above, no anniversary date changes, must enroll during OEP and change plans 1/1/14 regardless of anniversary date of current NGF plan

Obviously there will be clarifications on these, but this is the last I heard from the 2 big Blues in CA.

 

[headcoach]

Will the grandfathered plans be left alone or will they have to be changed.

Was not the purpose of maintaining a grandfathered that the client would not be subject to buying an ACA compliant plan

 

[Dave020]

Will the grandfathered plans be left alone or will they have to be changed.

Was not the purpose of maintaining a grandfathered that the client would not be subject to buying an ACA compliant plan

AFAIK, for whatever life span GF plans may have, they are not subject to ANY of the plan design/essential benefits provisions of ACA and the exchanges.

 

[headcoach]

thank you Dave..........that is what I thought, but needed your confirmation