FFE's - Agents & Commissions

Discussion in 'Health Care Reform Forum' started by Yagents, Nov 30, 2012.

  1. Yagents
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    Yagents Guru

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    Some good news.......... Looks like agents will be part of the FFE's, and will be paid....by the insurers on a level playing field. Two good things: 1. insurers are already able to pay us commissions and still meet the MLR. 2. We'll get paid on a timely basis vs. something like PCIP that took 3 months or more. Plus, if Chumps can keep people from entering the market, there will be a less number of brokers on the website listed. ;)

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    One provision would let the SHOP small business exchanges put insurance agent and broker information on their websites, and another provision would require carriers selling coverage through a federal individual or SHOP exchange offer similar producer compensation in the exchange and non-exchange markets.
    CMS has posted a preliminary version of the regulations on the Web today and intends to publish them in the Federal Register Dec. 7.
    Comments will be due 30 days after the official Federal Register publication date.

    http://www.ofr.gov/(X(1)S(rifxntcbfjqyrzrrqukge05p))/OFRUpload/OFRData/2012-29184_PI.pdf

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    Brokers
    One section of the proposed regulations deals with broker compensation for coverage sold through a federal individual exchange or a federal SHOP small business exchange.
    CMS officials note that it and its parent department have much less ability to influence health insurance broker compensation than a state has.
    In an effort to create a level playing field, CMS is proposing that a federal individual or SHOP exchange will certify a carrier as a QHP only if offers similar broker compensation to QHPs and non-exchange plans.
    "We request comment on whether 'similar health plans' is a sufficient standard and if not, which factors should be considered in identifying 'similar health plans,'" officials said. "We also request comment on how this standard might apply when small group market product commissions are calculated on a basis other than an amount per employee or covered life or a percentage of premium."
    The proposed regulations also would let a federal individual or SHOP exchange post the information of agents and brokers registered to do business with the exchange -- and only those producers -- on its website.
    "We believe that listing only brokers who have registered with the exchange is in the best interest of the consumer, both because the registration and training helps assure that the agent or broker is familiar with the exchange policies and application process and because the proposed listing will not contain large numbers of licensed brokers who are not active in the market," officials said.
    CMS posts risk-management proposals | LifeHealthPro
     
    Last edited: Nov 30, 2012
  2. Ann H
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    Thanks for keeping us informed, Bill. I can always count on your posts to be timely, newsworthy and valuable.
     
  3. Yagents
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    This from NAHU. I see good stuff for those who are prepared, I bolded the key parts:

    NAHU Washington Update - 12/05/2012
    We’ve been told to expect additional guidance on broker issues from the federal government relative to both federally facilitated and partnership exchanges and also state-based exchanges within the next few weeks. But here’s what we know and have been able to achieve regarding agents and brokers and exchanges today:
    • Unless a state specifically acts to exclude agents from exchanges, it is assumed that agents and brokers can continue to assist their clients and sell and service exchange-based products, including subsidized policies, and be compensated for doing so. So far, no state has acted to exclude agents and brokers and, in fact, they have primarily embraced the agent community.
    • The federal government will assume primary responsibility for agent and broker issues in fully-federally facilitated and partnership exchanges (states will continue to license producers and handle consumer protection and the outside marketplace).
    • The federal government plans to fully utilize registered agents and brokers to sell and service both individual and small-group exchange policies in all federally-facilitated and partnership exchanges. The plan is for broker compensation, regarding exchange-based policies, to be handled by the broker with the health insurance carrier, as it is today.
    • The new proposed triple-R rule specifies in its exchange section that the federal exchange will only certify carriers as having a qualified health plan if they can demonstrate that broker compensation for individual and small group exchange products is on par with compensation in the outside market. This specification corresponds with NAHU’s specific request in our May 2012 comment letter.
    • The new proposed rule asks for comments on the idea that exchanges may choose to limit broker referrals on their websites to only brokers who have been certified as being eligible to do business with the exchange (certification is expected to include licensure verification, an agreement to follow privacy requirements, etc.) NAHU has consistently advocated for the use of certified agents and brokers in exchanges.
    • Agents and brokers will be allowed to use their own websites to sell exchange-based products and offer exchange-based subsidies (using the state or federal exchange data hub for subsidy verification).
    • The federal government is developing a specific broker portal so that agents and brokers can assist their individual and group clients more efficiently with exchange-based coverage.
    • Health insurance exchanges, including the federally-facilitated exchanges, are required to consult with producers as a stakeholder group in exchange development. CMS is currently consulting with NAHU directly and regularly on broker issues and we have discussed providing them with state-based broker contacts for stakeholder consultation once states and CMS have made their final determinations about federal involvement in a particular state’s exchange.
     
  4. AllenChicago
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    Bill, U R AWESOME. Thanks for finding gold nuggets like the good news from NAHU. At least I think it's good news for brokers in most of the country.

    In Illinois, our (crooked) state has chosen to run its own exchange. I hope they leave the compensation arrangement between the agent and insurance companies, like it is now. For that matter, I hope they utilize us at all! (We got 0$ for helping people with PCIP)

    -ac
     
  5. pahealthquotes
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    wow, very interesting developments.. looks like we'll be playing ball come 2104. Big one for me is agents will be able to assist with subsidized policies, and be compensated. :biggrin:
     
  6. AllenChicago
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    One thing that will help ensure agent compensation is that the U.S. government will also subsidize health insurers to help them offset the cost of medical expenses incurred by the sickest insureds who buy exchange policies. I read this yesterday. It's yet another rule that's about to be introduced.
     
  7. somarco
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    You mean subsidized by taxpayers.

    So far, PCIP was underfunded (in spite of falling woefully short of projected enrollment goals, ERRP was likewise a disaster.

    Any reason to believe they will get it right this time?

    I doubt it.
     
  8. stuy119
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    Allen, I thought IL decided on a partnership exchange with the Feds instead of running it on their own, with the potential to change to self-control down the line?
     
  9. Yagents
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  10. taterpeeler
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    I read that somewhere as well allen... giving the insurance companies a subsidy to offset their hig claim folks... kinda like advantage plans do....... it's starting to look allot like we will be selling the under 65 version of medicare advantage plans... i think I have been stating that very fact for over a year now
     
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