Health Insurance Brokers Adding Fees-Dallas Morning News

Brian Anderson

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Interesting read in the Dallas Morning News about some health insurance brokers in Texas adding fees - one quoted now charges a flat $200 fee for help enrolling someone in a plan.

From the (lengthy) article:

...only eight percent of people sought the help of navigators last year, according to a Kaiser Family Foundation survey conducted between Feb. and Mar. 2016. The most frequently used source of assistance were health insurance brokers and agents, the report found. About 34 percent of people who switched plans last year used one, the poll found...

...This month Aetna said it would not offer commission for 2017 individual plans in 14 states, including Texas, Louisiana and Arkansas. Likewise, in September, Scott & White Health Plan said no commission will be given for marketplace plans sold during special enrollment periods, and that commission for marketplace plans sold during open enrollment will drop to one percent for a PPO and two percent for an HMO.

Cigna said there would no commissions for ACA-compliant individual and family plans sold in Texas whether for new sales, plan renewals or those purchased during special enrollment, like if someone gets married or loses a job after the regular open enrollment period has ended.

When Oscar decided in August to withdraw most of its plans from the Dallas-Fort Worth market, the company said it would continue to pay broker commissions only through the end of 2016. Insurers defend the commission cuts, noting their losses.

Blue Cross Blue Shield of Texas, which offered no commission for plans that began in 2016, has reintroduced the payment. It created a three-tiered commission model for new sales of ACA policies, with commissions ranging from five percent to 1.5 percent depending on the product...

...Brokers say fallout from the law is leaving them in a tough position. More frequently they are asking customers for “a flat fee paid in advance,” said Carolyn Goodwin. She’s a broker in DFW and a former director of legislative affairs for the Texas Association of Health Underwriters...

Before the health law, broker commissions could reach into the 20 percent range, but they have steadily decreased. One percent on a policy might equate to $30 a year for a broker who spent a full day helping a client. Their services include evaluating copays, drug formularies and provider lists on new plans, then creating detailed comparisons for each client and following up during the year if a client has a claim issue...

“A lot of research goes into really helping customers understand the plans, and we’re doing everything we can,” he said. “Good agents do a lot more work than most people realize. But those of us that stick around are probably going to be fee only.”


Latest blow for Obamacare: Health insurance brokers add fees | Health Care | Dallas News
 
But what’s also worrisome for health policy experts, is that people who do have options and use brokers to buy health plans for 2017 may not get information about on-exchange plans, even plans that are appropriate for their needs.

“If there is no commission, it’s less likely they are going to promote those plans,”
 
I wish this guy good luck.

UNLESS I'M mistaken, He's a "broker" which means he "CAN'T get paid" unless they pay their premium..and if they don't, he would have to refund the UPFRONT fee.

???
 
Gulfman,

This is a "fee" for "assistance with enrolling", paid directly by the client to the broker in advance. Nothing to do with the carrier or paying premium.

AFAIK, in Texas, the only requirement is that the fee amount and covered services is disclosed. You could charge for a consult and not write anything and keep the money.
 
Gulfman,

This is a "fee" for "assistance with enrolling", paid directly by the client to the broker in advance. Nothing to do with the carrier or paying premium.

AFAIK, in Texas, the only requirement is that the fee amount and covered services is disclosed. You could charge for a consult and not write anything and keep the money.

The grey area is this:

If you "consult" on the health and get paid a fee AND collect a commission on the dental, that's not allowed. The way I read it (and called TDI) is that if you collect commission from a client on any insurance product, you cannot collect a fee. Its client specific. Not product specific.

There's no way I am taking that risk.
 
Gulfman,

This is a "fee" for "assistance with enrolling", paid directly by the client to the broker in advance. Nothing to do with the carrier or paying premium.

AFAIK, in Texas, the only requirement is that the fee amount and covered services is disclosed. You could charge for a consult and not write anything and keep the money.

I strongly disagree as I just read the law. Hire an attorney to verify.

----------

The grey area is this:

If you "consult" on the health and get paid a fee AND collect a commission on the dental, that's not allowed. The way I read it (and called TDI) is that if you collect commission from a client on any insurance product, you cannot collect a fee. Its client specific. Not product specific.

There's no way I am taking that risk.

Thats not correct in Texas either.
 
I strongly disagree as I just read the law. Hire an attorney to verify.

----------



Thats not correct in Texas either.

I agree. IIAT has language that addresses this.

The law and rules permitting agents to charge fees applies to agents with General Lines Life, Accident, Health and HMO licenses. A person with that license who also has a Life & Health Insurance Counselor license is not permitted to receive a fee as well as a commission if he or she performs the services of an agent to the same client. In other words, if you charge a fee and receive a commission on a health insurance client, you can't be charging the fee under your Life & Health Insurance Counselor license.

So the way I interpret that is:

If I have a Counselors license-
I can examine a health insurance policy and charge a fee even if I'm not the agent on it and receiving no commission for it.
I cannot charge a fee under this license and then turn around and charge another fee to the same client in addition to commission.

If don't have a Counselors license-
I can charge a fee to someone for assisting them in enrolling in a plan and servicing it, in addition to commission.

I am completely off base?
 
I agree. IIAT has language that addresses this.

The law and rules permitting agents to charge fees applies to agents with General Lines Life, Accident, Health and HMO licenses. A person with that license who also has a Life & Health Insurance Counselor license is not permitted to receive a fee as well as a commission if he or she performs the services of an agent to the same client. In other words, if you charge a fee and receive a commission on a health insurance client, you can't be charging the fee under your Life & Health Insurance Counselor license.

So the way I interpret that is:

If I have a Counselors license-
I can examine a health insurance policy and charge a fee even if I'm not the agent on it and receiving no commission for it.
I cannot charge a fee under this license and then turn around and charge another fee to the same client in addition to commission.

If don't have a Counselors license-
I can charge a fee to someone for assisting them in enrolling in a plan and servicing it, in addition to commission.

I am completely off base?

This post is not meant to be argumentative (and I like that you are siting sources, vs just saying "Not correct" Hint, Hint, Hint)...trying to see what other think

This is where I'm confused, TDI is confused and I really don't need to be in Austin defending my business over a whopping $250 consult fee

Scenario:
Client calls and wants Cigna health and Cigna Dental.

I don't get paid on Cigna Health, so I charge the $250 consulting fee.

I DO get paid on dental, so I get a commission.

2 different policies. 1 client.

Thoughts?
 
This post is not meant to be argumentative (and I like that you are siting sources, vs just saying "Not correct" Hint, Hint, Hint)...trying to see what other think

This is where I'm confused, TDI is confused and I really don't need to be in Austin defending my business over a whopping $250 consult fee

Scenario:
Client calls and wants Cigna health and Cigna Dental.

I don't get paid on Cigna Health, so I charge the $250 consulting fee.

I DO get paid on dental, so I get a commission.

2 different policies. 1 client.

Thoughts?



ME THINKS, do one or the other, but not both. If you charge a fee upfront (which might not be legal----but i guess you could as a 'consultant'), forgo the commission. Or take the 'big' commission check.

WHAT a bunch of BS !!! (government has successfully destroyed another industry in the USA).

.
 
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