Health Sherpa

[AllenChicago]

Health Sherpa - R.I.P.

How long before the healthsherpa.com website is "adjusted", I wonder?

 

[taterpeeler]

I copied this so if you vanish this is here

Like many of you I've had my concerns with healthsherpa.com . As "thedg3" pointed out there are issues with the process that are apparent and need further review. It's even more ominous that he was asked to remove his posts about it.

Many on this forum have asked health sherpa publicly about their process for submitting outside of AEP and gotten no response from health sherpa. NONE! I also know several that have, as FLM recommended, called and emailed health sherpa to ask about their process but have still gotten no reply. Considering that, how can this not be troubling? As an agent I certainly have no interest in losing everything I have because of the risky process they are obviously using. Further, why the complete absence of ANY reply from them when they have been asked multiple times in threads they participated in?

I consider this a last resort after trying ad nauseam to get answers but getting nowhere. Some of you might be fine without knowing, brush it under the table or whatever. Personally I am not willing to risk the commissions I built. I wrote the below over a week ago with the intentions of posting but as you can see, haven't done so till now.

____________________

Hi, I'm a health insurance agent with concerns, like you, involving Health Sherpa (healthsherpa.com). Here are some facts that I've gathered...

BEAR WITH ME, the reason I am posting this is what they are doing is clearly in violation of federal law by way of their being a CMS broker entity and this means they are putting agents licenses and customers health insurance at risk. See the below where they clearly state:

"If you qualify for a special enrollment period, you enroll online through HealthSherpa or over the phone (by calling us at (866) 796-6017)."

healthsherpa.com/special-enrollment-period

Health Sherpa advertises that through their technology, agents are able to enroll clients for ACA plans that qualify for a special enrollment period. From what several agents are sharing they are doing it. At first this piqued my interest because like all agents these days, I'm looking for an easier way to help my clients.

Unfortunately I almost immediately noticed some red flags. There are things that just don't match up with what I know to be requirements of the process since I also at one point looked into being a web broker entity. My issue is that Health Sherpa, unbeknownst to the agents using their service, is engaging in practices which violate CMS rules and regulations and put agents and customers at risk.

Per CMS, the functionality does not currently exist for web-brokers outside of open enrollment to enroll people in ACA plans. That means there is no way that Health Sherpa could be enrolling clients without using some sort of a manual process.

Second, the Agent/Broker landing page for Healthcare.gov Web Brokers does not currently allow enrollments so they can't be doing it in that manner. This is another clue that Health Sherpa must be using a manual process.

Third, the process Health Sherpa shows to the agent is as follows – the agent inputs the data into the Health Sherpa website, the agent then receives a message that the application will be processed; there is no re-direct to healthcare.gov for the subsidy application or even creation of a customer profile as required. Proof again that some sort of manual process is happening.

Considering the connections are not available to enroll clients directly through the API's or Agent/Broker login, that only leaves two options on how a client could be enrolled through Health Sherpa:

1. Either a phone call into healthcare.gov (requiring the client to be on the line)

2. or by creating a client login on healthcare.gov.

The problems here are that Health Sherpa is never speaking to the clients so there is no possibility they are calling it into healthcare.gov and the clients are never creating their accounts on healthcare.gov yet are ending up with accounts. That only leaves one option; Health Sherpa is creating accounts on behalf of clients without any approval to do so, manually entering the applications on their own, and somehow directing the subsidy eligibility back to themselves to verify hours later (and sometimes days) to the agent that the enrollment has been completed. I can only guess that they must be entering fake email addresses in the system that point back to Health Sherpa and not the client as it should. What would the government find for those who enrolled outside of AEP via the healthsherpa website for the customers email addresses?

View the video health sherpa released, it shows that NO redirect to healthcare.gov occurs as is required by CMS!

youtube.com/watch?v=BhDpUT9vnV8

In a document published by CMS it states:

"The agent or broker may assist the consumer in creating his or her account if needed, but the consumer or a legally authorized representative must create his or her own Marketplace username and password and should not share this information with third parties, including agents and brokers."

That document can be found here: cms.gov/CCIIO/Resources/R...r-5-1-2013.pdf

The CMS guidance is very clear; the client must create their own username/passwords and not share it with an agent. That means an agent is not authorized to do so for them. If, in fact, Health Sherpa is doing so for the client as I presume they are in violation of CMS regulations, privacy laws, and should be looked further into.

Even this thread has information in it that points to the issues.

It not only has comments from agents questioning the process but also Ning Liang of Health Sherpa making claims such as he makes in post number 35, where Ning says and quoted in italics:
_____

Ning from HealthSherpa here - I wanted to address some of the points quickly:

1) Up to 1 day delay in enrollment. Currently, most of our apps go through within the same business day, usually within a few hours. We are working on solving the cases where we hit bumps in the road during Special Enrollment.

During Open Enrollment, we use a different process where most of these bumps go away. This past Open Enrollment, we were able to process most applications within 1 hour.

2) We have briefed CMS on both variants of our process. They were encouraging on the progress we've made with the enrollment user experience.

3) The public facing link will be available during Open Enrollment - development is completed but we are holding off until OEP to release.

4) We are looking at building other tools to facilitate group business, including a tool for employers to manage plans and costs for their insured population. If you are interested in these tools, please send me an email at ning AT healthsherpa DOT com.

Thank you for the feedback so far - we will continue to improve on the product based on what you guys feel will give you the most value.

Cheers,
Ning
_____

His own comments prove they are violating federal law and their agreement with CMS and HHS.

1.) Up to 1 day delay in enrollment?! – Proof of the manual process that I presume. If using the technology provided by CMS it would be instant or very close to it.

2.) Really? They've been in contact with CMS. CMS is encouraging of the progress Health Sherpa has made? Even when Health Sherpa is breaking the law? Sorry, I seriously doubt that.

Try it yourself at healthsherpa.com as if you are a customer! Then set up an agent account via their Agent link at the bottom of the page. Put in bogus info and yup, they will say the customer's application has been submitted!

 

[FLM2]

Like many of you I've had my concerns with healthsherpa.com . As "thedg3" pointed out there are issues with the process that are apparent and need further review. It's even more ominous that he was asked to remove his posts about it.

Many on this forum have asked health sherpa publicly about their process for submitting outside of AEP and gotten no response from health sherpa. NONE! I also know several that have, as FLM recommended, called and emailed health sherpa to ask about their process but have still gotten no reply. Considering that, how can this not be troubling? As an agent I certainly have no interest in losing everything I have because of the risky process they are obviously using. Further, why the complete absence of ANY reply from them when they have been asked multiple times in threads they participated in?

I consider this a last resort after trying ad nauseam to get answers but getting nowhere. Some of you might be fine without knowing, brush it under the table or whatever. Personally I am not willing to risk the commissions I built. I wrote the below over a week ago with the intentions of posting but as you can see, haven't done so till now.

____________________

Hi, I'm a health insurance agent with concerns, like you, involving Health Sherpa (healthsherpa.com). Here are some facts that I've gathered...

BEAR WITH ME, the reason I am posting this is what they are doing is clearly in violation of federal law by way of their being a CMS broker entity and this means they are putting agents licenses and customers health insurance at risk. See the below where they clearly state:

"If you qualify for a special enrollment period, you enroll online through HealthSherpa or over the phone (by calling us at (866) 796-6017)."

healthsherpa.com/special-enrollment-period

Health Sherpa advertises that through their technology, agents are able to enroll clients for ACA plans that qualify for a special enrollment period. From what several agents are sharing they are doing it. At first this piqued my interest because like all agents these days, I'm looking for an easier way to help my clients.

Unfortunately I almost immediately noticed some red flags. There are things that just don't match up with what I know to be requirements of the process since I also at one point looked into being a web broker entity. My issue is that Health Sherpa, unbeknownst to the agents using their service, is engaging in practices which violate CMS rules and regulations and put agents and customers at risk.

Per CMS, the functionality does not currently exist for web-brokers outside of open enrollment to enroll people in ACA plans. That means there is no way that Health Sherpa could be enrolling clients without using some sort of a manual process.

Second, the Agent/Broker landing page for Healthcare.gov Web Brokers does not currently allow enrollments so they can't be doing it in that manner. This is another clue that Health Sherpa must be using a manual process.

Third, the process Health Sherpa shows to the agent is as follows – the agent inputs the data into the Health Sherpa website, the agent then receives a message that the application will be processed; there is no re-direct to healthcare.gov for the subsidy application or even creation of a customer profile as required. Proof again that some sort of manual process is happening.

Considering the connections are not available to enroll clients directly through the API's or Agent/Broker login, that only leaves two options on how a client could be enrolled through Health Sherpa:

1. Either a phone call into healthcare.gov (requiring the client to be on the line)

2. or by creating a client login on healthcare.gov.

The problems here are that Health Sherpa is never speaking to the clients so there is no possibility they are calling it into healthcare.gov and the clients are never creating their accounts on healthcare.gov yet are ending up with accounts. That only leaves one option; Health Sherpa is creating accounts on behalf of clients without any approval to do so, manually entering the applications on their own, and somehow directing the subsidy eligibility back to themselves to verify hours later (and sometimes days) to the agent that the enrollment has been completed. I can only guess that they must be entering fake email addresses in the system that point back to Health Sherpa and not the client as it should. What would the government find for those who enrolled outside of AEP via the healthsherpa website for the customers email addresses?

View the video health sherpa released, it shows that NO redirect to healthcare.gov occurs as is required by CMS!

youtube.com/watch?v=BhDpUT9vnV8

In a document published by CMS it states:

"The agent or broker may assist the consumer in creating his or her account if needed, but the consumer or a legally authorized representative must create his or her own Marketplace username and password and should not share this information with third parties, including agents and brokers."

That document can be found here: cms.gov/CCIIO/Resources/R...r-5-1-2013.pdf

The CMS guidance is very clear; the client must create their own username/passwords and not share it with an agent. That means an agent is not authorized to do so for them. If, in fact, Health Sherpa is doing so for the client as I presume they are in violation of CMS regulations, privacy laws, and should be looked further into.

Even this thread has information in it that points to the issues.

It not only has comments from agents questioning the process but also Ning Liang of Health Sherpa making claims such as he makes in post number 35, where Ning says and quoted in italics:
_____

Ning from HealthSherpa here - I wanted to address some of the points quickly:

1) Up to 1 day delay in enrollment. Currently, most of our apps go through within the same business day, usually within a few hours. We are working on solving the cases where we hit bumps in the road during Special Enrollment.

During Open Enrollment, we use a different process where most of these bumps go away. This past Open Enrollment, we were able to process most applications within 1 hour.

2) We have briefed CMS on both variants of our process. They were encouraging on the progress we've made with the enrollment user experience.

3) The public facing link will be available during Open Enrollment - development is completed but we are holding off until OEP to release.

4) We are looking at building other tools to facilitate group business, including a tool for employers to manage plans and costs for their insured population. If you are interested in these tools, please send me an email at ning AT healthsherpa DOT com.

Thank you for the feedback so far - we will continue to improve on the product based on what you guys feel will give you the most value.

Cheers,
Ning
_____

His own comments prove they are violating federal law and their agreement with CMS and HHS.

1.) Up to 1 day delay in enrollment?! – Proof of the manual process that I presume. If using the technology provided by CMS it would be instant or very close to it.

2.) Really? They've been in contact with CMS. CMS is encouraging of the progress Health Sherpa has made? Even when Health Sherpa is breaking the law? Sorry, I seriously doubt that.

Try it yourself at healthsherpa.com as if you are a customer! Then set up an agent account via their Agent link at the bottom of the page. Put in bogus info and yup, they will say the customer's application has been submitted!

I don't shill for Health Sherpa but have an agent website and have submitted two applications, I received the application and subsidy determination letter within 13 minutes of submission for the 1st one and the 2nd one was within 30 minutes of submission. I don't know how they could do that by re-entering all of the data on healthcare.gov.

I also exchanged emails with Ning Liang today about their process and he said the following:

without giving away any trade secrets, I can say the following:
1) We have briefed CMS on our process, and we are in compliance.
2) We treat all consumer information as strictly confidential, and keep it encrypted using bank grade security in a secured facility.


Maybe the process is different when submitting through a paid agent website rather than their consumer site (I don't know) but they do have a contract with CMS and are making a representation that they are in compliance. That satisfies me, I don't need a witch hunt to take this any further.

My suggestion for any agent who is uncomfortable with their compliance is don't use them, it isn't like there isn't another way. I don't do many On Exchange applications (90% of my business will be Off Exchange) so this is a good solution for the small number that I have, at least for now.

 

[Guest]

I think $25.00 is a bit much considering your charged that weather they make their first payment or not. My buddy wrote over 200 and almost half have fallen off the blue book and now his chargebacks are huge.

 

[rugerred]

I think $25.00 is a bit much considering your charged that weather they make their first payment or not. My buddy wrote over 200 and almost half have fallen off the blue book and now his chargebacks are huge.

How did he get charge backs all is as earned here.

Sent from my Samsung Galaxy

 

[taterpeeler]

I think $25.00 is a bit much considering your charged that weather they make their first payment or not. My buddy wrote over 200 and almost half have fallen off the blue book and now his chargebacks are huge.

Not disagreeing with you on the fact 25 bucks per is high however what I have found is that most agents figured this process would have no service work and with obamacare the agent spends hours upon hours servicing their clients and hustles up getting the premium paid....

Back in the day health insurance agents could operate in the kill and eat mentality and never serviced their book, in the new world there is a different order.

Back a few moons ago I stated that the obamacare agent that made it would/must be a big producer to survive..... I think to make it you got to pop 300 and above.

Why the charge backs? were there advances? again, if there was advances then thee are your charge backs and as I also stated moons ago the advance agent would die a slow painful financial death

 

[rugerred]

Not disagreeing with you on the fact 25 bucks per is high however what I have found is that most agents figured this process would have no service work and with obamacare the agent spends hours upon hours servicing their clients and hustles up getting the premium paid....

Back in the day health insurance agents could operate in the kill and eat mentality and never serviced their book, in the new world there is a different order.

Back a few moons ago I stated that the obamacare agent that made it would/must be a big producer to survive..... I think to make it you got to pop 300 and above.

Why the charge backs? were there advances? again, if there was advances then thee are your charge backs and as I also stated moons ago the advance agent would die a slow painful financial death

You hit it on the charge backs. Even if the client doesn't drop there are still mistakes on the commission side. I went as earned and it sucks a little but getting better every policy.

Sent from my Samsung Galaxy

 

[somarco]

How long before the healthsherpa.com website is "adjusted", I wonder? (AC)

I copied this so if you vanish this is here (Tater)

Isn't this what happens in Scientology if someone get's out of line? First they are audited, then they are never heard from again.

L. Ron Hubbard is out there watching and listening. I know he is.

 

[Guest]

Florida blue paid up front for the year and now the agents i know are screwed having to pay a lot back.

Did Fl. Blue not pay everyone up front?

 

[taterpeeler]

Florida blue paid up front for the year and now the agents i know are screwed having to pay a lot back.

Did Fl. Blue not pay everyone up front?

I have no idea as I don't work that state however.... almost every medicare supplement company pay advances... we as agents can decline the advance offer and I do.....

it would seem to me that every carrier offers the ability to decline the advance but a bunch of agents get addicted to the advance dope and never decline.....