Mandated ACA Commissions for 2017 ?

[Yagents]

National press on the matter

Insurers cut commissions to restrict when and what plans people buy

Insurance agents now enroll about half of those who buy insurance on the government exchanges.

Despite improvements with the exchanges, many consumers still need help, says Lee, who acknowledges he was wrong the exchanges would "make buying insurance as easy as buying a book on Amazon."

Humana spokesman Mark Mathis said the insurer believes agents are "an important source of information and guidance," but it sometimes makes "changes in order to maintain sustainable and affordable health plans for our members."

CMS spokesman Aaron Albright declined to comment about the commission cuts, but said in an emailed statement that, “Whether through HealthCare.gov, the call center, navigators, enrollment through an agent or web broker, consumers have many channels to choose from most convenient to them."

 

[pahealthquotes]

Peter Lee, executive director of the Covered California exchange, said in an interview. "It flies in the face of the ACA ... to say in code to agents, 'Don’t bring us sick people', or to make it harder for some.to enroll."

Bingo!

No commissions to agents, phones tied up for hours & paper apps. Insurers are doing everything possible to discourage enrollment.

 

[somarco]

Insurers are doing everything possible to discourage enrollment.

Can you blame them?

 

[pahealthquotes]

Can you blame them?

absolutely not.

Isn't our lovely Govt supposed to be reimbursing the carriers for losses?

Pretty simple fix. Remove our commissions from MLR, set a fair compensation
at 18-20 pepm and move on. I do believe the adverse selection carriers saw in 2014 and 2015 will flatten.

Joe

 

[somarco]

Isn't our lovely Govt supposed to be reimbursing the carriers for losses?

Not all of them.

And some (all) of the govt reinsurance goes away next year.

Commissions are not the problem. Steerage is. When agents show people the best plan (lowest OOP for their condition) the carrier loses more than they do when hc.gov idiots just put them in the lowest net premium plan without regard for par providers and Rx formulary

 

[leevena]

absolutely not.

Isn't our lovely Govt supposed to be reimbursing the carriers for losses?

Pretty simple fix. Remove our commissions from MLR, set a fair compensation
at 18-20 pepm and move on. I do believe the adverse selection carriers saw in 2014 and 2015 will flatten.

Joe

This will not fix, let alone flatten, the adverse selection problem.

Also keep something in mind about this commissions discussion. For the most part, only agents/brokers believe that they deliver a value. By and large, carriers do not ascribe to this belief, and the govt certainly does not either

 

[Yagents]

For the most part, only agents/brokers believe that they deliver a value. By and large, carriers do not ascribe to this belief, and the govt certainly does not either

But my clients do, and they are the ones that vote at the ballot box.......On Nov 7th, just a few days after OEP starts. And believe me, they will know about losing my services in October.

BTW, over 75% of clients said they would pay me a fee if necessary to help them enroll.

 

[somarco]

over 75% of clients said they would pay me a fee if necessary to help them enroll.

Lee is correct about the perception of agent value. If your clients are willing (and permitted) to pay you a fee for your consult then they are free to do so. But that does not change the landscape on agent commissions one bit.

 

[Yagents]

Better watch out............Better not cry...........let me tell you why:

Just called the DOI's in AZ and FL, both laid out the following regarding charging fees for ON or OFF Market plans:

1. The federal ACA law does not allow agents to charge fees (First thing out of their mouths)
2. Each of these 2 states do not allow charging a fee for ACA plans per their statutes. And nothing is in the works.
3. Each of the carrier contracts would also have to permit a fee.

Be interested what all of your states are saying (besides GA and CA)

It's been a nice run since I joined this forum 6 yrs ago.

 

[somarco]

Pretty sure GA allows agents to charge a commission (if they have a councilors license) but have to forfeit their insurance license. That part may not be right since I know NE Mutual (or whatever they are called these days) charge a fee that is refundable by offset to commissions.