United Health Care - Opting Out of Most Exchanges!

[Dave020]

Agents will be compensated equally for enrollments inside and outside of the exchanges. That includes the special non-exchange plans offered by carriers outside only. Carriers will pay compensation for IFP plan enrollments.

Navigators and other non-agent direct benefit assisters may ONLY assist with enrollments inside of the exchange. Agents are prohibited from acting as Navigators.

 

[Ann H]

"There will be 2 divergent roads - exchange business and non-exchange. I can sell in both, and each will have their own kind of profitability."

Could you please clarify? As I understood, you could either be a "navigator" on the exchange or an agent outside the exchange, but not both. Conflict of interest type deal.

Agents cannot be Navigators and Navigators will receive a small fee but not a commission.

The following is true of the exchanges that the Feds are running and also confirmed for at least some state exchanges - Carriers will set the compensation, not the exchange and agents can be paid a commission for sales inside and outside the exchange.

From what I understood, the commission must be the same inside & outside the exchange for the same product. However, states could make other rules, and the Feds may have changed that rule as far as I know. At one time I know that there was some talk about agents only being allowed to sell either in or out of the exchange but not both. As far as I know, no state is seriously considering that option right now. Of course, if only a few carriers are in a state's exchange, the carriers might decide to stop compensating agents...

 

[pahealthquotes]

Agents cannot be Navigators and Navigators will receive a small fee but not a commission.

The following is true of the exchanges that the Feds are running and also confirmed for at least some state exchanges - Carriers will set the compensation, not the exchange and agents can be paid a commission for sales inside and outside the exchange.

From what I understood, the commission must be the same inside & outside the exchange for the same product. However, states could make other rules, and the Feds may have changed that rule as far as I know. At one time I know that there was some talk about agents only being allowed to sell either in or out of the exchange but not both. As far as I know, no state is seriously considering that option right now. Of course, if only a few carriers are in a state's exchange, the carriers might decide to stop compensating agents...

seems as though we'll be the last to know about compensation.

games insurance carriers will play

 

[Nelson C. Janney]

Can"t wait to see how this plays out.

 

[Yagents]

Would you like food stamps with that medicaid on the side?

State Health Exchange Will Drive Budget Increases « CBS Las Vegas

McMahon's character is George, who is 64 and retired. With time on his hands, George decides to get on the exchange and research his medicare supplemental insurance options. As he answers questions, George gets a pop-up box on his screen suggesting he might be eligible for SNAP, the supplemental nutritional assistance, or food stamp program. George could then answer a few more questions and find that he qualifies.

 

[obiswill]

In this situation, education is key. This great for the consultative sales agent, but can be the kiss of death for agents that only try to sell at all cost. To those agents I say goodbye and good riddance. The hardest thing to do is sell a policy to a consumer whose been screwed by an agent.

 

[Yagents]

Some answers to q's we have:
Aetna, Health Net look toward 2014 | LifeHealthPro

Aetna hopes to use networks of providers who agree to take "value-based reimbursement" to drive membership growth in the face of a soft economy and the changes imposed by the Patient Protection and Affordable Care Act
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Aetna executives said the company will take a "measured approach" to deciding whether to participate in specific states' PPACA health insurance exchanges, or Web-based insurance supermarkets for individuals and small employers, which are supposed to open for business Oct. 1.
Getting products like the exchange products approved typically takes about three months, but that could slow down as the Oct. 1 exchange startup date nears, Bertolini said.
Although the exchanges might be popular with individuals, it looks as if the only small employers that will jump to the exchanges will be employers that expect to get large subsidies, Bertolini said.
"We do see some potential for small groups to drop coverage" and send employees to the individual exchange programs, Bertolini said.
Even after the exchanges start up, about 20 percent of the individual market will operate outside the exchange system, and Aetna may continue to serve those off-exchange customers in states in which the company is not on the state's exchange, Bertolini said.

 

[Ann H]

So, by saying they hope to use networks of providers who agree to take "value-based reimbursement", they are saying ACO's (the new HMO).

I agree that the SHOP exchange for group insurance will be anemic.

I'm not so sure about their idea of 20% of IFP outside the exchange. There are a lot more than that who won't get subsidies and if small group implodes, those people will be buying insurance inside and outside the exchange, and not all will get subsidies. Also, if 50+ businesses hire part-time or drop their insurance, surely not all those people will get subsidies. Just the new IRS clarification of "affordable" meaning the self-only premium on group means a lot of families won't get subsidies.

 

[Yagents]

Humana offers reform update during 4Q conference call - Louisville - Business First

"I think in our Investor Day presentation (in November) we suggested that as many as 10 markets we'd participate on the individual exchange. One of the things that we found out since we were together in November is that in order to participate on the individual exchange, we'll also have to participate on the shop for the small group," he said. "And so that will cause us to change some of what we were thinking around the small group participation on the exchange to work collaboratively with our HumanaOne businesses to figure out where we're going to go state-by-state and market-by-market."
He confirmed the company was still considering entering the exchange market in 10 states.

 

[Yagents]

Nobody wants to play with Obama:

Obamacare's Health Exchanges Are Customer Free Zones - Forbes