Independent agency owner Colleen Callahan does most of her San Francisco benefits business in the small group market. Those commercial clients represent the majority of her revenue and—at least generally—the majority of her time.
That’s not the case leading up to March 15 deadline established under the Affordable Care Act, however. As more Californians rush to acquire coverage before tax penalties set in, Callahan is finding herself devoting more and more time to helping individuals apply for insurance through the state-based exchange, Covered California.
“In the last three or four weeks, we’ve been solely focused on the individual market,” Callahan said. “We are a larger small group market, but because service is so horrible right now, it’s taking us a long time to provide service for clients. It’s hours-long waits [on Covered California].”
The same is true for Dan Eich, a producer in Olympia, Wash.
“We’re still trying to dig out from November, December and now January with all the changes we’ve had to help clients with,” he told Insurance Business. “We haven’t even gotten a chance to look at the group market.”
And that’s working with Washington Healthplanfinder, one of the relatively successful state-based insurance exchanges. For those dealing with HealthCare.gov, the backlog of individual clients becomes even greater and the chance to focus on more lucrative small group market grows slim.
Ernie Sweat, senior consultant with FBA Benefits in Layton, Utah, has found a way to ensure his time is dedicated to his small business clients, however.
Sweat said he recognized the potential for the individual market to suffocate his small group resources early on, and acted accordingly.
“I’ve avoided that by finding a business partner who handles the individual marketplace for me,” Sweat said. “If you’re going to help an individual through the marketplace, it’s going to be a great burden to you and your staff, and that’s something we recognized early on.”
As a consequence, Sweat has been able to service small business clients exclusively while still benefitting from the onrush of applicants in the individual market. Before forging this agreement, that wasn’t the case.
“[The marketplace] is a nightmare,” he said. “Prior to striking this arrangement to siphon this business off to someone who has the fortitude to deal with it, we’d just get bogged down with individuals who needed help with the application process and then having to revisit the application because some family members qualified for subsidies and others didn’t, and some children qualified for CHIP when they shouldn’t have.”
“You have to deal with that before you even get to the position where you can help someone select a health plan,” Sweat added.