Producers “not out of the woods” on health exchange issues

Despite the improvement in online healthcare exchanges, insurance execs see major challenges ahead for producers.

Producers “not out of the woods” on health exchange issues

Life & Health

By

When HealthCare.gov and a smattering of state exchanges rolled out Oct. 1, producers were unsure of what to expect. Two months in, two insurance professionals have seen some solid trends that spell difficulty for producers working with the sites, though both shared a positive outlook for the industry.

During a Tuesday webinar sponsored by Aflac, Deborah Wilkinson of URL Insurance Group and Jason Montrie of Land of Lincoln Health identified some common problems producers have been experiencing with the exchange sites and how to get around them.

“As of Monday, [HealthCare.gov] really has—knock on wood—been working more smoothly, but I’m not saying we’re out of the woods at all,” said Wilkinson, vice president of Health Plan Options at the Pennsylvania-based firm.

For Wilkinson, the biggest concern is making sure clients are enrolled and paying premiums by the time the Dec. 23 deadline rolls around. Highlighting the slow process of establishing a HealthCare.gov account to subsequent enrollment, Wilkinson said the Jan. 1 effective dates “are really escaping us if enrollment and payment is not made soon.”

As such, she advises all producers to “screen” their clients for subsidy eligibility before engaging with online exchanges. If clients are not eligible to receive tax subsidies, “quite frankly, there’s no reason to go to HealthCare.gov,” Wilkinson said.

For those who are, Wilkinson suggested producers avoid enrolling them through paperwork sent in to the Health and Human Services Department, as it’s “about a 30-day process” and “too big of a liability” if the process is not complete in time for clients to make payments.

Wilkinson also warned that many producers are having issues getting credit for the plans they sell through the health exchanges. Reports of HealthCare.gov workers not taking or saving identifying agent information are waning, but issues still remain and proper producer records are vital to saving commissions.

“Do a three-way conference call or educate your client on making sure they volunteer your information so that you get credit,” she said. “It’s imperative that you document everything so you can claim those cases on the back-end.”
Montrie, vice president of channel and network development with health co-op Land of Lincoln, told producers to evaluate plans carefully and select one that clients “aren’t afraid to use.”

Specifically, Montrie said long-term customer trust will be built not by finding the lowest premiums, but through looking at plans through the lens of total cost—including deductibles. Producers also need to ensure clients’ preferred physicians are available through their chose plan.

Despite the difficulties ahead, but Montrie and Wilkinson agreed that producers have a vital role to play in the era of healthcare reform—one that isn’t going away soon.

“People are going to be much more in charge of their healthcare choices, which increases the need for guidance and folks to walk them through the process,” Montrie said. “The days of employers saying ‘You get health insurance plan A’ are over. We see an enormous opportunity for the agent and broker community.”

 

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