Insurance brokers received what seemed like welcome news Sept. 9 when Politico reported a dedicated HealthCare.gov call center would be up and running in time for them to enroll clients through the federal exchange. But industry sources tell AIS that CMS hasn’t yet offered any details about how the new feature will work. Moreover, the long-stalled online Web portal, which would allow insurance brokers to enroll members directly through HealthCare.gov, won’t be available anytime soon. CMS did not respond to AIS’s request for comment about the call center or Web portal.

While navigators have access to a toll-free telephone number that connects them to HealthCare.gov, no comparable resource exists for agents and brokers. Moreover, brokers have complained that telephone scripts used by federal call-center representatives don’t recognize agents and brokers, and that reps generally will work only with the applicant.

A dedicated call center would “save time, solve problems and properly service those looking to get enrolled,” says Dave Mordo, director of compliance at Gary Wood Associates, Inc., a New York City insurance agency, and member of the National Association of Health Underwriters (NAHU). “So far, progress has moved at a snail’s pace in this regard.”

During a regular call with broker trade groups, CMS on Sept. 8 offered some details about a phone line that would be made available before Nov. 1. The next day, CMS held a follow-up conference call — likely in response to the Politico article. During the call, CMS officials downplayed the new feature and offered few details. Rather than a phone line exclusively for brokers, it appears it will be open to a variety of users including agents and brokers. The representatives likely won’t be able to amend a client’s case record.

In April 2013, CMS told agents and brokers that they would not have access to a dedicated web portal for selling coverage through federally facilitated and partnership exchanges, as had been envisioned, but suggested it would be developed in 2015.

The lack of a dedicated portal for federal exchange states has been a source of frustration among insurance brokers. Under the existing enrollment system, it can be difficult to determine the role a broker played in the enrollment process. There also are commission delays if the broker isn’t correctly listed as the “broker of record” on the payment or enrollment files distributed by the exchange to the insurance company. Moreover, helping clients find coverage through an exchange is far more labor-intensive than enrolling someone outside of an exchange.

“CMS needs to create or enhance their operational system to afford brokers the exclusivity of a fully operational broker portal that comes as close to real-time enrollment as possible,” Mordo contends.
The broker Web portal idea is separate from the hope that CMS will develop an online mechanism for Web-broker entities that will allow them to assist consumers in applying for exchange-based coverage and subsidies using their own websites without having to redirect applicants to HealthCare.gov midway through the process.

While some state-based exchanges have a dedicated broker portal, federally run exchanges do not. Washington, D.C.’s insurance exchange opened its broker portal in October 2013. NAHU “used it as an example with CMS on what a good portal looks like,” says Linda Wharton Boyd, Ph.D., who heads outreach efforts at D.C. Health Link.

In Kentucky, insurance agents and kynectors have had their own access point since the first open-enrollment period in 2013.

Going into the third open-enrollment period, brokers who operate in federally facilitated exchange states are still unable to facilitate an enrollment online. As it stands now, brokers have to rely on their client to relay their National Producer Number to HealthCare.gov in order to ensure they receive a commission from the insurance carrier. While they can help their clients find the best coverage option, the broker can’t make a sale through HealthCare.gov. Moreover, brokers typically have no way to know if their client actually enrolled.

There is optimism that HealthCare.gov CEO Kevin Counihan, a former sales executive at Cigna Corp. who worked closely with brokers at the Massachusetts Health Connector and later as CEO of Connecticut’s state-based exchange, sees the value brokers bring in their ability to boost enrollment.

“Kevin has been wonderfully responsive and no doubt understands and appreciates the role of the broker,” Mordo tells AIS.

“Agents and brokers have long wanted a dedicated phone line and a portal to support their enrollments. It may take a while for CMS to fully satisfy these requests,” adds Mike Adelberg, a former senior official in CMS’s Center for Consumer Information and Insurance Oversight (CCIIO), now at FaegreBD Consulting in Washington, D.C.

“A lot of agents feel a little like Harry Potter when he was stuck under the stairs at his aunt and uncle’s house,” jokes Wesley Bissett, senior counsel for government affairs at the Independent Insurance Agents & Brokers of America. “HHS has really failed to embrace agents and brokers as true partners,” he tells AIS. “It’s frustrating because there are tens of thousands of agents who go through training every year to get certified.” Bissett says while he’s optimistic about the phone line, there are concerns that it will be little more than window dressing. Representatives on the other end of the phone will need to have proper training to work with brokers and agents, since they will have different needs than a typical consumer. “We’re optimistic and hope for the best, but also skeptical of the likely success of this initiative.”

Unlike navigators, Mordo notes that brokers don’t have access to federal funding. “Proper compensation for a group of professionals not entitled to grant money goes a long way to inspire participation,” he adds. Although brokers don’t have access to federal funding, they are paid commissions while navigators are not.

Bissett agrees with Mordo that CMS seems to favor navigators over brokers and points to the annual $67 million in funding recently awarded to them for the next three years. “There is no comparison between the emphasis and resources that have been dedicated to navigators and what has been given to brokers,” he tells AIS. “If only a fraction of those resources had been dedicated to the agent and broker channel, you’d see agents looking forward to the open-enrollment season. It will be hard for agents to get too excited about the unveiling of this new phone line.”

Excerpted from the 9/1/2015 issue of AIS’s Inside Health Insurance Exchanges

© 2015 by Atlantic Information Services, Inc.