With the deluge of changes in the functioning of the market and the new role of benefit marketplaces (aka private exchanges), most brokers feel they are stuck between a rock and a hard place. They know that they want to make the shift to exchanges, but are not yet certain how the move will benefit them. Moreover, brokers are concerned about differentiating themselves in an increasingly competitive private exchange market. Are you facing a similar challenge? We have an answer for you.

During our hCentive xChange conference, broker attendees participated in a roundtable discussion on how they collectively planned to achieve differentiation on the marketplace, and this is what we learned.

1)    Almost all brokers are harrowed by the benefit marketplace experience – For most brokers, moving to an exchange is disastrous. Almost all of their peers are suffering from early jitters of transition, but at the same time, they are very optimistic about the move to the platform. Most brokers felt that the change in marketplace is similar to the Medicare Part D ruckus, in the sense that it will get better with time.

2)    Individual Market will be more competitive compared to Group Market – Compared to the group market, the individual market will be more challenging and rewarding for brokers. More choice would mean more customers, and a larger chance for brokers to differentiate from their competition and tailor offerings that get them a bigger share of market.

3)    Benefit Marketplaces will be influenced by the performance of Public Exchanges – Over time, public exchanges will be laying the path for benefit marketplaces to tread upon. Currently, public exchanges have a higher share of enrollments, but benefit marketplaces are expected to take over by 2018. Public exchanges are the torchbearers for the market, and they are expected to ease the enrollment process for everyone and ensure that the risk pools are maintained in the private exchange market.



4)    Brokers will have a continuing role in shaping the private exchange market – Continuing in the footsteps of public exchanges, private exchanges will thrive and grab their share. In this environment, brokers will have a role to play, and contrary to the fear, will not fade away or become obsolete. In fact, brokers will have a bigger role to play, especially in educating their buyers and helping them make the perfect decision by sifting through available plans and finding ones that best meet their family’s needs. From a knowledge standpoint, a broker’s role in inimitable and irreplaceable.

 5)    Communication and Engagement will be key – As private exchanges prevail, brokers will have to rethink their strategy and phase it around communication and customer engagement. Follow ups and engagement tools will hold primary importance as customers will be expecting next-level interaction with their brokers.

6)    Adaption will be imperative to success in private exchange market – Almost all participating brokers agreed that adapting would be crucial if brokers do not want to be rendered useless in the private exchange market. Brokers don’t need to worry about cuts in their commission, but should rather focus on providing new lines of products and more choice to their customers. Communication and engagement will supplement their new offerings and changing stance toward customers.

The key to differentiation, as concluded in our breakout session, lies in mutating with the private exchange setup and supplementing broker offerings through value adding tools. In a final note, brokers have a great role to play in the future of private exchanges and to have a piece of that cake, evolution of their services and technology will be the answer.

As the third open enrollment period comes to a close, I’m reflecting back on the 2016 season and what did and did not work well for brokers.

One component of the enrollment process that really stood apart for me was the ability to seamlessly connect to HealthCare.gov (FFM) for quick and easy subsidy qualifications and enrollments.  Web Broker Entities refer to this process as the “Double Redirect” and is required by CMS for enrolling individuals online, regardless if they choose to self-service or leverage a broker’s assistance. As a licensed broker employed by hCentive that works on Federal and State Exchanges regularly, I can’t stress enough the importance of having online broker benefits tools that are CMS compliant. If your online enrollment platform provider is not CMS compliant, you’re putting your book of business at risk with sudden changes in the way clients enroll, or worse, not being able to conduct business.

Brokers are required to participate in annual training with CMS if they wish to sell on HeathCare.gov. During your training and/or certification process CMS clearly states there are two ways for a broker to enroll an individual:

  1. a broker may assist a client directly while they log into HealthCare.gov with their individual account, or
  2. by logging into HeathCare.gov as a broker, using a Web Broker Entity’s (WBE) direct enrollment process.
    [WBE Process]: When working with a client using a WBE, an agent or broker is securely redirected from the QHP issuer’s or Web Broker’s website to HealthCare.gov.  Once the broker is on HealthCare.gov they can complete the eligibility application with the consumer, using the agent or broker’s HealthCare.gov user ID. After the application is completed on HealthCare.gov, the agent returns to complete the enrollment on the Web Broker Entity’s site.

See: Resources for Agents and Brokers in the Health Insurance Marketplace

Reflecting on the above, is number one or number two consistent with what you, the broker, have been doing during the last few months of OEP? Or did you have to modify the way you were helping your clients due to a change in the way your current technology platform was working? If number one and/or number two above follows your process, then your technology partner has been conscious of their product design and eliminated any compliance risk for you and your clients.

For more information on working with a technology partner that offers brokers a CMS compliant platform to manage group and individual business, end-to-end management of quoting, enrollment, and administration and more.

These days everyone looks to technology, particularly apps, for consumer information and purchasing. Considering this and the exploding technology space for HR and benefits enrollment technology, I’m asking—can technology replace the role of the health insurance broker in assisting individuals and employer groups with their insurance purchasing decisions? In an Employee Benefits News article Ray Mara, SVP of Group Products at Guardian says “Employers rely on their benefit brokers not only to advise them on plan offerings and design, but increasingly on the service administration of those programs.” Keeping this in mind, let’s do a quick review on the value of using a broker to make insurance and benefit purchasing decisions:

  • Tailored Recommendations – Brokers work with their clients to make specific recommendations tailored to meet the client’s needs. For an individual client, they will discuss budget, goals, ACA requirements (potential subsidies available), and any specific family needs. For an employer client, they will review the organizational culture, approach to benefits, budget, compliance requirements, etc. Coupled with their industry knowledge they are well positioned to make a best-fit recommendation.
  • Market Intelligence – A broker understands their geographic market and the insurance carrier offerings. They can sit with their clients (or instruct them online) on comparing carriers, coverage details, and costs. They can easily point out the differences, identify problematic or beneficial areas, and help their clients analyze these differences, leading to stronger recommendations.
  • Relevancy – A broker with an existing client relationship has the ability to periodically review plan designs and cost to ensure their recommendations remain relevant to their clients’ situation.
  • Client Advocate – When a broker has relationships with their clients, they become a natural advocate for when issues may arise with insurance companies.
  • Enrollment Support – Additionally, for employer clients, the broker can take an active role in communicating benefits to employees and supporting the employees during Open Enrollment or throughout the year.

Considering the above, do we actually believe it’s possible for technology to replace the broker relationship? I think not.



Health insurance plans, and other insurance-related products are complex and it is ever increasingly important to make the right choices. Sure, decision support tools can be built into technology platforms to assist with filtering a multitude of plans for a consumer to choose. However, the personal relationship with a broker and their knowledge of carrier products and the marketplace cannot be replaced.

Ideally we’d like to see technology products that promote a partnership with brokers. In a technology-supported partnership, the broker and their clients benefit from the efficiencies of an online insurance marketplace and enrollment system. Imagine having the expertise of a seasoned insurance broker aligned with a single technology platform that allows brokers and their clients to view plans, make choices, enroll, and review on an on-going basis. Brokers are here to stay and the technology to support them, and their clients, will continue to grow as an important part of the consumer purchasing process.

Relevancy, value addition, and guidance – these are keywords being used in the evolving broker market at existing broker businesses. The role of brokers is changing due to the onset of a benefits marketplace approach in individual as well as employer business. At hCentive, we have been at the helm of the change rocking the broker market, and we have been participating in discussions with our broker clients, and this is what we have arrived at.

Die Out or Mutate, but Decide Soon

Out of our roundtable discussion at our past hCentive xChange Customer Conference, this was the prime sentiment echoing across our participating broker clients – brokers are in a dire need to evolve with the market or face extinction. With the new benefits marketplace exchange strategy making inroads, the traditional role of brokers is losing its charm and brokers need to evolve with the role to present better value to customers.
To compound the challenge, brokers need to adapt to the market’s speed, and that means adjusting with market change velocity. Die out or mutate, but take a quick decision to stay competitive in the market.

Right Engagement is Key to Retention

On the engagement front, brokers have made strong headway, but almost all our clients agreed that things could be improved here. Currently, the majority of a broker’s focus is on engagement, but only a few brokers are doing things right. The focus needs to move away from regular, low-value stuff, such as sending birthday cards, to high-value engagement, such as guiding customers with knowledge about their insurance health plans and shopping over marketplaces. Brokers need to realign their automated engagement touch points to present value to their audience.
At the same time, brokers need to strategize their automated touch points in a way that they are not the default authority whenever their clients have questions or issues. The strategy needs to be a combination of self-service and engagement during enrollment and renewal processes.



Leverage Knowledge and Exchange Familiarity

With exchanges and carriers, brokers have an advantage that is unprecedented – their knowledge base and exchange familiarity. From this standpoint, brokers will have a continued, renewed role to play, given that they sustain their knowledge and deliver it through all their engagement channels.
In this task, exchange familiarity will give them another advantage, and all of this will ultimately come together for their benefits marketplace strategy.

Rely on Multiple Product Lines for Continued Payout

With exchanges running the show, brokers cannot distinguish against their competition through offerings or price. The exchanges have taken over that role, and brokers need to up their game for continued payout from the market. Combining their knowledge vantage point with multiple product lines, brokers can arrive at a solid strategy that lets them establish new value in the evolved market without sacrificing too much of their commission. In short, if you want to continue being competitive in the market, you need to rely on multiple product channels and use your vantage point for lasting growth in the market.

As one of its primary aims, Obamacare has always centered on the theme that all Americans should have access to affordable healthcare. When the PPACA (Patient Protection and Affordable Care Act) was passed, subsidies and tax credits were put in place to allow uninsured to be able to afford health insurance plans. With enrollment numbers picking up, it is still clear that there are many uninsured who haven’t signed up.

There are several reasons impacting the number of enrollments and most of those reasons can be split into three broad categories – flawed health exchanges, convoluted processes and a lack of knowledge. Although the administration has spent a lot of money and time for educating Americans on the health insurance marketplaces, several groups have cited that they do not have all the information they require, especially people who think they qualify for some kind of health insurance subsidy but are not sure about their status. Fortunately, volunteer groups and exchange navigators are making a big push toward educating these groups. Let’s take a look at each of these endeavors in detail:

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Continuing from the first part of our series, which showed the most important facts to know before the March 31 open enrollments deadline, such as penalties, subsidies, and Medicare coverage. This second part of the series is going to take a dive into the remaining 4 aspects you need to consider in the wake of the approaching deadline. These 4 points will help you see why now is the right time to enroll for better health insurance through Obamacare exchanges, and how you can reach out for support to get health insurance through subsidized exchanges. Let’s take a look.

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The launch of the ACA, aka Obamacare, has been a bit of a rollercoaster — technical issues, canceled policies, etc. However, most of these issues have been sorted and we are just a few days away from the end of open enrollment. Of course to ensure confusion continues, the administration announced recently announced an extension for people who have started the enrollment process but not completed it.  If you want coverage but have not shopped for health insurance yet, these last few days are crucial for you.  In a two part series, we have covered the 7 most important things that you need to know before the enrollment window ends. So, let’s get started.

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As evident from the outcome, the management of Obamacare health insurance marketplace implementation was not a strategic success. However, there is no doubt that Obamacare was a well-planned endeavor that hopefully will result in lowering of healthcare costs (as this remains to be proven), if not all other aims it had set for itself before the implementation.

Experts have highlighted some essential aspects that need to be the strategic focus for elongating the success of the act. Let’s take a look at the top six aspects that deserve lasting strategic attention from the government for maximizing the progress.

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The Obamacare healthcare.gov implementation might go down in history as one of the poorest managed high visibility project in our time. A good percentage of the nation is aligning against the health reform, mainly because of the failures associated with the rollout.

However, things are not as bad as they seem. Obamacare, believe it or not, has shaken the foundations of health insurance industry and is expected to have lasting effects on the way health payors and our nation perceives health insurance. Today, we delve into the seven things that the Obamacare implementation has brought forth which are changing perspectives.

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November has ended and the health insurance marketplaces are not working as they were supposed to. There are still glitches in the system and a major piece of news has been released by the administration – there will be a one year delay in the ACA mandate that allows small businesses purchase health insurance online. While it is obvious that this move has been made to lower the load on the staggering website, it has revealed a new alliance between the administration and the brokers.

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