broker

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.

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