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.
The administration’s move to bring in a gap of one year before small businesses can get online and purchase insurance has opened up a new avenue of opportunities for brokers and agents. The officials at CMS, the authority responsible for the rollout of healthcare.gov, have openly mentioned that in the period of gap, small businesses can still look toward insurance brokers and agents for health insurance coverage. The concept of SHOP, Small Business Health Options Program, exchanges will be put to use for helping agents and brokers enroll small businesses until the official healthcare.gov website is capable of putting them through the system. Currently, the federally facilitated marketplace is suffering from major challenges in the SHOP department and these errors have elongated the mandate implementation until November 2014. However, this new alliance is actually quite ironic, especially when you consider the formation of rules two years back.
Two years ago, when the administration established the 80-20 medical loss ratio rule, it required health plans to spend at least 80 percent of premiums toward actual medical costs, thereby excluding broker fees from this mix. There was a concept of including broker fees in administrative costs as they help consumers choose quality coverage, but it did not later figure in the whole mix. However, with this mandate delay, the administration is restoring its faith in the insurance agents and broker concept, and is actually relying on them to help them sail through these troubled times.
When the delay in enrollments through SHOP was announced, it was met with disappointment and frustration. However, the administration’s move to pull brokers and agents in is definitely helping them control the consumer frustration, and, at the same time, also giving them additional time to fix healthcare.gov. December 1 has passed, but the website is still not working perfectly. While the front end of the website has been fixed, the backend still requires a lot of work.
Consumers are still getting enrollment errors and are unable to take the process all the way through. Duplicate, missing or inaccurate information – the errors are frustrating and prevalent. In some cases, people who are trying to get their enrollments canceled are facing a complete obstruction from the system. Some people who have qualified for subsidies through the system are not getting the total subsidy amount. For instance, a resident of Alaska is eligible to receive a monthly subsidy of $366, but the system is only letting her use $315. Worse still, there is no one to help her figure this out. In a nutshell, the healthcare.gov needs a lot of backend work, and the administrations needs all kinds of support in this period to avoid another delay and complete collapse of interest in the health reform.
In the months to come, brokers and agents will transform into a pivotal entity that will help consumers enroll for new health insurance and will assist government in meeting the challenges of the health insurance marketplace to avoid another major disappointment.