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Health Care Reform:

Health Insurance & Affordable Care Act

Affordable Care Act: Brokers Can Sell in Exchanges

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"Just because a plan covers autism benefits, it might not cover the specific benefits I need," she says. "A consumer may not know to ask, but that's where brokers come in."

Still, consumer advocates say they’re concerned that brokers or insurers may not direct consumers first to all the exchange plans for which they could receive a subsidy to reduce their costs.

"I'd encourage anybody looking for a plan to go first to the exchange website and get a full sense of the range of options that are there," says Sabrina Corlette, project director at Georgetown University’s Center on Health Insurance Reforms.

Insurance brokers and insurers who want to sell exchange plans must undergo training in order to do so. They typically receive a commission on plans that they sell for which they have an agreement with the insurer. That happens for both plans sold on and off the exchange. Brokers that sell marketplace plans on the Internet must at a minimum provide consumers with the names of every available exchange plan. Other brokers don't have to present all exchange plan options to consumers. "They can steer people to the plans that they're affiliated with and presumably know more about," says Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation (KHN is an editorially independent program of the foundation.) "It’s not a reason for people not to use a broker, but it's important for people to understand."

Likewise, consumers who go directly to an insurer's website will see all the exchange plans it offers, as well as a link to the marketplace, where they can see all exchange plans available from other insurers.

However, consumers might fail to consider all their options because they'd see just a single insurer's plans first, says Cheryl Fish-Parcham, deputy director of health policy at Families USA, an advocacy group.

In addition to their expertise, there may be other reasons to consider shopping with a broker or insurer. For one thing, not all insurers are represented on the exchanges; in some cases the number may be very limited. Consumers who want to buy a policy from a particular insurer may need to shop outside the marketplace.

And for people whose income is close to or exceeds 400 percent of the federal poverty level, "it may not be worth the hassle of filling out the subsidy application and maybe changing your carrier and your provider," says Carrie McLean, director of customer care for ehealthinsurance.com, an online web broker that has been authorized to sell exchange plans in the 34 states in which the federal government is running the exchanges or partnering with the states. "That's going to be important for consumer choice."

Mon, Dec 19 2011

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