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Health Care Reform:

Health Insurance & Affordable Care Act

Affordable Care Act: Brokers Can Sell in Exchanges

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Brokers help consumers drill down for detailed plan information about participating providers and covered benefits, among other things, says Susan Rider, an independent insurance broker with Gregory & Appel Insurance in Indianapolis.

"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.

Mon, Dec 19 2011

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