With enrollment
for health insurance plans available through state and federally facilitated
marketplaces just days away, a new survey of NAIFA members shows that agents
and brokers are unwilling to sit on the sidelines and instead will take an
active role in helping consumers navigate the complex world of the health
insurance marketplace under the Affordable Care Act.
According to the survey, more
than half (56 percent) of NAIFA members who sell health insurance said they
plan to sell plans through state or federally facilitated marketplace when
enrollment opens to consumers on Oct. 1. Of the 54 percent who live in states
with a federally-facilitated marketplace, 50 percent of respondents said they
have participated in government training for agents from the Centers for Medicare
& Medicaid Services (CMS), and 29 percent said they plan to take the
training. The survey of 600 NAIFA members, conducted Sept. 10-12, 2013, is being
released during the NAIFA Career Conference and Annual meeting.
“It’s not surprising our
members are taking the time to participate in training so they can continue to
serve clients with expert advice on health insurance plans that will be
available in the group and individual market,” said NAIFA President-Elect John
F. Nichols, MSM, CLU. “While the
thousands of ‘navigators’ hired will help consumers enroll for plans through
the marketplace, consumers and businesses will require assistance that goes far
beyond registering for a plan. That’s what our members can best provide.”
Sixteen states plus the
District of Columbia will run a state-operated exchange; 26 states will operate
under a federally facilitated exchange, and seven states have chosen a model
that involves partnership between the states and the federal government. (See list of
state exchanges by model.)
With enrollment set to open Oct.
1, field reports from NAIFA members reveal widespread confusion among consumers
about how the law will impact them.
Small business owners are
particularly concerned about how the health care overhaul will affect premiums
and other costs, according to respondents. NAIFA members say they are fielding
numerous questions about businesses’ requirements under the law and what types
of plans will be available on the state and federal exchanges.
“Most small
business owners are so confused and discouraged that they don’t know what to
ask other than, ‘How much will it cost me?’” says one NAIFA member from Winston
Salem, N.C.
Many of the brokers and
agents (44 percent) are reaching out in their communities, beyond their
existing client base, to assist consumers with questions about health insurance
and the ACA. Some report providing briefings at town hall meetings, while
others are visiting senior centers, churches and other community centers. At
least one out of 10 respondents said they have secured referrals from
hospitals, pharmacists, doctors and other organizations that believe consumers
will need expert advice in the healthcare marketplaces.
For example, one hospital
system in Southwest Missouri officially will refer its patients to NAIFA members for advice, and the
Tennessee Hospital Association is listing NAIFA members as reliable and trusted
resources for consumers.
“When purchasing a plan from
a marketplace, the companies that sell health insurance should immediately
assign consumers an agent,” Nichols said. “Coverage does not begin and end with
enrollment. Consumers benefit from the expertise that brokers and agents
provide in servicing the plan throughout the year. They need to be involved, or
customer service will be a missing element in healthcare reform.”
Individual Mandate
Some NAIFA members believe
that the Affordable Care Act’s individual mandate is likely to increase
business, with 30 percent saying their health care business will grow because
of the individual mandate. However, 40 percent think their business will shrink
as the government implements more ACA provisions, while 18 percent anticipate
no change; 13 percent are uncertain.
Of those who expect growth,
54 percent believe their business will increase by 10 percent or more. Nearly a
quarter (23 percent) expect to hire additional staff.
“While the ACA already has
presented many challenges for healthcare providers, consumers and agents and
brokers, NAIFA members realize there are opportunities to leverage their
expertise. In the end, we want consumers and agents to benefit from the added time,
training and talent invested in learning the complexities of this new law as it
goes into effect in the months and years to come,” Nichols said.
NAIFA has launched an ACA resource site (www.naifa.org/advocacy/aca) for members and their clients. The site
includes FAQs addressing questions about the exchanges, essential benefits,
taxes, the individual mandate, Medicare Advantage and other ACA provisions.
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