The Times West Virginian

Headline News

December 9, 2013

Insurance agents feel left out of overhaul

Brokers meet frustration trying to help customers navigate the Affordable Care Act’s marketplaces

MIAMI — When insurance agent Kelly Fristoe recently spent 30 minutes helping a client pick a mid-level health plan and the federal marketplace website froze, he called the government’s hotline and tried to finish the application. But the operator refused to credit Fristoe as an agent on the application, meaning he wouldn’t get the commission or be listed as the follow-up contact if his client needed help again later.

The Wichita Falls, Texas, insurance agent is one of many brokers across the country finding frustration as they try to help customers navigate the Affordable Care Act’s marketplaces while earning the commissions they’ve long built their businesses around. Some insurers and insurance agents are calling on President Barack Obama’s administration to allow them to bypass Healthcare.gov and enroll consumers directly amid growing complaints about problems with enrollment information generated from the website.

The so-called “back-end” problems could mean that consumers who think they’ve successfully signed up for a health plan may find themselves unable to access their coverage come January. The problems include enrollment information that’s rendered practically useless by errors, duplication or garbles. Efforts to fix the issues are under way.

Nearly 70,000 agents and brokers have been certified nationwide to sell health insurance on the federal exchange. Many say they could be the troubled health law’s best ambassadors with the potential to boost lackluster enrollment figures — only about 27,000 had enrolled via the federal website nationwide in the first month. But instead, many agents said they’re continually met by obstacles.

“You look at this dismal number they have of how many people have enrolled on Healthcare.gov,” said Fristoe. “If they would just relax and loosen up, because me and all of my associates across this nation want to help these consumers get enrolled into the market.”

Federal health officials announced on Nov. 22 that they’d fixed some portions of the website to allow more insurers and insurance agents to enroll consumers directly. The feds are asking roughly 16 insurers, agents and brokers in Florida, Texas and Ohio to test it out and give detailed feedback about the fixes, hoping to expand it to other states in the coming weeks. Health officials have been vague about the scope of the botched applications insurers are receiving and what steps they’re taking to fix the problems. One bug related to Social Security numbers, which federal health officials said accounted for more than 80 percent of insurers’ problems, was fixed last weekend.

But the problems have persisted, prompting the head of the National Association of Health Underwriters to write the president Tuesday, urging him to make additional fixes a priority, saying agents have a significant backlog of clients with incomplete applications.

“We want to make it clear that a number of back-end technical obstacles still exist for health insurance agents and brokers trying to actively support the federal marketplace,” said CEO Janet Trautwein.

Insurance industry executives also met with Obama last month and encouraged him to let them take a more active role in enrolling consumers in the 36 states relying on the federal website. Brokers’ frustrations with the website are amplified by the pressure they face to add customers to offset reductions in their commissions under the law.

Among the complaints, agents say the website isn’t always crediting brokers when they help enroll consumers — meaning they’re losing out on commissions. Once an application is started, consumers can’t go back in and add a broker’s name if they help midway through the process. Federal health officials said there are 975,000 customers who have started an application but not selected a plan.

Agents say they’re also still waiting on the federal government to add a promised feature on the website that would easily connect consumers with local insurance brokers.

Insurers and insurance agents are allowed to sign consumers up for health plans through a “direct enrollment” process. Even though the process may start on the insurer’s website, at some point it’s redirected to the technology-plagued Healthcare.gov website to determine if customers are eligible for subsidies, and then ideally transferred back to the insurer’s site. But various points in the process have been mired in glitches. Federal health officials said they’ve fixed some of the problems, but skeptics fear the improvements still won’t allow for a smooth shopping experience and are pushing for a way to bypass the website.

Brokers face similar problems in some of the states that are running their own exchanges, such as Oregon. It’s easy for insurers to enroll customers who want a health plan and don’t qualify for a subsidy. The trouble comes when insurers and agents need to sync to federal data hubs to verify income, citizenship and other personal information. Democratic Florida state Rep. Richard Stark, who is also an insurance agent, said many of his clients have received inaccurate subsidy estimates from the federal government for clients. For example, a client with twin children was told one is eligible for a subsidy, but not the other.

Like others stymied by website malfunctions, Ken Statz and other agents at his firm in Brecksville, Ohio, filled out paper applications and mailed them, but it was taking time to hear back from the federal government about whether clients are eligible for a subsidy. Then they tried to get creative, planning to fill out the applications with clients during the day and hire someone to input the information into healthcare.gov during off-hours after 11 p.m. But that didn’t work either because the site asks personal identification questions that only the user would know.

“We don’t have a clear pathway to get them enrolled into the plan. (The federal government) hasn’t given us the ability to do that. They’re kind of missing the mark on this. They need to realize that we are the best pathway,” he said.

Democratic U.S. Sen. Jeanne Shaheen of New Hampshire recently sent a letter to federal health officials urging them to fix the barriers hampering brokers and possibly create a way to bypass the Healthcare.gov site. She suggested a dedicated call-center line or mailing locations for paper applications.

Stark has noticed a chilly reception toward his industry when he’s attended local outreach organizations on the health overhaul.

“They basically didn’t want to work with insurance agents because they felt agents were going to steer a customer toward (a plan) where they think they will make the most money,” said Stark. “If I steer someone incorrectly to a plan that doesn’t meet their needs, there’s a lot of hell to pay as an agent.”

Navigators will likely be gone when enrollment ends in March. That’s why Statz said it’s important for federal health officials to empower agents to “help people now, but help them make decisions on their accounts moving forward.”

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