Over the course of two different letters to U.S. Department of Health and Human Services (HHS) Secretary Burwell, the Executive Director of Covered California, Peter Lee, outlined the benefit of Certified Insurance Agents to their enrollment activities and suggested there should a uniform commission structure for health insurance agents. Mr. Lee’s comments come at a critical time when many health insurance companies are reducing and even eliminating agent commissions.
Anthem Blue Cross, following internal policies to protect agents, prevents their members from selecting their preferred health insurance agent through Covered California. The Blue Cross policy of not recognizing an agent delegation made by a household in their Covered California account prevents the selected agent from properly representing the family members and being compensated for his or her time. The Blue Cross agent of record policy occurs when the Covered California member originally enrolled with another agent or without an agent and the member is considered a house account.
UnitedHealthcare has alerted their appointed health insurance agents that they will not pay any commissions for individual and family plans sold after January 1, 2016. The abrupt cancellation of commissions applies to Marketplace state based exchange plans and health plans sold off-exchange directly through United Healthcare. Commissions on enrollments prior to December 31, 2015, will be honored.
Covered California Certified Insurance Agents assisted 429,365 individuals for possible enrollment into the expanded ACA Medi-Cal health insurance from January 1, 2014 through July 31st, 2015. The Medi-Cal assistance enrollment figure comes from a Public Records Act Request that I submitted in early October of 2015 to Covered California. As the $58 compensation to agents for Medi-Cal enrollments ceased over the summer I felt it was important to learn the level of agent involvement with funneling Californians in Medi-Cal health plans.
Covered California has locked Certified Insurance Agents into representing all exchange plans to consumers and forbids agents from steering consumers to health plans with the best commission structures. Unfortunately, Covered California has no regulations that address any minimum compensation levels that the health plans or health insurance companies must pay agents for their efforts. Covered California announced over the summer that compensation for Medi-Cal enrollments would end for agents. Most recently Western Health Advantage (WHA) announced a split commission structure where Certified Agent enrolments would receive less compensation for Covered California plans than WHA’s off-exchange plans.
Covered California has released a series of marketing videos to develop interest and drive sales to their small employer group plans. Formerly known as SHOP (Small business Health insurance Options Program), the small employer group offerings, authorized as part of the Affordable Care Act, has been re-branded as Covered California for Small Business. The small employer group marketplace exchange initially flopped as it was beset with an online application process that failed and subsequent management problems that resulted in billing nightmares for many clients. Fortunately, they seem to have righted the foundering small group boat at Covered California.
A group of Covered California Certified Insurance Agents have begun organizing the early stages of a class action lawsuit against Covered California for unpaid compensation. Led by John Dickey who earlier took Covered California to small claims court, the goal is to enlist enough health insurance agents with verifiable losses to establish a base for […]
Covered California announced in mid-July they were awarding $10 million in grants to a Navigator program that performed poorly in 2015. Two weeks later Covered California sent out a letter to agents that they would no longer be compensated for assisting individuals and families who are determined eligible for Medi-Cal. For the 2015 open enrollment […]
Of the nearly 3 million Californian’s enrolled in Medi-Cal, Covered California estimates that approximately 2 million became newly eligible under the ACA expanded Medi-Cal rules. Many of the new Medi-Cal members are working families and individuals. They have little time to sit on hold with their local county social services department to correct Medi-Cal errors […]
A year and half after the launch of Covered California the CalHEERS enrollment website is still a work in progress. Covered California released more instructional briefs on changes they’ve made to the California Health Enrollment Eligibility Retention System (CalHEERS) website. Just when Certified Insurance Agents thought they had figured out how to navigate CalHEERS, new […]