On a recent webinar, Chris Patton, Vice President of SHOP Sales and Agent Management for Covered California, reported that over 15,000 insurance agents have registered to become certified to sell both individual and small group health plans through the California health insurance exchange. Of those thousands of agents, less than 1700 had completed the necessary training for certification only days before the start of open enrollment. In addition, no agents will actually be certified as of the launch on October 1st because agent agreement has not been released.
Certifying agents bigger task than expected
The unfortunate lack of certified insurance agents ready to serve California on Oct. 1st seems to have resulted from a combination of technical difficulties, resource allocation and reluctance. Early in the development of Covered California’s strategy to enroll millions of California’s into the new ACA plans, the emphasis was put on the creating an army of Certified Enrollment Counselors. Certifying insurance agents was a back burner priority possibly because of the strident opposition many agent organizations had expressed over the Affordable Care Act.
Enrollment Counselor is running slow
Even with a Herculean effort to get the 20,000 Certified Enrollment Counselors (CEC) trained, certified and affiliated with a Certified Enrollment Entity, few of these In-Person Assisters will be available in the first month of open enrollment. While the CECs can only focus on individual and family plans (IFPs), insurance agents are eligible to work with both IFP and small group plans for business and nonprofits.
Agents welcomed by Covered California
With the In-Person Assistance rolling out slower than molasses on a cold morning, more energy seemed to be put into getting agents certified to fill a potential vacuum CECs from the In-Person Assistance program. Whether it was the vagaries of bureaucracy or just an underestimation of the structure necessary to train and certify insurance agents, no California health agents will be able to help write a health plan policy and receive credit through the Covered California on-line enrollment system CalHEERS.
Too many cooks in the kitchen?
Various excuses have been made but the insurance agent agreement necessary to allow licensed agents to actually sell and receive credit for those sales through Covered California has yet to materialize. Chris Patton was optimistic that the agent agreement would start to filter out to agents who have completed all the training on or after October 1. Agents must still sign the agreement, pay an on-line fee to be appointed and send over confirmation of his or her errors and omission insurance.
Can all health plans be represented fairly?
A preliminary agent agreement I read through stipulates that agents must represent all the carriers equally to the client. This is great in theory, but for agents who have not been appointed by several of the carriers, which will allow them to be compensated for the sale, some health plans will get little attention from agents. There are several regional health plans that are just not returning phone calls or email requests to be appointed.
Who does the agent really represent?
Then there are captive agents that are affiliated with a general agency and may only be appointed with one or two of the statewide insurance companies (Blue Cross, Blue Shield, Health Net) and none of the regional health plans (Sharp, WHA, Chinese Community).
- Can Covered California really expect an agent that only represents one fourth of the carriers to accurately represent all the carriers to an individual or family?
- How will a family know when they are contacted by an agent that the agent is appointed with certain health plans?
- Is this fair to consumers that agents have no incentive to discuss certain health plans because they are not appointed and receive no compensation for the sale?
Small group plans have no representation issues
To ensure that you know the perspective of the insurance agent you might be dealing with for an individual or family policy, ask him or her which companies they are appointed with? This is not an issue for small groups since by virtue of being a Certified Insurance Agent the agent or broker will receive compensation from Covered California and not the specific insurance companies. The Small Business Health Options Program (SHOP) doesn’t require the agents to receive individual appointments from each carrier being offered.
We have time
In reality, too much attention has been placed on the beginning of open enrollment. There is a boat load of information from the health plans and Covered California that is set to be released on or after October 1. Once this information is released (e.g. physician groups, hospitals, formularies, rates, plan specifics) both consumers and agents will have time to comb through data to make a comparative analysis.
Dotting the “i” and crossing the “t” delays
With the challenges of getting agents certified and their information populated into the Covered California data base don’t expect too many agents to be available for referral until mid-October. And then, just like a bad Halloween movie, you will start to be bombarded by scary marketing literature from agents wanting to help you enroll in a Covered California health plan. Just remember the Covered California mask doesn’t mean that the agent actually represents all the plans in your area.
