Kevin Knauss: Health, History, Travel, Insurance
Post related to the commissions paid to insurance agents from Covered California, health insurance, carriers, health plans for assisting consumers with enrollment.
Whereas I was optimistic about 2025, I am pessimistic about 2026. Because the enhanced subsidies were not passed by Congress, I’m seeing people drop health insurance. I anticipate more people will drop health insurance during the year because they just will not be able to afford the high health insurance premiums.
If you consider certified agents are an extension of the Covered California customer service staff, the different agent compensation models are like paying a different hourly wage based on the health plan enrollment. The varying compensation amounts introduces a certain level of bias. If you are paid $15 an hour for enrollments in health plan X and only $8 per hour for enrollments in health plan Y, which health plan would you favor?
Covered California does not pay agents to assist consumers with enrollments into individual and family plans. The insurance plan or carrier compensates the agent. Agents are not paid anything for answering questions about Covered California. They are only paid a commission if the person enrolls into a health plan the agent represents and is appointed with.
If the carriers feel threatened by the HCSM plans, they should lobby the legislature to ban those plans as well. Don’t use health insurance agents, under the guise of retribution from Covered California, to achieve the objective of limiting the enrollment in these plans. I completely get that if all the healthy people leave the pool, the carriers are going to have problems paying claims, and may exit the market altogether. We don’t want this to happen. But I’m just the agent. Don’t shoot me to protect your business model.
The health plans and Covered California may give lip service to the value of the agent community, but it is not reflected in the compensation we receive. I’m not trying to get rich as an insurance agent. My net revenue listed on my Schedule C for 2016 was $34,000. If the new compensation schedules significantly erode my insurance revenue then I will have to find other income streams. Maybe Covered California will hire me to answer phone calls; I hear they have a great benefits package.
By assuming that Covered California is one big selling machine, the report also paints agents as little more than clerks at a supermarket. Agents do more than just ring up the consumer’s purchase and then watch them take their goods out the door. Agents, just like Covered California customer service representatives, are available all year to help with reporting changes to Covered California and assist with health plan problems. Some agents have complained that Covered California helps enroll the easy cases and the agents must work with individuals and families who have more complicated households, immigration issues, and income questions that require more time.
I try to be pretty pragmatic when it comes to presidential elections. Regardless of the promises made by any candidate, we rarely see any real change in the U.S. with the election of a new president. However, Donald Trump ran on a platform to repeal and replace Obamacare. Since 90% of my income comes from enrollment generated by the Affordable Care Act, I am facing a drastic reduction of my income if Trump fulfills his promise.
For the first time in my life I can commiserate with people who are losing their livelihood because of a government action. Just as some workers have been displaced because the government outlawed a product, changed an environmental regulation, or enacted a trade deal that smothered their industry, I too am on the receiving end of government legislation that will decimate my income. If Obamacare is repealed and the subsidies that make health insurance affordable for millions of Americans ceases, I will lose 90% of my clients.
With the constant erosion of the commission structures to agents for enrolling consumers into health plans in California, many agents have expressed their desire to stop assisting individuals and families with enrollment into Covered California health insurance. There has been renewed talk of allowing agents to charge a consultation fee to make up for the dwindling commissions they earn from the health plans and insurance companies. However, if agents want to make a decent return for enrolling consumers into health plans they need to provide the service so many of them advertise. We need to move from order-takers to consumer advocates, and we need fair compensation for our services.
For the second time since the launch of Obamacare and Covered California, Anthem Blue Cross has cut the commissions they will pay agents for assisting consumers with enrollment into individual and family plans. Anthem Blue Cross now has one of the lowest commission structures for agents helping individuals and families apply for health insurance in California. This commission cut, coupled with rules limiting Covered California delegated agents from receiving commissions, has resulted in agents thinking twice before assisting consumers with Anthem Blue Cross health plans.
