November 22, 2013


In This Issue
Senator Shaheen Sends HHS A Letter About Agent Concerns with Exchange Enrollment
2015 Open Enrollment Delayed
As The Policy Cancellation and Extension Saga Turns
Clearer Enrollment Paths Insight?
Agents and Brokers In Senate Spotlight
Well That Explains Why So Few People Have Paid For Plans
What We're Reading
E-mail the Editor
Visit the NAHU Website
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Clearer Enrollment Paths Insight?

One of the biggest concerns NAHU has had with the whole rollout of is the lack of a reliable and easy path for certified agents and brokers to take their clients through the enrollment process. This week, we may have had delusions or seen a glimmer of light at the end of the tunnel. First of all, as a result of media and political pressure NAHU and coalition partners have been placing on the Administration, they made a public statement that from this point forward, brokers who place a three-way call with clients to the call center should always be able to receive credit for helping their client. While CMS has been saying this privately to NAHU for the past six weeks and some agents have had success with this path, especially when they engaged a supervisor, overall the willingness of call center representatives to take agent information from consumers was inconsistent at best. This week, the Administration has gone on the record in the press and in public speeches on multiple occasions saying that they guarantee this is now a valid process for agents to use with their clients.

This week the Administration also announced they have made great technical progress in enabling carriers and web brokers (as well as their independent broker partners) to process exchange-based applications and subsidy determinations through the federal data hub by bypassing This mechanism is being deemed by the press as “direct enrollment.” In short, under the direct enrollment mechanism, carriers and web-quoting engines will be able to interface with, enabling agents and brokers to enroll individual clients and receive subsidy determinations using channels and technology used in the non-exchange marketplace today. These mechanisms will also allow people to go to carrier and web-broker websites directly and enroll, just as they can do in the individual market today. NAHU believes when this technology is fully functional, most agents will find it much simpler to navigate than In a briefing to state insurance regulators this week, AHIP CEO Karen Ignagni and CCIIO Deputy Director Chiquita Brooks-Lasure both testified that while they hope this enrollment path will be ready very, very soon, they could not provide a date yet. As of this evening, CMS announced that carriers in Ohio, Florida and Texas will be able to pilot test this technology starting this weekend.

Finally, NAHU is seeking clarification from the IRS on a subsidy issue, which if resolved could also facilitate enrollment more directly. We have requested immediate clarification if individuals who can afford to advance the premium on their own monthly but might also be subsidy eligible could by an exchange offered QHP directly from a carrier “off the marketplace” and with out getting a marketplace subsidy determination. We have asked if it would be permissible for those individuals to obtain a subsidy determination and advance premium credits later, when the marketplace is working better, or simply claim the credit on their 2014 taxes with an exchange-based determination. As soon as we get resolution to this issue, we will let the membership know!

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