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Covered California Delays Navigator Program August 26, 2013

Posted by QUOTEBROKER in Insurance Quotes.
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Covered California, the state-based healthcare exchange, today announced that they will delay their navigator program, originally scheduled to be implemented in time for this fall’s health insurance exchange open enrollment.  CoveredCA stated earlier this year that the initial goal of the Navigator program was to “promote maximum enrollment of individuals into coverage” by ensuring that navigators “are knowledgeable of both subsidized and non-subsidized health coverage and qualified health plans” and that navigators “are equipped with the information and expertise needed to successfully enroll individuals into coverage” during open enrollment for health insurance this fall.

Kudos, Covered California, for realizing that the initial goal cannot be met, and pivoting to an already existing infrastructure of trained, licensed, and insured agents and brokers to perform these tasks.  While navigators would have had to undergo a crash-course in healthcare, existing agents and brokers have a lifetime of experience in the field and will make for a much smoother transition to 2014.

Agents and brokers have a continued stake in ensuring that their clients’ coverage on the new health insurance exchange is the best possible fit for their specific needs.  Agents and brokers have an existing relationship with millions of clients, making them the ideal choice to help their clients’ decisions during health insurance exchange open enrollment this fall.  Kudos to CoveredCA for recognizing the invaluable conduit that the existing agent/client relationship is and leveraging it to produce the best results for their upcoming open enrollment this fall.  After all, that was their goal in the first place.

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1. gandalf47 - September 26, 2013

I am not a licensed health insurance broker or agent in the State of CA, though I once was. I worked for more than 40 years in the healthcare industry as a claims adjuster and, later as a licensed agent, and then finally, as a hospital executive. The only one of the three categores that required me to be licensed was to actually SELL the insurance policie. However, in retrospect, being both a claims adjuster and an effective hospital executive actually required me to know MORE about insurance policies (both private AND governmental) than being a licensed sales person who derived all of my income from selling policies. Sometimes, the policies with the largest commissions were actually NOT the best policies for the CLIENT, but were the best ones for my bank account. That is the reason that I stopped being a SELLER of insurance, and became an INTERPRETER and ADMINISTRATOR of insurance, removing the inherent conflict of interest that is built into the system.

Herein lies the false impression that licensed brokers would do a better job informing prospectice CLIENTS of thier rights and/or benefits under the new law. I submit that many will, but many won’t, as brokers have a self interest to guide CLIENTS toward policies that will pay the broker better commissions. If licensed brokers are allowed to serve as “navigators” specifically for the ACA, they should be required sign an agreement that, during the time they servie as official “navigators” for the ACA, they may not earn any commissions on policies sold to prospective CLIENTS. I put “clients” in ALL CAPS, since the brokers have a stake in what they tell people about the new law. I repeat, not ALL brokers are unscrupulous, but many are.

It is my opinion that navigators should be paid an hourly rate based on their level of experience and should have no personal stake in which plan, Silver, Gold, or Platinum that they ultimately recommend. I, for one, am perfectly capable of being trained in the specifics of the law, and could, in common “lay terms”, without confusing “insurance-speak”, explain the pros and cons of the law to the average person. When the enrollment period expires, then my role would end, along with my financial relationship with the State Exchange. There would be no conflict of interest, as there would be with an insurance broker, who would be paid for every year that the CLIENT renewed the policy suggested by the broker. Even if that specific broker leaves the agency, the agency would be paid until the policy expires or is cancelled.

How many insurance brokers will suggest a State Exchange policy over one from a private insurance company that pays a commission for similar converage, even if the premium is higher?

QUOTEBROKER - September 27, 2013

Hi Galdalf,

Thank you for your candor. Since you’ve left the business, much has changed. Regarding compensation, the leading carriers pay a flat rate regardless of which plan the consumer enrolls in. There is no incentive to enroll the client in any particular plan.

Regarding your idea here: “I, for one, am perfectly capable of being trained in the specifics of the law, and could, in common “lay terms”, without confusing “insurance-speak”, explain the pros and cons of the law to the average person. When the enrollment period expires, then my role would end, along with my financial relationship with the State Exchange. There would be no conflict of interest, as there would be with an insurance broker, who would be paid for every year that the CLIENT renewed the policy suggested by the broker. ”

You are ignoring the most valuable asset of having a licensed agent. Under your scenario, what stake do advisors have in providing accurate advice? Your advisors would be paid hourly- that fixed income regardless of results would be a huge detriment to client services. Persons with your resume don’t grow on trees- the vast majority of navigators would have less experience in the medical field, and certainly not the diversity of working both in administration AND sales as you do. But if your relationship with the exchange and the client ends after Open Enrollment, who will consumers look to the other 10.5 months of the year when they have issues with their policy?

Furthermore, while you personally may be perfectly capable of being trained in the specifics of the law, our brokerage has been studying the ACA and its evolution for the past 4 years- from sub-committee bill to passage to the Supreme Court’s upholding to next week’s implementation. The complexity of the legislation can not be easily conveyed in the meager number of hours (not days or weeks, hours) that navigators will be required to train. There would be some navigators with background and experience such as yours, and they would do an excellent job. The vast majority would not have such a resume. As agents and brokers, our livelihood depends on our knowledge of the legislation and our ability to provide the proper guidance for the consumer’s short AND long term satisfaction, as well as continued and ongoing service. Under your model, advisors would have no incentive to provide for the long term. That’s what you get with our agency- a long term commitment to your satisfaction.

2. Covered California Subsidy Calculator and Plan Comparison Tool | Quotebroker Insurance Services - September 3, 2013

[…] against one another in addition to your current plan, if applicable. This service is available at no additional charge to you, and is highly recommended.  The proper plan choice, suited specifically to your needs, can save […]


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