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Covered California giving agents lip service – Articles – Employee Benefit Adviser

Some California agents are not happy with the way the state-run health care exchanges are treating them and there are many more road bumps to cross in the near future, said a San Diego-area broker.

Speaking at America’s Health Insurance Plans 2013 State Issues Conference in Arlington, Va., Bill Hammett IV, president at Hammett Health Insurance Services, said that in the buildup to Oct. 1, California exchange officials relied on brokers heavily and told them they would be an invaluable resource. However, as the exchange has rolled out, “that has not been the case. … The exchanges are only giving us lip service,” Hammett said.

In the most populous state in the nation, California’s agent population represents millions of people between employer clients and their employees, Hammett, past-president of the San Diego chapter of the National Association of Health Underwriters, explained.

While there are more than 17,000 licensed insurance agents in the state, as of last week, only 1,200 have been registered to sell in the health exchange. Yet, Hammett said 5,400 community organizers and unions have been licensed to sell on the exchange. “We [agents] are a little upset,” he added. “There is growing unrest in the agent population with the exchanges.”

With another 5,000 union and community organizers still to be licensed and just 3,000 more agents, those who traditionally were the main source of health insurance will be outnumbered five-to-one, Hammett said. “We are concerned about that, the exchanges living up to their word” to use our services, he said.

In a release, MD Sam Smith, president of the California Association of Health Underwriters said that the group’s leadership has been in constant contact with Covered California and addressed a number of issues found to be holding up the certification process.

Smith further stated the Covered California is “rapidly working through the backlog of agents waiting for formal notice of certification and the uploading of their certified agent status.” Covered California projects that the current backlog will be clear by Tuesday, Oct. 22.

Hammett also believes the exchanges have been misleading about how many employers will drop coverage. Of his 200 employer block, many of them are talking about cutting employees hours to 29 hours a week in order not to be required to provide health insurance coverage, he said. One of his restaurant clients worked with Hammett to determine all 11 of the chain’s eateries could afford only three full-time employees each, and plan to move the other employees to under 29 hours a week.

Further, Hammett said he expects more bumps in the road as the true reach, or lack thereof, of the insurance offered through the exchanges becomes known to consumers. For example, doctor networks, he said, have been kept under wraps on the exchanges. Talking with his insurer friends, he believes they will be “uber skinny” and some major hospital providers are just not going to be in the networks.

13 Comments

Posted by: Phil L | October 21, 2013 4:56 PM

I have no doubt that the Exchange disaster is not a cause of concern for single payer activists because they would be happy to have Obamacare fail so that they can point to the failures of the supposed market-based system, and replace it with Single Payer. The sole purpose of the Exchanges, which duplicate an already efficient and robust broker distribution network, is as a vehicle for them to impose Single Payer. This is already apparent in the design of the coveredca.com website which looks like it was designed by single payer activists without any input from insurance agents. Agents are barely mentioned in the website, and hard to find. The photo above the link to find agents show 4 youthful individuals with mickey mouse looking headsets on top of their heads. They look more like toll free number clerical operators than licensed insurance agents and employee benefit consultants. Whereas the photo above the Certified Enrollment Counselor link shows 4 corporate-looking business people. I don’t know what CEC’s are supposed to look like, but I have been to Healthy Families certification meetings. They don’t look anything like what’s in the covered ca photo. They would look out of place in a corporate conference room.

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Posted by: Phil L | October 21, 2013 4:48 PM

The coveredca.com website is designed to try to downplay or hide the true cost or premium for the plans that people are enrolling into. They try to only show what the cost is after deducting the subsidy that one qualifies for. There are two reasons I can think of why the Administration would want to do this: 1) They don’t want the American taxpayer to know just how monstrous the amount of money is that they will be paying to subsidize everyone, 2) They don’t want you the buyer to know how expensive it would be when you either lose your subsidy or when the Govt. stops funding the subsidies.

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Posted by: Phil L | October 21, 2013 4:37 PM

On Oct.1, after finally completing every possible requirement they asked of me over a 2 month period (i.e. application, classroom, online modules, exam, documents and fee payment) it took the Covered California Exchange another 17 more days to certify me. During these 17 days I called multiple times, endured hour-long phone holds, writing multiple emails and contacting all the Exchange officials I could find, before I was finally certified. And that only happened after I resent to them documents that they had lost for 17 days. Even with the agent certification, I am unable to advise clients because we don’t have access to either the provider networks nor to off-exchange plans. I would be doing a disservice to my clients and a possible liability to me if I were to help them enroll into a plan where they have to go out of network to see their doctors. Moreover, it would be an omission on my part to tell them to enroll into an Exchange plan without having seen what other off-exchange plans are available in the marketplace.

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Posted by: Michael L | October 21, 2013 4:00 PM

Sam and Bill are doing the right thing by holding the exchange accountable to explain how and when the rest of the agents can get certified. I am extremely proud to have worked at Covered CA over the past year to help get thousands of CA agents ready for the new marketplace. Since I left, they have continued to host agent webinars and launched the agent training and website. We’ll see if the backlog is cleared by Oct 22nd. The exchange (and your customers) need agents to be successful!

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Posted by: Jerry T | October 21, 2013 3:35 PM

Not to sound abrasive folks, but, do not be naive. ACA 2010 has as one objective to run insurance agents out of the health care industry. Salesmen are not required in a one payer system. Were there salesmen for Medicare when it was introduced in 1965? Navigator is just a synonym for bureaucrat/gov’t employee and union member paying dues to ultimately be funneled into Congressional coffers at election time. What is our commission on an individual product sale? E.G. say, it is 20% 1st year on $5000 annual premium. That is $1,000 per case. Insurance companies were promised they would be “relieved” of that commission burden if they would support ACA. How? No agents, no commission, to say nothing of their ad campaigns.Gov’t would benefit by increased tax revenue on the insurance companies by this marginal difference in expenses. One payer system makes all of that happen and more. Insurance Companies are supposed to land a windfall through ACA. No? Have you observed the insurance companies’ stock prices since, oh, say, 2010? How much did the insurance industry fight ACA?Those uncertified CA agents appear to me to be the guys and gals who elected to change careers; sell something else other than health insurance.The only reason groups are exempted from the Oct 1 mandate is because the gov’t was concerned its website could not handle the volume. The individual mandate has crashed its systems all by itself. Just wait until groups fall into the mandate. Whatever your group insurance commission income is, blow it a kiss in 2014/15, assuming gov’t websites get fixed. Just sayin’.

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Posted by: mikebraun1 | October 21, 2013 2:20 PM

I am not surprised. In Ca the end goal is to fill the coffers of political appointees and grassroots community organizations. There was a ton of money turned into Acorn and the like.

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Posted by: Michael L | October 21, 2013 2:12 PM

Sam and Bill are doing the right thing by holding the exchange accountable to explain how and when the rest of the agents can get certified. I am extremely proud to have worked at Covered CA over the past year to help get thousands of CA agents ready for the new marketplace. Since I left, they have continued to host agent webinars and launched the agent training and website. We’ll see if the backlog is cleared by Oct 22nd. The exchange (and your customers) need agents to be successful!

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Posted by: Paul W | October 21, 2013 1:50 PM

Is really true that unions and community organizers are selling insurance on the exchange without insurance agent licensed? If anyone thoughts this change would go over smoothly, they need to have their head examine. Typical of we Americans, we will bitch about anything that don’t happen instantaneously and when it does, then we will bitch about it happening to fast.

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Posted by: Dean B | October 21, 2013 1:49 PM

Things are certainly not even that good on the Federally Facilitated Exchange. The certification process was stopped dead in it’s tracks n Oct 1, and has yet to come back on line. But, if you want a true idea of who the administration wants actually selling insurance, take a look at the training and materials provided through the Navigator certification as opposed to what is provided to agents/brokers. They are actually told how the Exchange looks, and given detailed instructions on how to use it, field by field, and where to go for assistance and answers. Their resources are far superior to ours. Make NO mistake–the Obama administration does not want us selling Obamacare.

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Posted by: Wes B | October 21, 2013 1:47 PM

We shouldn’t forget about the Medicare drug expansion that occurred about a decade ago. You would have thought the world was coming to an end with the level of animosity that was generated because of growing pains and the learning curve. But people got through it and now don’t think much about it. Are people really that much more impatient and vile-tempered now? This will pass also, if people can calm down a bit.

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Posted by: Diane | October 21, 2013 1:16 PM

Technical glitches “be darned” the true nightmare is this is not “affordable” nor does it provide “care” as in “access to care”. The plan was to run agents & brokers out! If OOP & deductibles are still high, many are still not receiving health care. What health insurance problem did this solve besides pre-existing & 20 somethings riding parental coat tails??

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Posted by: Joy P | October 21, 2013 1:00 PM

Absolute nightmare! From taking an hour to contact them for information to ease of use for our web portal to faxing applications to a fax machine that rarely answers. Should have been turned over if we have to have this exchange to the private industry to run.

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Posted by: sussman | October 21, 2013 12:53 PM

As usual, Bill gets it and pulls no punches. California and Maryland (my state) were supposed to be “stars” with their own Exchanges, and although broker certification is doing just fine here, getting someone insured (or into the system) has been an ongoing nightmare.Lynda Sussman

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