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In an effort to make the Marketplace attractive for both consumers and insurance companies, Healthcare.gov CEO Kevin Counihan stated in a January 19 press release that CMS is eliminating “several unnecessary special enrollment periods” while clarifying the definitions of other SEPs. He also vowed that CMS will provide “stronger enforcement so that special enrollment periods serve the purpose for which they are intended and do not provide unintended loopholes.”

These changes are in response to complaints from health insurance companies that it is too easy for people to wait until they got sick to enroll in coverage, and with continued consolidation in the industry, the government wants to do everything it can to convince insurers to continue offering Marketplace plans.

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As you know, the first two enrollment deadlines for 2016 coverage have come and gone. During these last couple of weeks of the annual open enrollment period, people can sign up for coverage to begin on March 1st. We know you’re busy trying to sign up as many people as possible in the last few days, so we’ll keep this short, but we did want to share a couple items with you that may help you better advise your clients and bring in a few more sales.

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Health Savings Accounts (HSAs) first hit the scene back in 2004, and since that time they’ve grown at a steady pace. Every year, more and more brokers get on board with consumer-directed health plans and HSA plans in particular. Still, not every agent is a fan. It’s not easy to create conscientious healthcare consumers. Americans have shown an unwillingness to save their money, and, without up-front copayments, some people go without needed care.

But, like it or not, our clients are gravitating towards high deductible health plans (HDHPs) these days. At the bronze level, which price shoppers tend to gravitate to, that’s really all that’s available in the individual market. Many of those who aren’t receiving a subsidy have trouble affording anything else.

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A lot of emphasis has been placed on the Affordable Care Act’s premium tax credits over the past couple years—and rightly so. The Advanced Premium Tax Credit (APTC) makes it possible for millions of Americans to purchase health insurance; without the financial assistance, many would likely remain uninsured.

There is another type of financial assistance, though, that gets a lot less fanfare than the APTC: cost-sharing subsidies. While you may have learned about the subsidies when the law was first passed and are likely guiding your lower-income clients to subsidized plans, we thought you might benefit from a quick review of how the subsidies work, in turn enabling you to better explain them to your clients.

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In what seems like a strange move to most brokers, some carriers have stopped paying commissions on their most desirable plans, those with larger provider networks and out-of-network options. Why in the world would they do this? Do they not value the agent anymore?

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It’s funny to think that, just a few years ago, many of us were worried that the government was creating a do-it-yourself, Travelocity©-like website that might eliminate the need for health insurance agents altogether. Boy, were we wrong.

It is true that Healthcare.gov and the state-based exchanges are significantly better than they were during the first open enrollment period. The sites aren’t crashing anymore, and they do allow individuals to compare their options and apply online without any outside assistance, but how many consumers actually understand what they’re looking at? The reality is that health insurance is becoming more—not less—complicated, and it can be very difficult for the average person to find the right plan without consulting with a professional.

Here are just a few of the reasons why health insurance agents are more important than ever.

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Are you striking out when trying to sell supplemental and ancillary insurance? Maybe it’s because you’re trying to cram all of your sales efforts into a single call or appointment. There are three big reasons why this may not be a good idea.

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It’s that time of the year again—open enrollment. The 2016 individual open enrollment period begins November 1 and ends January 31, which means that brokers who specialize in individual coverage will be very busy for the next three months. To help make sure this is a successful selling season for you, we thought we’d share a few quick thoughts.

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One of this fall’s “hot topics” highlighted in this month’s AHCP newsletter (link to newsletter), was the definition of small group for purposes of the plan design and rating rules and how it varies and may change. One such change is that brought about by the Affordable Care Act. Starting in 2016, companies with 100 or fewer employees will be considered small employers and be subject to the essential benefits requirement and the modified adjusted community rating rules. Currently, every state sets the cutoff at 50 employees, rather than 100.

 

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A lot of the brokers who work with AHCP focus on both group and individual health insurance. Sure, most of you also market a full range of voluntary and supplemental products to your clients and prospects, but there’s no denying that health insurance is at the top of everyone’s priority list.

For that reason, we thought it would be helpful to highlight some of the biggest concerns your clients are likely to have this fall. While you may not offer detailed advice on their tax or legal questions, this tutorial should help you avoid the “deer in the headlights” look if they touch on a topic you don’t feel familiar.

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California Consumer Privacy