Insurers and insurance agents are allowed to sign consumers up for health plans through a "direct enrollment" process. Even though the process may start on the insurer's website, at some point it's redirected to the technology-plagued healthcare.gov website to determine if customers are eligible for subsidies, and then ideally transferred back to the insurer's site. But various points in the process have been mired in glitches. Federal health officials said they've fixed some of the problems, but skeptics fear the improvements still won't allow for a smooth shopping experience and are pushing for a way to bypass the website.
Brokers face similar problems in some of the states that are running their own exchanges, such as Oregon. It's easy for insurers to enroll customers who want a health plan and don't qualify for a subsidy. The trouble comes when insurers and agents need to sync to federal data hubs to verify income, citizenship and other personal information. Democratic Florida state Rep. Richard Stark, who is also an insurance agent, said many of his clients have received inaccurate subsidy estimates from the federal government for clients. For example, a client with twin children was told one is eligible for a subsidy, but not the other.
Like others stymied by website malfunctions, Ken Statz and other agents at his firm in Brecksville, Ohio, filled out paper applications and mailed them, but it was taking time to hear back from the federal government about whether clients are eligible for a subsidy. Then they tried to get creative, planning to fill out the applications with clients during the day and hire someone to input the information into healthcare.gov during off-hours after 11 p.m. But that didn't work either because the site asks personal identification questions that only the user would know.
"We don't have a clear pathway to get them enrolled into the plan. (The federal government) hasn't given us the ability to do that. They're kind of missing the mark on this. They need to realize that we are the best pathway," he said.
Democratic U.S. Sen. Jeanne Shaheen of New Hampshire, recently sent a letter to federal health officials urging them to fix the barriers hampering brokers and possibly create a way to bypass the healthcare.gov site. She suggested a dedicated call-center line or mailing locations for paper applications.
Stark has noticed a chilly reception toward his industry when he's attended local outreach organizations on the health overhaul.
"They basically didn't want to work with insurance agents because they felt agents were going to steer a customer toward (a plan) where they think they will make the most money," said Stark. "If I steer someone incorrectly to a plan that doesn't meet their needs, there's a lot of hell to pay as an agent."
Navigators will likely be gone when enrollment ends in March. That's why Statz said it's important for federal health officials to empower agents to "help people now, but help them make decisions on their accounts moving forward."
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