Many insurance carriers announced last year that they would not pay Individual Health Insurance Brokers commission for policies issued after Open Enrollment ended. Now, Blue Cross has just announced that they will not be paying brokers for any new policies effective January 1, 2017 or later. However, you, the tax payers, will continue to pay Navigators, Certified Application Counselors, and Non-Navigator Assisters to assist.
You are probably asking, "What are Navigators, Certified Application Counselors, and Non-Navigator Assisters?" When the Affordable Care Act started the Health Insurance Marketplace it created new positions- Navigators, Certified Application Counselors, and Non-Navigator Assisters- the act created a system where organizations and individuals would go through some courses and then apply for Federal grant money to open up as Navigators, Certified Application Counselors, and Non-Navigator Assisters. They would usually get up front money to get started then they in some cases got paid per person they help. The thing to note is that since they are paid by grant money set up by the Affordable Care Act through the Federal government, it did not impact Health Insurance Carriers and allowed them to keep more of the money rather than having to pay us as brokers out of their premium collections. This also helped in calculating their Medical Loss Ratio. For more info on that see my other blog post- (http://veritasrm.blogspot.com/2016/09/need-help-with-health-insurance-brokers.html).
One major thing to note here....
Almost none of these people are licensed insurance agents. They dont have to pass any insurance tests, just a short Centers for Medicare & Medicaid Services training. In addition, there were issues back in 2013 because many of them did not have any background checks performed and were dealing with personal information and it was creating some problems.
You are probably asking, "What are Navigators, Certified Application Counselors, and Non-Navigator Assisters?" When the Affordable Care Act started the Health Insurance Marketplace it created new positions- Navigators, Certified Application Counselors, and Non-Navigator Assisters- the act created a system where organizations and individuals would go through some courses and then apply for Federal grant money to open up as Navigators, Certified Application Counselors, and Non-Navigator Assisters. They would usually get up front money to get started then they in some cases got paid per person they help. The thing to note is that since they are paid by grant money set up by the Affordable Care Act through the Federal government, it did not impact Health Insurance Carriers and allowed them to keep more of the money rather than having to pay us as brokers out of their premium collections. This also helped in calculating their Medical Loss Ratio. For more info on that see my other blog post- (http://veritasrm.blogspot.com/2016/09/need-help-with-health-insurance-brokers.html).
One major thing to note here....
Almost none of these people are licensed insurance agents. They dont have to pass any insurance tests, just a short Centers for Medicare & Medicaid Services training. In addition, there were issues back in 2013 because many of them did not have any background checks performed and were dealing with personal information and it was creating some problems.
A Navigator is an individual or organization that's trained and able to help consumers, small businesses, and their employees as they look for health coverage options through the Marketplace, including completing eligibility and enrollment forms. These individuals and organizations are required to be unbiased. Their services are free to consumers.
A Certified Application Counselor is an individual (affiliated with a designated organization) who is trained and able to help consumers, small businesses, and their employees as they look for health coverage options through the Marketplace, including helping them complete eligibility and enrollment forms. Their services are free to consumers.
A Certified Application Counselor is an individual (affiliated with a designated organization) who is trained and able to help consumers, small businesses, and their employees as they look for health coverage options through the Marketplace, including helping them complete eligibility and enrollment forms. Their services are free to consumers.
A few things to mention about Navigators, Certified Application Counselors, and Assisters-
1- They are paid by the tax payers and not the insurance carriers. With the passing of the Affordable Care Act, in very basic terms, insurance carriers were only allowed to keep 15-20% of the premiums for profit and overhead. In the late 1990's we were making 10-15% commission on individual health insurance policies. Once this law was passed, carriers had to cut commissions drastically since these commissions had to be included in the 15-20% overhead. If they had more than that, they had to give money back to the policy holders.
2- Navigators are required to be impartial up to and including not being able to recommend a plan for someone according to the training I have had to do through the Centers for Medicare & Medicaid Services. This means that they really only help people get online and enter information in on the applications, but if someone asks what plan would be best for them, they are prohibited from making a statement. According to other documents, Navigators will be able to help people choose a plan but the way I read it, Certified Application Counselor will be the ones that will help people pick a plan.
3- In 2018, Navigators will be required to give some service after enrollment.... a novel concept.... but will they get paid more for doing so?
On a search of Johnson City, TN, there were 19 Navigators, Certified Application Counselors, and Assisters and 127 Brokers with 25 miles. I can tell you that for the past 3 years, we have been absolutely slammed trying to help people. It will be interesting to see how much of an increase there will be in the number of Navigators, Certified Application Counselors, and Assisters in the next year.
Andrew Darlington
Veritas Risk Management - Home, Business, Auto, Life, Work Comp, Employee Benefits, and anything else that ends in insurance....
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