When state-run insurance exchanges were established, many builders assumed that live people would only provide consumers with information regarding plan choices and how coverage works. Consumers, they thought, would then apply for coverage on their own.
Automating the buying process and cutting the workload of agents and brokers on state health insurance exchanges was meant to keep costs in check. However, this is turning out to not be the case, reported LifeHealthPro.
The article referenced two states--Colorado and California--that experienced distribution challenges caused by consumers using live people to sign up for coverage. Here are two things those states have learned along the way.
Increased enrollment through brokers
The percentage of enrollments that came via agents and brokers on Colorado's exchange increased from 31 percent in 2014 to 37 percent in 2015. Brokers and agents in the state are outpacing their competition: Colorado's nonprofit "healthcare guides," noted the article, enrolled 6,758 consumers during the first 10 weeks of the second enrollment period, compared to 9,817 consumers during the entire first enrollment period.
California's exchange experienced a similar situation. During the 2015 open enrollment period, 43 percent of enrollees used certified exchange agents, up from 39 percent in 2014. On the flipside, 30 percent of consumers enrolled without any live help, down from 41 percent a year ago.
Assisting consumers takes longer--and more brainpower--than anticipated
Connect for Health Colorado interim CEO Gary Drewes said the state's exchange does not get revenue when it assists consumers who end up purchasing Medicaid coverage. Additionally, state officials noted that, when helping some 10,000 callers who experienced difficulties, it took an about three to four hours to resolve a problem. While offering one-call resolution would be more helpful, the article mentioned, it would also force the state to dish out more money to hire staff.
The role of insurance brokers in the industry has been debated. While it's possible that the Small Business Health Options Program insurance exchanges were meant to replace brokers, it's also possible that brokers may be essential to exchanges, FierceHealthPayer previously reported.
For more:
- here's the LifeHealthPro article