Park City, Utah (PRWEB) May 18, 2013
Today, Zane Benefits, Inc. published a new information on insurance agents’ role in Marketplaces. Zane Benefits, which provides comprehensive and flexible alternatives to traditional employer sponsored health benefits, is the leader in health care reform, defined contribution and health reimbursement arrangements.
According to Zane Benefits’ website, the Department of Health and Human Services (HHS) recently released a much-anticipated statement and Q&A on the role of agents, brokers, and web-brokers in the health insurance Marketplaces.
According to HHS, individuals and small businesses who access health insurance coverage through their state Marketplace will be able to receive assistance in a variety of ways, including in-person, online, and phone support. The statement provides more information about how agents will register with the Marketplaces, assist consumers in applying for plans and receive commissions.
This statement relates mostly to the states defaulting to a federally-facilitated Marketplace (26 states at time of writing) or a state-federal partnership Marketplace (7 states). The 18 states planning for a state-based Marketplace are defining their own regulations and procedures.
Role of Agents in Health Insurance Marketplaces
According to Zane Benefits’ website and the HHS, agents and brokers (including web-brokers) will play a role in educating consumers about Marketplaces and insurance affordability programs, and will help consumers receive eligibility determinations, compare plans, and enroll in coverage. HHS anticipates that in addition to assisting individuals, agents and brokers will play a "critical role in helping qualified employers and employees enroll in coverage through the Small Business Health Options Programs (SHOPs)."
The release specified that agents and brokers intending to work with consumers in federally-facilitated and state-partnership Marketplaces will be able to enroll consumers in two ways: through an issuer’s website or through the Marketplace's website.
Either way the registered agent’s or broker’s identifying information will be passed along to the appropriate issuer to facilitate the issuer’s payment to the agent or broker for each enrollment transaction.
Agent Registration with the Health Insurance Marketplace
According to Zane Benefits’ website and the HHS, for the federally-facilitated or partnership Marketplaces, all agents and brokers must register with CMS so that they may assist qualified individuals for individual Marketplace coverage.
CMS expects that an online registration process will begin in the summer of 2013, prior to open enrollment in October 2013. The registration process will require the agent or broker to:
- Confirm identity by answering a number of simple questions online.
- Complete a Marketplace-specific online training course.
- Agree to comply with federal and state laws, rules, standards and policies, including those related to privacy and security policies, as a condition of working with consumers in the Marketplace.
Once registered, the agent or broker will receive a unique Marketplace user ID. This unique identifier, along with the agent’s or broker’s national producer number (NPN), will be used in issuing compensation from the issuer to the agent or broker.
Enrolling Consumers in the Health Insurance Marketplace via Issuers Website
According to Zane Benefits’ website and HHS, many agents and brokers already use issuer websites to assist consumers, and will be able to continue using issuer websites to work with consumers in the federally-facilitated Marketplaces. This issuer-based "pathway" will be available to agents and brokers who are assisting individual consumers starting in the fall of 2013.
HHS says "An agent or broker initiates this pathway by logging on to the issuer’s website. Once the consumer determines that he or she would like to apply for coverage through the federally-facilitated Marketplace, the agent or broker will be securely redirected from the issuer’s agent website to the Marketplace website to complete the eligibility application, using his or her federally-facilitated Marketplace user ID to access the Marketplace website. The agent or broker will be prompted to enter his or her federally-facilitated Marketplace user ID and NPN as part of the eligibility application."
About Zane Benefits
Zane Benefits was founded in 2006 to provide a revolutionized SaaS (Software-as-a-Service) administration platform ("ZaneHRA") for Health Reimbursement Arrangements (HRAs) and defined contribution health care. The flagship software provides a 100% paperless administration experience to employers and insurance professionals that want to offer better health benefits without a traditional group health insurance plan at lower costs. For more information about ZaneHRA, visit http://www.zanebenefits.com.