Why your broker won’t help you get coverage…

From insurance Business America, 2/11/16:


The bad news for health insurance agents continues.

Earlier this week, three of the largest insurance companies in the country announced they would not be paying broker commissions for consumers that sign up for plans after the open enrollment season deadline.

Anthem, Aetna and Cigna announced the ban on broker commissions independently, hoping the actions would dissuade people from signing up for their individual marketplace plans outside of the designated period.

Additionally, Cigna and Humana announced they will no longer pay commissions on the more expensive “gold” plans sold through the Affordable Care Act marketplaces in an effort to encourage enrollment in cheaper, higher-deductible plans at the “silver” or “bronze” level.

The actions come amid criticism from insurers on “special enrollment periods” that allow consumers to shop for insurance outside of the designated window each year. Health insurers have said that consumers are using the provisions granting a special enrollment period – such as job loss or a move – to sign up for insurance when they are sick and plan to use healthcare services.

Because they cannot bar consumers from signing up, however, they are pushing back by dissuading agents – who have been instrumental in enrolling customers to their plans – from taking the time to do so.

Agents have suffered heavy commission losses from the “Top 5” health insurer already this year, with UnitedHealth Group first scaling back and then altogether eliminating compensation for brokers.

Just weeks after UnitedHealth’s announcement, Manhattan-based startup Oscar sent a letter to agents saying it will no longer be paying brokers $14 per contract per month for individual subscribers or $26 for enrolled families as planned. Instead, all Oscar policies will generate only $6 per contract per month regardless of people in the plan.

These decisions have led agents to readjust their business models. Many have elected to no longer assist clients who select Oscar or UnitedHealth plans, while others are focusing more heavily on other markets.