August 27, 2013
This is #8 in a series of Obamacare Reports. (See also postings by Mitchell Law Office)
The new Health Exchanges for the Affordable Care Act (ACA) are scheduled to become operational on October 1, 2013. Marketplaces will then become available for the competitive sales of health insurance policies.
Extensive arrangements are being made for insurance agents and brokers to receive special training and to register so that they may assist consumers in applying for and choosing health insurance.
Training and registration are soon to become available for navigators and certified application counselors (CACs). All of these procedures are being set up by the Department of Health and Human Services (HHS).
However, no training or registration pathway has been prepared for attorneys who wish to develop special qualifications to help clients deal with ACA and Exchange issues. This means that attorneys are “on their own” when preparing to provide advice to clients.
Insight into the scope of agent and broker training may be obtained by reviewing a set of slides prepared by HHS, dated August, 2013.
These slides apply specifically to training for the federal Exchanges (Federally-facilitated marketplaces, or FFMs) that cover about two-thirds of the states. However, many states are expected to allow similar support services for the remaining state Exchanges.
Licensed agents and brokers who complete training and registration, and obtain approval from state licensing boards, will be able to help individuals and small-business employers complete Exchange shopping and purchasing activities. Payment for services will be received through commissions from the insurance issuers.
The training and FFM agreements became available on August 1, 2013.
Training is to take place on the Medicare Learning Network (MLN); includes courses and exams; and will take about four hours to complete. A National Producer Number (NPN) is required to “log in”.
A series of courses may then be completed. Each course consists of a series of defined topics. Various types of agreements must also be signed. Certificates are provided for completion of each course.
An earlier HHS document from May, 2013, provides additional information about the roles of agents and brokers.
If consumers are determined to be eligible for an expanded Medicaid program (in about half of the states), agents and brokers are to refer the person to the appropriate state agency (and will not receive a commission).
It is not clear at this time how relationships will develop among attorneys; agents and brokers; navigators and CACs; and many other groups that will be giving advice regarding the ACA.
In many cases, cooperative relationships may be established. However, in other cases, conflict may result regarding primary responsibility for client representation.
More on these and related topics may be found in a recent book by the authors that describes implementation of the ACA and its impact on legal practices.
Previous installments of “Obamacare Reports” address the various ways in which implementation of the ACA is affecting legal practices: