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Advisors Get Resourceful While Dealing With Flawed System

Ask most health insurance advisors how successful they have been in obtaining coverage for clients since the online marketplaces went live, and they will reply with a hoot of laughter.

It turns out that most advisors have been no luckier than the average Joe in working their way through the balky online marketplace. While maintaining a sense of humor, advisors are as frustrated as the rest of the public over the missteps in the Affordable Care Act rollout. But although they were forced offline for a month while the ACA enrollment site underwent repairs, health insurance advisors are not sitting back and waiting for something to happen. They are doing what they always do: providing advice and engaging their clients while they are wondering what will happen next.

“We are in a bit of a holding pattern right now as far as doing anything on the [ACA] website is concerned,” said Liz Gallops, individual health insurance specialist with JBA Benefits in Raleigh, N.C. “It’s been a lot of ‘let me take your info and we will get you signed up when the website is working again.’ We reached the point where we just stopped trying to go online.”

Gallops said that about one-quarter of her company’s clients don’t qualify for federal subsidies to purchase health insurance, but they have been notified that their current health insurers are raising premiums significantly. “One strategy that we have been able to use for these clients is that we have been able to move them to a different carrier as of Dec. 1, 2013, in order to stave off a major premium increase for the next 11 months.”

In Roseburg, Ore., Kelsey Wood of Gordon Wood Insurance and Financial Services said that he has “never taken more applications for insurance in my life” as he has since Cover Oregon, his state’s insurance exchange, went online. “I hired two extra producers and opened a mall store,” he said.

“We’re supposed to be able to go to Cover Oregon’s website, log in a customer, set up an account, verify their identification – and none of that works,” he said. “We can go to the website and shop plans. It’s a wonderful shopping experience. But we haven’t been able to enroll anyone yet.”

When the online system fails, it’s time to fall back on the tried-and-true method of applying for insurance: pen and paper. That’s what Ken Statz, president of Statz and Associates in Brecksville, Ohio, is doing.

“We’ve taken the paper applications that the Department of Health and Human Services [HHS] provides, and we added our unique certification number and National Producer Number to them,” he said. “We began the process of getting paper applications out to those who want to enroll and taking their information, and then we will submit that information to HHS.”

Statz has been resourceful online as well as on paper. In essence, he has stepped in as an exchange. He said he has been able to calculate whether his clients are eligible for subsidies, and for how much, and then go to his carriers’ websites to compare prices on coverage at different “metal” levels (platinum, gold, silver and bronze).

For his group clients, Statz has been busy as well. “I have a group of 45 employees and they normally have a May 1 renewal date,” he said. “We were able to get them an early renewal [for] a better plan at an increase of only 6.7 percent, which is far less of a premium increase than they would have faced had they waited until May 1.”

Statz has been meeting individually with employees of some of his group clients, doing subsidy calculations on each employee to see how they might fare on the exchange. “I am spending a lot of time trying to be proactive and educate my individual and group clients on what’s coming,” he said. “For our individual clients, we are trying to get them information on their estimated subsidy.”

Ed Anderson of Hawkins Insurance Group in Edina, Mo., also has had to be resourceful while waiting for the ACA marketplace to be back in service. “I have been able to quote prices to clients through our Blue Cross marketplace and also to get clients information through the Kaiser Family Foundation website,” he said. “We also are handing out paper applications to collect information from clients.

“A lot of our people will qualify for a subsidy. We’ve had good results in getting subsidies for clients – but we just can’t get them verified online because the system isn’t working,” he lamented.

“We’re trying to work smarter, not harder” in the wake of the online delays, said Kelly Fristoe, owner of Financial Partners in Wichita Falls, Texas. One way in which he is keeping busy is by working with his group health clients. “We have two employee groups with Feb. 1 renewal dates. They already are facing very large rate increases. We were able to terminate their employer-based plan and make arrangements for me to educate their employees about purchasing insurance through the marketplace.

“I’ll be the guy that the employer reaches out to in order to educate the employees about coverage,” he said. “I want to help them get the most suitable plan for their needs.”

In Arkansas, a federal partnership has been set up so Medicaid-eligible residents can use federal funds to purchase health coverage. But the state’s online marketplace, Arkansas Connector, is experiencing logjams in getting applicants’ eligibility verified, said Cammie Scott, president of C.K. Harp and Associates of Springdale, Ark.

“So we’ve had to resort to doing things like faxing in [copies of] clients’ drivers licenses because we can’t get through online,” she said.

Minnesota’s exchange website, MNsure, has been working, albeit slowly, said Bob Quinlan of Quinlan Insurance and Financial Services in Winona, Minn. “But I have all my clients calling me now and asking, ‘What are my options?’ ” he said. “Even though coverage doesn’t take effect until Jan. 1, people want to know what’s available and how much it will cost.”

Further complicating the situation in his state, Quinlan said, was that personal information, such as the Social Security numbers of agentswho took online training to sell insurance in the MNsure marketplace, was compromised.

Even though federal officials say the ACA website will be fully functional by the end of November, some advisors are concerned about what will happen when the website woes are corrected and there is another rush of people applying for coverage.

“If things are not fixed by mid-November, I’m starting to get worried because then there’s not much time left to get coverage for those who need it by Jan. 1,” said Russ Childers, life and health insurance agent from Americus, Ga.

In the meantime, advisors are resigned to working with clients as best as they can while dealing with a cumbersome online enrollment system.

“It’s broken, it’s a mess, but we’re working with it,” Wood said. “That’s all we can do.”

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Follow her on Twitter @INNsusan. Contact her at [email protected].

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