5 Reasons Health Insurance Brokers Become Even More Important in 2017
Bret Roebling December 29, 2015
The Affordable Care Act (ACA) presents opportunities, and uncertainties, to health insurance agents and brokers. Yet as the ACA continues to roll out, it's becoming clear that health insurance brokers are needed to help consumers and small businesses navigate the changing regulations, health plan choices, and enrollment process.
Here are Five reasons health insurance brokers stand to become even more important to consumers.
1. A lot more individuals will be buying coverage - for the first time
With the individual mandate, the individual health insurance tax credits, and the new individual health insurance marketplaces, a lot more people are buying individual coverage. And a lot more people are talking about health insurance.
So where do brokers fit in? Currently, studies estimate that only 56% of individuals work with a health insurance broker to purchase individual health insurance. And yet looking at 2015 consumer enrollment numbers, there is still a disconnection between uninsured Americans who look up health insurance.
2. Some current health plans have being extended
This adds another cog into the decision-making process for consumers, and another area where health insurance brokers can be very helpful. Can I now keep my current plan? How does my current plan compare with an ACA plan? What is the cost comparison (with and without the tax credits)? What are the different doctor networks?
Bottom line: Health insurance brokers are even more important to consumers as health reform regulations are a moving target. Health insurance brokers can help consumers find the best plan for their needs, at the best price.
3. A lot more small businesses will be buying health benefits for the first time, too
Health insurance brokers become more important in the small group market as well. Small businesses are relying on brokers to evaluate new options for coverage. Small businesses (with fewer than 50 employees) are not mandated by the ACA to offer traditional health insurance by 2015, or pay the "employer shared responsibility fees". So many small businesses are turning to brokers to explore more affordable alternatives to traditional health insurance. A recent study found that health insurance brokers are associated with more, cheaper health coverage.
Bottom line: Health insurance brokers who have a variety of options for small businesses, and an expertise in health reform, will gain and retain the business of small groups in 2015.
4. SHOP enrollment can be through health insurance brokers in 2016
This ACA delay makes health insurance brokers more central in the SHOP exchange, and the process is similar to how businesses purchase small group coverage today.
Bottom line: Health insurance brokers will play a more important role with the SHOP exchanges in 2016.
5. Small businesses need (and want) help navigating health reform
Health insurance brokers who can help businesses navigate health reform will thrive in 2016. Nationwide companies found that employers look for these top five features when selecting an employee benefits broker:
Managing health care costs
Keeping in compliance and up to date on changing legislation, including health care reform
Benefits administration and employee benefits education
Keeping up to date on regulatory changes
Controlling workers’ compensation costs and managing exposures
Bottom line: Businesses need a health reform expert to navigate regulations. Many brokers are filling this role as a consultant - and billing for it.
6. Health insurance brokers have more experience than "navigators"
Navigators are people and organizations hired by the public health insurance exchanges to help consumers learn about exchange health plans and enroll in coverage. However, the navigator programs are under the spotlight this week, with news of navigator program scandals.
Bottom line: Health insurance brokers are generally licensed, experienced professionals.Type your paragraph here.
Medicare prescription drug premiums projected to remain stable
On the eve of the 50th anniversary of the signing of Medicare and Medicaid into law, the Centers for Medicare & Medicaid Services (CMS) projected today that the average premium for a basic Medicare Part D prescription drug plan in 2016 will remain stable, at an estimated $32.50 per month.
“Seniors and people with disabilities are continuing to benefit from stable prescription drug premiums and a competitive and transparent marketplace for Medicare drug plans,” said acting CMS Administrator Andy Slavitt. “While this is good news, we must ensure that Medicare Part D remains affordable for Medicare beneficiaries so that they can have access to the prescription drugs that they need.”
This news comes despite the fact that total Part D costs per capita grew by almost 11 percent in 2014, driven largely by high cost specialty drugs and their effect on spending in the catastrophic benefit phase. As the Medicare Payment Advisory Commission (MedPAC) recently reported, total Medicare payments to plans for reinsurance have grown by more than three times the pace of premium growth.
However, growth in per-Medicare enrollee spending continues to be historically low, averaging 1.3 percent over the last five years. The recent 2015 Medicare Trustees report projected that the Medicare Trust Fund will remain solvent until 2030, thirteen years longer than they projected in 2009, prior to passage of the Affordable Care Act (ACA).
Seniors and people with disabilities are continuing to see savings on out of pocket drug costs as the ACA closes the Part D donut hole over time. Since the enactment of the ACA, more than 9.4 million seniors and people with disabilities havesaved over $15 billion on prescription drugs, an average of $1,598 per beneficiary.
For the past five years – for plan years 2011-2015 – the average Medicare Part D monthly premium for a basic plan has been between $30 and $32. Today’s projection for the average premium for 2016 is based on bids submitted by drug and health plans for basic drug coverage for the 2016 benefit year and calculated by the independent CMS Office of the Actuary.
The upcoming annual open enrollment period – which begins October 15 and ends December 7 – allows people with Medicare to choose health and drug plans next year by comparing their current coverage and plan quality ratings to other plan offerings. New benefit choices are effective January 1, 2016.
To view the Part D Base Beneficiary Premium, the Part D National Average Monthly Bid Amount, the Part D Regional Low-Income Premium Subsidy Amounts, the De Minimis Amount, the Part D income-related monthly adjustment amounts, and the Medicare Advantage Regional Benchmarks, go to: http://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Ratebooks-and-Supporting-Data.html and select “2016.”
To learn more about the Medicare Part D prescription drug benefit, go to: http://www.medicare.gov/part-d/.
Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter @CMSgov
Health Insurance Quotes in 90 Seconds or less
Once you have health insurance, you must report changes to your income, household, address, and health coverage eligibility as soon as possible. These updates may change the coverage or savings you’re eligible for.
If your income goes up or you lose a member of your household: You may qualify for less savings than you’re getting now. If you don’t report the changes, you could wind up having to pay money back when you file your federal tax return for the year.
If your income goes down or you gain a household member: You could qualify for more savings than you’re getting now. This could lower the amount you pay in monthly premiums. You could also qualify for Medicaid or CHIP coverage.
If your change qualifies you for a Special Enrollment Period: Some life changes – like getting married, having a baby, or losing other health coverage – qualify you for a Special Enrollment Period. This means you can change health plans outside the annual Open Enrollment period.