Brokers Positioned to Assume Key Role in SHOP Exchange Success

Thursday, May 28, 2015
Michael Gomes

Slowly, Exchange administrators and other public policy experts are realizing that Brokers need to assume a central role in the Exchange system going forward in order to optimize enrollment numbers. The synergistic relationship between Brokers and the Exchanges was recently highlighted in an article showcasing the importance of Broker services in ensuring that the Affordable Care Act’s (ACA) small business health options program (SHOP) succeed.  

Anya Rader Wallack, executive director of HealthSource Rhode Island, called Brokers an “untapped potential and key to our success in the future” of growing SHOP. She elaborated by mentioning that the SHOP Exchange in her state had about 500 employers with a little less than 4,000 employees. And while this is already more than double the numbers from 2014, Wallack noted that, “we have a good base to build on, but we are now looking how to use resources in a much more targeted way.”

Despite the agreement that Brokers need to be more involved though, obstacles and other challenges remain as to the best ways to include them in the Exchange process. Although some Exchanges do have positive relationships with Brokers that they are hoping to continue to foster, some Brokers feel negatively about Exchanges being in “their space”. However, the tide appears to turning towards a new appreciation of how Brokers may be the key to the survival of SHOP Exchanges. This matter was a hot topic of discussion among state health insurance exchange (HIX) executives at a recent policy conference.

The New Mexico Experience

Originally, New Mexico’s SHOP Exchange excluded Brokers from the selling process, understandably making many upset. Tensions were so high that they insisted that the Exchange go about the process without them. However, now the SHOP Exchange representatives “understand the important role Brokers play and encourage other Brokers to be part of the solutions and work with the exchange.”

Brokers are now asking for training so they can fully understand the insurance products being offered through the New Mexico Exchange. State officials admit there were not many training resources available for Brokers in the past, so this new initiative will focus on “robust marketing and targeted outreach, not only to brokers but small businesses around the state.”

SHOPS Need Broker Support

Even with training, Brokers still have a long road ahead of them in regard to boosting SHOP enrollment. For example, Dori Zweig wrote that, “So far, some states' SHOP enrollment numbers are dismal. For instance, Nevada's SHOP exchange--Nevada Health Link--enrolled only six individuals as of Feb. 22.”

“Continuing the conversation is crucial for enrollment success,” said Bruce Gilbert, executive director of Nevada Health Link. “It's imperative for state exchanges to communicate with agents and Brokers to come up with strategies for improving results.”

If a Broker is interested in pursuing work with their SHOP, they should first ensure that they are properly registered. The Centers for Medicare and Medicaid Services (CMS) has a resource so Brokers can double check this important information.

BenefitMall has been reporting on some of the rollout challenges associated with SHOP Exchanges for some time. We also recently reported on a RWJ and Urban Institute study that highlighted some of the challenges recently faced by Brokers and why the ACA administrators had marginalized their services early on. The good news is that many of these early missteps are now being corrected by federal and state officials.    

Stay Tuned

Stay tuned as we continued to discuss the ways in which Brokers can assist health insurance exchanges, as well as any other issues affecting Brokers.

The views expressed in this post do not necessarily reflect the official policy, position, or opinions of BenefitMall. This update is provided for informational purposes. Please consult with a licensed accountant or attorney regarding any legal and tax matters discussed herein.