CMS Releases Explanation of the Role of Agents, Brokers, and Web-brokers in Health Insurance Marketplaces

From the Desk of Larry Grudzien

Consumers who access health insurance coverage through an Affordable Insurance Exchange, or Health Insurance Marketplace, will be able to receive assistance in a variety of ways, including in-person, online, and through telephone support. Agents and brokers, including web-brokers, are among those who will play a role in educating consumers about Marketplaces and insurance affordability programs, and in helping consumers receive eligibility determinations, compare plans, and enroll in coverage.

In particular, CMS anticipates that agents and brokers will play a critical role in helping qualified employers and employees enroll in coverage through the Small Business Health Options Programs (SHOPs). Yesterday, CMS released a document explaining the role of agents, brokers, and web-brokers in health insurance marketplaces.

Section I of this explanation provides a high-level overview of the role of agents and brokers, including web-brokers, in Federally-facilitated Marketplaces and State Partnership Marketplaces. In section II, it addresses common questions raised by states and other stakeholders including State-based Marketplaces. In section III, it addresses questions specific to web-brokers. Finally, the Appendix includes process flows for both pathways.

To access this document, please click on the link below:

http://cciio.cms.gov/resources/regulations/Files/agent-broker-5-1-2013.pdf

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