January 23, 2014

 MNsure Agents

Recent media reports have highlighted an issue regarding the role of agents and MNsure the state's health insurance exchange.  The initial roll-out of the MNsure has been a disaster not just for individuals trying to navigate the web site, but especially for agents who have been trying to assist persons in signing up online.


First, it is very difficult for a person to identify an agent or broker online.  The MNsure site does not provide links to certified agents as promised.  Instead, one may locate a PDF file listing agents who are certified by zip code.   The original idea of a "broker portal" which would allow agents and brokers access to their clients and the ability to monitor their progress during the application process is not available.  In the rush to meet the October deadline for enrollments, the broker portal fell through the cracks.  It won't be available for several months.


If you have been able to use the web site to enroll persons in MNsure health coverage you have probably been disappointed with the results.  Agents may help people to establish accounts, but once a person has been deemed to be eligible for either Medicaid or MinnesotaCare, there is no further role for an agent.  You cannot be paid to enroll person into public programs.   This is the role for MNsure assisters and navigators.   We have been told that federal law prohibits agents from acting as navigators or assisters.


All compensation to insurance agents and brokers must come from the companies for which they write business.  During the initial debates about the role for agents with the Affordable Care Act and eventually MNsure, the Agents Coalition for Health Care Reform lobbied to maintain the current license and reimbursements systems with carriers.  We did not wish to have agents work for or be agents of the insurance exchange nor have their reimbursement set at the same minimal fee that is being paid to assisters and navigators.   These lobbying efforts were successful and the role of the agent and the current system of independently appointed agents was maintained.   Unfortunately, the initial MNsure roll-out concentrated on the three fourths of applicants who qualify for state programs, and the role of agents in enrolling people in private insurance was less developed. 


Agents may only enroll individuals into health plans with carriers for which they have an active appointment.   In fact, you are required to disclose to potential MNsure policyholders the fact that you are not authorized to sell every plan on the exchange and that you may be compensated from the health plan that they choose.  This was part of the MNsure authorization law passed during the last legislative session.    Here is the language in that act:


Any insurance producer assisting an individual or small employer with purchasing coverage through the Minnesota Insurance Marketplace must disclose, orally and in writing, to the individual or small employer at the time of the first solicitation with the prospective purchaser the following:

(1) the health carriers and qualified health plans offered through the Minnesota Insurance Marketplace that the producer is authorized to sell, and that the producer may not be authorized to sell all the qualified health plans offered through the Minnesota Insurance Marketplace;

(2) that the producer may be receiving compensation from a health carrier for enrolling the individual or small employer into a particular health plan; and

(3) that information on all qualified health plans offered through the Minnesota Insurance Marketplace is available through the Minnesota Insurance Marketplace Web site.


Even though you have navigated the process for your clients you will have noted that the ability for someone to designate an agent or broker occurs very late in the application process.  Also, under the current system, it is impossible for a person to designate both a navigator and an agent on the same account.  So even if you referred by a MNsure assister to help someone with private insurance, you may not be able to even be identified on the account.  This is clearly a huge mistake.   MIIAB is working with MNsure executives and carriers to develop a standard "agent of record designation form" that would credit and compensate agents for their work.  This requires going back to good old fashion paper.


The MNsure executive leadership has changed.  There appears to be more appreciation of the prominent role agents can play in the success or failure of MNsure.  Agent groups have been meeting with MNsure to address our concerns.  In the meantime, the system is not working as planned, not only for agents, but everyone else. 


A recent report from an independent consultant suggests that the troubled online insurance marketplace be scrapped and that he state start over on its insurance exchange.   Will this occur?  We shall find out soon.  



Dominic Sposeto

MIIA Lobbyist


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