The IAA One Minute Blog

On Monday, March 12, 2012, the Department of Health and Human Services (HHS) published final rules on health insurance exchanges. The exchanges are a major part of the Affordable Care Act and are meant to provide competitive marketplaces for individuals and small employers to directly compare available private health insurance options. Insurance Administrator of America is here to let you in on the details of the exchanges and how these exchanges will affect you.

States Set Up Their Own Exchanges

In an effort to make exchanges as flexible as possible, the final rules allow states to structure exchanges in their own way. States can decide on whether they want their exchange: as a non-profit entity established by the state, as an independent public agency, or as part of an existing agency.

Exchanges will need to carry out a multitude of functions:

• Certifying health plans as qualified health plans offered in the exchange
• Operating a website to facilitate comparisons among qualified health plans for consumers
• Operating a toll-free hotline for consumer support
• Determining eligibility of consumers for enrollment in qualified health plans and insurance affordability programs
• Facilitating enrollment of consumers in qualified health plans

States will have flexibility in how they will perform these duties.

According to the Affordable Care Act, a state's exchange plan must be approved by HHS by January 1, 2013. The final rule on March 12 allows for states to have conditional approval if a state shows advanced preparation, but cannot demonstrate complete readiness by January 1, 2013. An important point to note however is the federal government will come in and set up exchanges for states refusing to do so. No state will be allowed to not have an exchange.

The New Role of Agents and Brokers

One of the key words that have been thrown around with the exchange program is "navigator". According to the Affordable Care Act, navigators will educate and inform health insurance consumers and assist them in navigating the exchanges.

While agents and brokers can become navigators, the final rules do not allow states to require navigators to be licensed agents or brokers. In this new world of health insurance, agents and brokers must show how important it is to have a licensed agent or broker working as a navigator.

Although the information above may seem alarming, IAA wants to assure you that there is a place for agents and brokers within these new exchanges. The final rules recognize that agents and brokers have the ability to play an active role in marketing exchange products. It is well known that support from agents and brokers is fundamental for these exchanges to prosper.

What IAA has to Say

Health insurance is continually evolving and IAA wants to make sure you understand how you will be affected. While health insurance may be changing, IAA will always be on your side. Always here, always working for you.

If you want to read more about the Affordable Care Act click here and here.