HAFA takes legal action against New York state

Health Agents for America, along with members of the independent health insurance agent community, is taking legal action against New York state following the decision to eliminate commissions for agents assisting consumers with enrollments on that state’s Affordable Care Act exchange.

New York issued a directive, implemented Jan. 1, that prohibits insurance companies doing business in New York from paying commissions to agents and brokers who enroll or renew consumers in essential plans in that state’s ACA marketplace.

The verified petition was filed April 25 in the Supreme Court of New York, County of New York on behalf of HAFA and four health insurance agents. Defendants in the case are NY State of Health (New York state’s official ACA marketplace), the New York State Department of Financial Services, New York Superintendent of Financial Services Kaitlin Asrow and New York Commissioner of Health James McDonald.

The petition said that in March, the four health insurance agents - Tania Moreira, Maria Isabel Garcia, Belkys Martinez and Alexandra Montanez – began to lose access to the NY State of Health broker portal. Their clients were reassigned to one or more agents of the NY State of Health without the consent of the four petitioner agents or their clients.  The four agents contend that this action interfered with an existing contract between them and each of their clients.

New York’s actions constitute a legislative rule or policy change that affects insurance carriers, agents and brokers across New York state, the petition said.

HAFA and the agents were not provided notice, explanation or an opportunity to comment or be heard before the imposition or enforcement of this new policy, the petition said.

In addition, New York locked brokers out of their portals on the exchange platform and assigned their clients to agents of the exchange, without prior notice or consent, the petitioners contend.

The four agents and HAFA seek annulment of New York’s policies, as well as a temporary restraining order and a preliminary injunction barring enforcement of New York’s prohibition on agent commissions.

HAFA seeking end of commission ban

HAFA and the agents also seek a special proceeding to review and annul New York’s directive that prohibits insurance companies doing business in New York from paying commissions to agents and brokers who enroll or renew consumers in essential plans in that state’s ACA marketplace. The petitioners also ask the court to reverse the state’s removal of the brokers as agents of record for their clients.

The petition states that the commission ban, as well as the exchange’s taking of the brokers’ clients, “is effectively a ban on petitioner brokers' participation in the state marketplace regarding the enrollment of consumers in essential plans.” The petition also states that the brokers and carriers had valid contracts specifying commissions to be paid for marketplace enrollments.

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Susan Rupe is editor in chief, magazine, for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].