Consumers, Brokers Say Connecticut Exchange’s Solution Is Inadequate

Unable to get her questions answered by the Access Health CT call center last year, Diane Lafferty did what 40 percent of exchange customers did and turned to an insurance broker for help.

"I have to say I don't know what I would have done without her help," Lafferty said of her broker.

A psychotherapist from Watertown who was setting up her own practice when she was applying for health insurance Lafferty said she would sit down with her broker and together they were able to get questions answered and get her insured.

But Lafferty and many other customers won't have that opportunity this year because the two private health insurance companies participating on the exchange, Anthem and ConnectiCare, both eliminated broker commissions from their proposed rate increases.

Access Health CT CEO James Wadleigh has been saying for months that he's working on a plan to help consumers enroll in a plan without the help of a broker. On Friday, that plan involved having Faneuil Inc., its new call center vendor, hire 20 licensed brokers.

But Lafferty and the broker community said it's not enough.

If 40 percent of the health exchange's business came from brokers last year that means more than 40,000 customers used a broker to sign up for a plan on the exchange. The 20 brokers hired by the call center vendor would need to service 2,000 customers a piece during open enrollment which is between Nov. 1, 2016, and Jan. 31, 2017. It's a task that is all but impossible.

According to an Access Health press release, the majority of the brokers will be placed in the call center while others will be working from two storefronts in New Britain and New Haven. In addition, a few will be kept on staff when open enrollment is complete to assist with special enrollments during the rest of the year.

There were at least 250 to 300 brokers available to sign up customers last year. Access Health CT officials said that not all of them were active in enrolling customers, but were available to offer the plans to their customers as an option.

Only licensed brokers are allowed to give consumers advice about which plan to choose and brokers are not allowed to accept a fee for any consumer who is receiving a subsidy through the exchange, according to Insurance Department regulations.

That means consumers may have a more difficult time this year picking a plan or even enrolling in one.

"Without a broker I would not have chosen the appropriate plan," Lafferty said.

John Calkins, a member of the Connecticut chapter of the National Association of Health Underwriters, called the decision "ridiculous."

Calkins said Access Health CT knew back in January that it was possible that insurance companies would fail to include broker commissions in their rates for on-exchange business. Instead of doing something about it, like California did by requiring the commissions be paid, they allowed it to happen, he said.

"It's discrimination," Calkins said. "If you have money and you don't qualify for a federal subsidy because you make more than 400 percent of the federal poverty level, then you're going to be able to use a broker."

He said "these poor people will have nowhere to turn."

Calkins pointed out that brokers are covered for errors and omissions for coverage, so the insurance guarantees that go with using a broker will also disappear. He predicted that not everyone who wants or needs a broker will get one because it would be numerically impossible for the 20 brokers to serve more than 40,000 consumers.

Calkins predicted there are going to be a lot of angry consumers calling a "1-800 number from hell," trying to get coverage.

By statute only licensed brokers are allowed to advise customers on plan choice.

"AHCT does not have control over the decision to pay or not pay broker commissions," Wadleigh said Monday. "Given that Open Enrollment is a month away, we made a decision to leverage our call center to hire approximately 20 brokers to serve our customers' needs. After open enrollment, we will take time to reassess and reevaluate our broker program to identify how we can best serve consumers in the ever-changing marketplace."