A New Market for Producers:
THE WASHINGTON HEALTH BENEFIT EXCHANGE
By Keith Bell, Director of the Small Business Health Options (SHOP), Washington Health Benefit Exchange
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any producers in our state have likely heard about some of the changes associated with the Affordable Care Act and are curious about how this will ultimately affect them and their business. A key component of the Affordable Care Act is the creation of health insurance marketplaces where people can go to easily shop for health plans and gain access to financial assistance from the federal government to help pay for their coverage, depending on their income level.
The Washington Health Benefit Exchange is a quasigovernmental agency created in 2011 to implement an online health insurance marketplace in our state. Known as Washington Healthplanfinder, the marketplace will allow individuals, families and small businesses to: • Make apples-to-apples comparison between Qualified Health Plans (QHPs) that meet minimum essential health benefits such as preventive care and vision services as outlined by the ACA. • Determine eligibility for federal tax credits or less expensive co-pays and deductibles. • Receive personal assistance finding, selecting and enrolling in the right health plan to meet their needs. The Exchange will offer plan products from the state’s leading health insurance carriers, but will also help determine state residents’ eligibility for Medicaid. Families with incomes between 138 – 400 percent of the Federal Poverty Level ($32,500 to $94,200 for a family of four) will be eligible for savings on their insurance premiums. A program for small employers (1-50 employees) called Washington Healthplanfinder Business will provide small businesses with new choices, including the ability for employers to offer their employees a single plan or from a range of plans within their budget. Employers can also choose the level of contribution toward their employees’ coverage and make a single monthly payment rather than making payments to multiple plans. Open enrollment through Washington Healthplanfinder begins on October 1, 2013 for coverage that begins January 1, 2014. 14
The Role of Producers in the Exchange The Exchange has designed its state-based insurance marketplace to allow producers to play a critical role in helping Washingtonians access health plans offered through the site. The marketplace will provide exclusive access to an untapped market of consumers and small businesses who may now be eligible for premium subsidies or tax credits to help pay for their insurance coverage. More than 280,000 individuals are expected to enroll through Washington Healthplanfinder in 2014, with 60 percent of those individuals previously uninsured. Producers may also work with existing clients to offer health insurance through Washington Healthplanfinder. The site will offer producers: • A password-protected login and dashboard to track their client database, client contact information and application status. • A unique profile for each producer in the Washington Healthplanfinder system will allow consumers and small businesses to easily locate them by name or zip code. • Customer service will be available to answer questions and provide support to producers as they work with clients. Producers who are authorized to sell Washington Healthplanfinder products will be able to present QHP offerings to individuals and small businesses in Washington State. Training and Compensation Licensed producers can become authorized to sell health plans offered on Washington Healthplanfinder upon completing a training course. Producers must also be appointed by respective health insurance carriers to sell specific plan products .The Exchange is currently developing a robust training course and training schedule to take place this coming summer to ensure preparation for open enrollment on October 1, 2013. Producers will receive compensation from their appointed carriers for sales of insurance plans offered on Washington Healthplanfinder. Health carriers are currently submitting their health plans and plan rates to be reviewed by the Washington State Office of the Insurance Commissioner in partnership with the Washington Health Benefit Exchange. These plans will be announced in late summer. For questions about how producers can get involved, please email producer@wahbexchange.org.