Enrollment by agents and brokers: Agents and brokers can assist with qualified health plan enrollments without being navigators, if states permit this. An agent or broker that enrolls individuals in qualified health plans through an exchang e must first enter into a formal agreement with an exchange. At a minimum, the agreement must require the producer to register with the exchange, receive training about qualified health plans and about insurance affordability programs, and comply with privacy and security standards. When an agent or broker enrolls someone in a qualified health pl an through the exchange, the agent or broker must ensure that the applicant completes the application on the exchange website and completes the eligibility verificati on process. Ultimately, the exchange—not the agent or broker—transmits enrollment information to the selected plan. If a producer’s website is used to display the choices of qualified health plans, that website must meet certain standards, including that it display all of the qualified health plans offered by the exchange. (45 CFR §155.220) The interim final federal rule says that agents and brokers that meet certain standards (including having an agreement with the exchange) can also assist individuals in applying for advance premium credits and cost-sharing reductions
Posted on: Mon, 08 Jul 2013 19:01:01 +0000
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