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Brokers are reluctant players in challenging health care coverage enrollment season

Julie Appleby, Kaiser Health News on

Published in Health & Fitness

"Yes, health insurance is complicated," said Lisa Hamler-Fugitt, executive director for the Ohio Association of Foodbanks, which provided such help for the past four years through federal grant-funded navigator programs in the state. Navigators are trained individuals or groups that guide consumers and small businesses through the process, for free.

"(Customers) didn't turn to us just during open enrollment, but also when they had questions about how to use their plan, about deductibles and copayments."

This year is different.

The Trump administration, criticizing the navigator effort nationwide, slashed funding. The Ohio program learned it would get a 71 percent cut and reluctantly closed its doors for this enrollment season.

There were also cuts to other states, which varied, but averaged 40 percent nationally. In Tennessee, for example, navigator funding was reduced by 16 percent, while in Indiana it fell 82 percent.

The Department of Health and Human Services appears to be turning to brokers to fill this gap. It announced in late October that the federal online marketplace, healthcare.gov, has a new resource under its "Find Local Help" tab. Consumers can enter their contact information in the "Help On Demand" feature -- and get a call back from a state licensed broker.

 

It isn't known how many brokers signed up to participate, but agent John Dodd thinks it's a good idea.

"This move of working more with brokers will help make up some of the difference (from losing the navigator program), although anytime you remove help, that's not a positive step," said Dodd, president-elect of the Ohio Association of Health Underwriters and owner of his own agency in Westerville.

But growing pressure on brokers -- from smaller commissions to increased complexity of the health offerings -- means they may be harder to find.

Last year, several big Blue Cross Blue Shield insurers cut or reduced their commissions, citing it as a cost-cutting move, following a similar action in 2015 by UnitedHealthcare. Some brokers then began charging a fee to help people enroll, while others stopped entirely.

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