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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

When insurers pay commissions, the amounts are included in premiums and can be between 2 and 5 percent, depending on the carrier.

This year, "I'm still going to help my clients, but I'm not doing direct enrollments," said Nathans. He will refer customers who need this assistance to a colleague.

There are reasons why the enrollment process is a heavy lift.

Licensed insurance broker John Jaggi of Forsyth, Ill., said he and his daughter, Anne Petri, also a broker, often spend the first 35 minutes of appointments just helping clients figure out the math to determine if they can get a premium subsidy. People who qualify earn less than 400 percent of the federal poverty level ($48,240 for an individual) and don't have other coverage.

By that point, clients are exhausted and don't even want to talk about the details of the plan, Jaggi said. And he's paid "almost nothing" for his efforts.

Still, Jaggi and Petri plan to continue helping individuals with this year's enrollment.

 

A Trump administration decision in October likely has created even more demand for these services. President Donald Trump said then that he was stopping federal "cost-sharing reduction" payments to insurers. These payments were used to offset the costs of coverage for certain low-income policyholders by reducing their deductibles and copayments.

Even without the federal assistance, insurers are still required to provide these cost reductions. To make up for them, insurers boosted premiums, particularly in middle-level "silver" plans. Because the cost of these plans is also the benchmark used to set the tax-credit subsidy many people receive to help pay their premiums, eligible consumers will likely receive more federal assistance this year and have more affordable options from which to choose.

In other words, people who receive the tax credits are not likely to feel a financial pinch. People who don't, though, will likely take a hit.

"You have to feel bad for them," said Petri. "How can they afford another $100 to $200 a month in premium?"

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