Connect for Health Colorado and non-resident brokers

At today’s Connect for Health Colorado board meeting, there was some discussion over the issue of whether or not Colorado’s exchange should work with out-of-state web brokers. Here’s the background on the issue, and I want to clarify my position in case there was any confusion.

I’ve been a local broker in Colorado for 14 years. I pride myself on the personalized service that I provide to Colorado residents who are shopping for health insurance, and I absolutely believe that local brokers can provide higher quality customer service than a nationwide “big box” web broker. But some people don’t need much in the way of customer service. They know what sort of coverage they want, and they’re just trying to see their options, pick a plan, complete their enrollment, and get on with their day.

Some of those people end up using web brokers who are based in other states. Maybe they have prior experience with the website, maybe they used it when they previously lived in another state, or maybe they just found it on Google. Whatever the reason, people will continue to use big-box web brokers, regardless of our various opinions about the quality of their customer service.

My job as a broker involves providing the best possible service to Colorado residents who want help selecting and using a health insurance plan. But my volunteer position on the Connect for Health Colorado board of directors involves putting aside my own agenda and considering instead what’s best for the exchange, and for Colorado residents as a whole.

Obviously if I only considered my own best interests, I’d say that Connect for Health Colorado should only work with in-state brokers, as that would force Colorado residents who want a broker’s assistance to use me or one of my Colorado-based colleagues in order to get coverage through the exchange and have access to premium subsidies and cost-sharing reductions.

But let’s take a step back and consider the bigger picture. Connect for Health Colorado needs to enroll as many people as possible in order to be financially self-sustaining. From that perspective, an “all hands on deck” approach seems to make the most sense; ie, the more brokers who are working to enroll people, the more robust the exchange’s enrollment will be.

And from the perspective of Colorado residents, we need a “no wrong door” approach. There are still people who don’t know about the ACA’s premium subsidies, and there are people who don’t understand that if they enroll off-exchange during open enrollment and then have a drop in income later in the year, there’s no opportunity for them to recoup the premium subsidy they would have received if they had enrolled through the exchange.

If we go back to my first point – the fact that people are going to continue to use out-of-state web brokers to enroll in health plans, regardless of whether or not those web brokers can enroll people through the exchange – it makes sense that the most consumer-friendly approach is to make sure that people have access to enrollment through the exchange from as many avenues as possible.

Some brokers – both resident and non-resident – have no interest in working with the exchange, and their clients won’t have access to exchange plans (and subsidies) unless they switch brokers. But when brokers want to work with the exchange, it seems to run counter to the best interests of the exchange and consumers to deny those brokers access to the exchange.

If the Colorado Division of Insurance has deemed that a non-resident broker is licensed to sell plans in Colorado, and if the non-resident broker has satisfactorily completed Connect for Health Colorado’s training and certification, what more needs to be done? Are we saying that the DOI can license non-resident brokers to sell the exact same plans outside the exchange, but not in the exchange? If so, whose best interests are we considering?

Attempting to squash competition from web brokers might seem like it would help local brokers. But instead, it would result in lower total enrollment through Connect for Health Colorado in the long run, and would lead to consumers ending up with off-exchange plans and then finding out when they file their taxes that they could have received a tax credit… if they had gone through the exchange instead.

Again, a “no wrong door” approach is in the best interest of consumers. Do I think those consumers would be better served by a local broker? Obviously, yes. But if they’re going to use a non-resident web broker instead, that’s their prerogative. And if that web broker wanted the opportunity to be able to enroll those clients in exchange plans, and we deny them that opportunity, aren’t we doing those residents a disservice?