Washington Health Benefit Exchange
Board of Directors Presentation October 2018 as of: 9-26-18
Washington Health Benefit Exchange 201 2017-2018 2018 OE 5 5 - - PowerPoint PPT Presentation
Washington Health Benefit Exchange 201 2017-2018 2018 OE 5 5 Role o e of A Agen ents & Broker er Tec echnical A Advisory Committee ee Board of Directors Presentation October 2018 as of: 9-26-18 RAB/TAC M Members Nina
Board of Directors Presentation October 2018 as of: 9-26-18
▪ Nina Florenz Years of Industry Experience Kirkland Insurance Associates, Inc. XX ▪ David Preston Insurance Resource Group XX ▪ Harald Schot LifePlan Financial Inc. XX ▪ Jim Streitenberger Premera Blue Cross XX ▪ Ex-Officio: Jeff Baughman Office of the Insurance Commissioner XX ▪ Terry Hokinson Coordinated Care XX ▪ Jeffrey B. Johnson JBJ Insurance Group XX ▪ Rachel Lauser Applied Team Insurance XX ▪ Kimberly Sage (Kaiser)
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W A OR CA MT I D NV AZ UT W Y CO NM TX OK KS NE SD ND MN I A MO AR LA MS AL GA FL SC TN NC I L W I MI OH I N KY W V VA PA NY ME VT NH NJ DE MD W ashington D.C. MA CT RI AK HI
1179 /69766
1 / 12 14 / 164 33 / 513 4 / 56 212 / 878 9 / 5 5 / 18 2 /15 3 / 3 3 / 43 MD: (1 / 0) 11 /0 13 / 3 1 / 2 7 / 54 4 / 13 3 / 115 36 / 32 20 / 177 125 / 2421
1 / 0 1 / 0 2 / 0
▪ More brokers each year are having to make a decision if they can serve the individual market. ▪ Complex plan designs, Provider Networks / RX Formularies. ▪ Shorter OE, Overlapping OE with Medicare and Small Group. ▪ Inability to identify exchange clients that need assistance with renewals, CEV failure, Medicare. ▪ Consolidation of Agencies – Fewer brokers servicing more clients.
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▪ Agency Call Centers in other states tend to be staffed with seasonal help. ▪ Fewer brokers are available for face-to-face servicing. ▪ Many clients never partner with a broker after receiving services. ▪ Broker compensation - Lower / elimination of commissions, more brokers are charging fees. ▪ Fewer Brokers are staying engaged with the Exchange.
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▪ Advanced knowledge of insurance products, networks, Rx, and benefits that have a direct impact upon their choice of product, their wellbeing and financial situation. ▪ The ability to establish long term relationships. ▪ Healthcare advocacy. ▪ Very low cost distribution channel. ▪ Brokers are generally available nights and weekends. Many will schedule telephone appointments anytime that is convenient for the individual year around.
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▪ Brokers are licensed and can help individuals make informed
recommendations since they are not licensed. ▪ Brokers are part of the team of multiple resources available to individuals, HBE Customer Service, Navigators, Brokers and Store Fronts. ▪ Consumers look to brokers for validation of plan selection, physician networks and RX Formularies.
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▪ Broker compensation One time payment for Apple Health, CA model. Uncompensated work, is it fair? ▪ Exporting data from broker dashboards to better serve clients. ▪ Broker application link saves time / direct link. The Federal Hub now has this feature. ▪ Keep local brokers engaged in the individual market.
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▪ Brokers want to serve the individual market but they will need help. ▪ Many HBE resources are wasted on non productive brokers. ▪ ID core group of brokers and make them more efficient. ▪ Focus on time savers to service more consumers during OE. ▪ Improving the consumer and broker experience.
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Summary by Broker State
State Broker Count WAH QHP QDP
AZ 1 18 12 2 CA 33 346 513 49 CO 4 74 56 10 FL 5 9 18 2 GA 212 856 878 144 HI 1 ID 14 121 164 16 IL 9 1 5 IN 11 MD 1 5 MI 3 34 43 7 MN 3 3 MT 2 15 3 NM 4 31 13 1 NV 7 17 54 15 NY 1 2 OH 13 3 3 1 OR 125 1,606 2,421 275 PA 1 TX 20 228 177 13 UT 36 6 32 8 WA 1179 57,709 69,766 14,094 WI 2 WV 3 99 115 9
Totals 1690 61158 74295 14649
Numbers Customers Enrolled as a result of a Navigators or Brokers OE5
QHP Total Enrolled Applications 7,273 Helped by NAVIGATOR 851 11.70% Helped by BROKER 2,495 34.30% Helped by ACCT WORKER 284 3.90% Self Enrolled 3,643 50.09% WAH Total Enrolled Applications 2,706 Helped by NAVIGATOR 809 29.90% Helped by BROKER 422 15.59% Helped by ACCT WORKER 983 36.33% Self Enrolled 492 18.18%
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OE5 OE6 ▪ Applied Team Insurance Applied Team Insurance ▪ Vault Insurance and Investments Financial Designs, Inc ▪ GHB Insurance GHB Insurance ▪ Warshauser Agency Suzie Health Insurance ▪ Rice Insurance Rice Insurance ▪ First Premier Insurance Services Yakima Neighborhood Health Svc. ▪ FND Insurance & Financial Services Advisor Benefits ▪ Insurance IQ ▪ Financial Designs, Inc ▪ McGregor Insurance Agency ▪ Jung Park Insurance
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