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 Regulators Ease Agents’ Concerns On Future Health Care Role 

 
Published 7/23/2010 

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NU Online News Service, July 23, 3:32 p.m. EDT

WASHINGTON—The National Association of Insurance Commissioners (NAIC) has created a task force to examine ways of ensuring that agents continue to be involved in the health insurance market even after the new health care exchange concept starts in 2014.

Sandy Praeger, Kansas insurance commissioner and chair of the NAIC health care task force, supported that goal during a meeting of several commissioners with reporters at a conference on health care law implementation held by the NAIC Thursday and Friday in Washington.

Kevin McCarty, Florida insurance commissioner, said, “A number of us feel very strongly about the important role agents play in providing advice and counsel to thousands of Floridians and Americans across the country in making critical health care decisions.”

Under the new law, administrative and other costs must be limited to 15 percent, and the medical loss ratio (MLR) must be 85 percent of premiums.

The problem for agents is that currently, sale of small group and individual policies earn commissions as high as 20 percent.

Representatives of agent groups—specifically the National Association of Health Underwriters, the Independent Agents and Brokers of America, and the National Association of Insurance and Financial Advisors—have been working with the state commissioners in order to ensure that their role in the health care industry is assured going forward.

Mr. McCarty said that some people have said the insurance exchange program will lessen the role of agents.

“I disagree with that,” he said. “Agents serve as a valuable tool” in providing health care, and we are working to protect the integrity of the relationship.”

Mr. McCarty noted, however, that the state commissioners will seek to do that “while maintaining the transparency and integrity of the new law.”

He added that agents provide comprehensive advice when selling and servicing health insurance policies. He said that comparing “buying an airline ticket with purchasing something as complicated as health insurance is not a fair comparison.”

According to Jane Cline, West Virginia insurance commissioner and president of the NAIC, the MLR regulations must be in place before Dec. 31.

The commissioners brought up several issues in their meeting with reporters and noted that they are working hard with state Medicaid directors, state Departments of Health, and other regulators to reach consensus on regulations governing components of the health care bill.

Under the law, the state commissioners make recommendations on how to implement certain provisions of the Affordable Healthcare law, which must then be approved or modified by the Department of Health and Human Services.



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    • 7/23/2010 4:01:42 PM
    • Dave Sherrill
    • Corrections
    • The MLR requirement in the new law is only 85% for large groups. It is 80% for small group and individual. Individual products currently pay as much as 20% first year commission, but small group products do not pay nearly that much. These MLR requirements will make it very difficult for insurance companies to remain in the health insurance market.
    • 7/24/2010 6:49:01 PM
    • Julie
    • Health insurance in Nevada and other states
    • The role of the agent is vital. We just moved to Nevada and where lucky enough while searching the internet to find an outstanding site called NevadaHealth.com, it compared all the rates and health plans in Las Vegas and I was able to pick the phone and talk with a live agent to help us choose the correct plan. I don't think this country can afford to lose more jobs you have literaly millions of agents or staff that work with health plans. Could you imagine if they got rid of everyone. I guess my question is who is going to answer my questions about health plans when there is no agent. They have to hire someone and the money is going to have to come from somewhere.. Just my 4 cents on the subject.
    • 7/25/2010 12:04:23 PM
    • Jeremy Engdahl-Johnson
    • Being prepared
    • PPACA requires state exchanges by 2014. What to know in 2010? Underlying complexity will sneak up on the unprepared - http://www.healthcaretownhall.com/?p=2875

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