Agent's Role in Covered California
CAHBA provides a way for consumers to get advice in selecting health care coverage through Covered California with the help of a licensed health insurance agent. Our Find-a-Pro application will make it easy for consumers to connect with a local agent who will be a trained, certified, and contracted with Covered California. A consumer can read the agent profile and contact the agent directly by phone, e-mail, or agent website. Any business the agent writes is 100% his or hers. CAHBA does not share in the commission. Local agent ads are free until October 1, 2013. Start now by registering your agent profile.
Role of Agents in the Exchange
Covered California will work with licensed agents (aka brokers) who assist consumers in completing the eligibility application, comparing and selecting qualified health plans (QHPs), and enrolling consumers through the exchange. Agent compensation for working with consumers in the Covered California marketplace will depend on following the procedures outlined below.
Certification by Covered California
All agents must be certified with Covered California so that they may assist qualified individuals for individual Marketplace coverage. In completing the registration process, the agent or broker will:
- Confirm his or her identity by answering a number of simple questions online.
- Complete an agent-specific training course including passing an examination.
- Sign Covered California Agent Agreement. Agree to comply with federal and state laws, rules, standards and policies, including those related to privacy and security policies, as a condition of working with consumers in the exchange. Agent Agreement.pdf
Once an agent has completed these three steps, he or she will receive an active Covered California user ID. This user ID is the agent’s unique identifier in the exchange, and it will be essential for the agent to receive compensation from an issuer.
Exchange Pathway for Assisting Consumers
Agents will also be able to assist consumers directly on the exchange website using the exchange portal pathway. Agents and brokers will be able to use this pathway to help enroll qualified individuals with individual exchange options, as well as qualified employers and employees with SHOP options. In the Covered California pathway, the consumer, employer, or employee will log directly into his or her own exchange account. The agent or broker may assist the consumer in creating his or her account, but the consumer or a legally authorized representative must create his or her own exchange username and password and should not share this information with third parties, including their agent.
The agent will then work with the consumer to complete the eligibility application. The consumer will be prompted to enter the agent name on the application to indicate that the agent or assisted the consumer. After the consumer receives an eligibility determination, the agent or broker can advise the consumer in comparing QHPs on the Covered California website and submitting the consumer’s selection. All plan choices will be displayed. As with the eligibility application, the consumer will enter the agent’s or broker’s exchange user ID as part of the enrollment transaction to indicate that the agent or broker assisted the consumer with plan selection and enrollment.