Question: How do you see the agent completing an enrollment in the Exchange? Will we be able to enroll subsidized members? What about our existing individual members?
Answer: It remains to be seen how the Exchange guides enrollments from the carrier and agent channels. The best I can do at this point is provide some likely scenarios.
- Only a contracted carrier or the Exchange itself - acting as administrator for the carrier - can complete an enrollment. Agents and Navigators involved in outreach, education, and pre-screening will complete an application for enrollment and submit it to the Exchange.
- Agents and Navigators could pre-screen individual health insurance applicants for eligibility for subsidized coverage in the Exchange or Medical, and transmit pre-populated applications and a warm hand-off to Exchange staff to complete enrollment.
- Contracting carriers could partner with the Exchange in enrolling both current members who are subsidy-eligible, and new subsidy-eligible members that the carrier identifies as part of the its marketing efforts. This is a cost-effective means to provide a sizable portion of the Exchange’s projected first year enrollment.
The process we envision would be similar to the current method submitting an online application to a carrier for underwriting, Of course, post reform there will be no medical underwriting, but financial underwriting in its place.