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PPACA and the Technology to Help Brokers Thrive

Healthcare reform continues to offer a few sobering facts for brokers. The 80 percent minimum medical loss ratio– for individual and small group insurers–will continue to squeeze commissions, and advances now are a thing of the past, while the workload is as high as it’s ever been. New sales distribution channels, including private exchanges and federally-mandated state exchanges, provide consumers with new choices that may or may not include a broker. Renewals and new sales will be more complicated as consumers take a closer look at insurance, many for the first time.

Over the past six years the individual marketplace has increased by 80 percent and will continue to increase as the individual mandate sends approximately 30 million Americans to the market as first-time buyers who need help navigating their options. Even if the Supreme Court decision affects the individual mandate, the spotlight remains on the need for insurance, and these needs will only continue to grow. In either scenario, brokers will be relied upon to bring expert knowledge to a confused marketplace and continue to serve as valued advisors.

Updates to the Patient Protection and Affordable Care Act highlight the ability for states to permit agents and brokers to assist individuals, employees, and employers with enrollment into qualified health plans.  PPACA also speaks directly to the requirements placed upon any online tools offered by brokers and details the standards that are expected to be met with regard to:

  • Disclosure of Qualified Health Plan (QHP) information
  • Ability to view all QHPs offered through the exchange
  • Displaying all QHP data provided by the Exchange
  • Maintaining records in electronic format
  • Providing consumers with an option to withdraw from the process

The technology to help brokers sell and retain more business and to thrive in a post-reform environment is available now and essential to future growth.

Health insurance products can be complex and expensive, and decisions are consequential, so consumers need to know what they’re buying before they commit.  Knowledgeable brokers need to align themselves with the proper online tool set to support, guide, and educate while providing consumers with the necessary plan comparisons.

Electronic quoting provides benefits that will make it easy for consumers to generate quick and accurate insurance quotes, while enhancing the consumer experience and increasing online education. By eliminating the more manual processes of health insurance quoting, brokers will realize significant benefits, including an accelerated response time, an increase in broker revenue, and an improved end-to-end workflow, while helping to reduce distribution costs.  Electronic quoting simplifies the business process while enriching the all-important relationship between the consumer and broker.

Brokers need to keep things as simple as possible and provide consumers with a fast and easy way to generate plans and rates from a single page, generate a quick, preliminary, or final quote, and allow the output to be directly delivered. Brokers can further enhance the electronic quoting experience by providing consumers with multiple benefits for comparison– inclusive of the individual product details and benefit level pricing.

Following in the footsteps of electronic quoting, online enrollment should make the process of understanding and applying for health insurance less complicated.  By including real-time educational tools, brokers should see a reduction in the total number of enrollment errors, call-center volume, and drop-offs. Enrollment needs to be a seamless process from quote to enrollment, giving consumers an easy and, more importantly, less stressful experience. Providing end-to-end administration of the application and initial enrollment process will ultimately help to streamline what was previously thought of as a time-consuming step. Online enrollment, when done properly, will reduce administrative time and errors and create a more efficient enrollment process.

Whether for an individual employee or small or large group, the online enrollment process should consistently follow the same steps as often as possible. As an electronic enrollment proceeds, the application should have the ability to change dynamically as information is entered. Only the information pertinent to the applicant should be used to determine whether the applicant is eligible for the plan in question. Just as important, once the process has been started, customers need to be able to access their applications at a later time to complete.

Consumers will continue to go online to access information in increasing numbers, and brokers can be their primary resource to guide them through the changing health insurance landscape. Efficiency is key here. Brokers need to take advantage of an online platform that shortens the sales cycle time and minimizes administrative costs. And let’s not forget about ancillary products. Reform governs health insurance, so these other lines will continue to provide valuable opportunities to cross or up-sell products that may be more profitable. The ability to act as educator and advisor is the broker’s advantage because customer service and ongoing relationships allow for that level of differentiation.

About Bob Barry

Bob Barry
  Bob Barry is the Senior Vice-President of Product and Market Strategy at Connecture (www.connecture), where he is responsible for identifying market needs that InsureAdvantage solutions can serve. He began working in the insurance technology industry in 1998 and has over 26 years of experience in the health and life insurance industry. He understands the challenges of health plans, particularly when it comes to automating their sales processes, and he reaches out to brokers, prospects, and members to complete business online, and has been helping provide solutions to them for over 10 years. 

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