Brokers

Back in April, KFF reporter Julie Appleby wrote a stunner of a report about rogue agents switching ACA exchange enrollees to different policies without their knowledge or permission.

In response, a couple of weeks later the Centers for Medicare & Medicaid Services (CMS) issued a statement about the actions they're taking to resolve the issue,

and a month after that they issued a second update.

Last week CMS issued another update on the situation and actions they're taking to prevent this type of fraud:

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Over at the Wiley Online Library, Aleka Gurel, Director of Government Affairs at HealthSherpa, has published an excellent, in-the-weeds analysis of the history & impact of private insurance brokers & agents on ACA marketplace (on exchange) enrollment.

Here's an excerpt (note that this website is actually among the data sources she cites):

About a month ago, KFF reporter Julie Appleby wrote a stunner of a report about rogue agents switching ACA exchange enrollees to different policies without their knowledge or permission.

In response, a couple of weeks later the Centers for Medicare & Medicaid Services (CMS) issued a statement about the actions they're taking to resolve the issue.

Today they issued an update on that:

In response to the recent story by KFF reporter Julie Appleby about rogue agents switching ACA exchange enrollee plans without their knowledge or permission, the Centers for Medicare & Medicaid Services (CMS) have released a statement about the actions they're taking to resolve the issue:

CMS is committed to protecting consumers in the Marketplace. CMS has received reports of consumers in HealthCare.gov states whose coverage was switched by agents and brokers without their knowledge. In response, CMS is taking swift actions to protect consumers from unauthorized activity by agents and brokers, and to root out bad actors who are violating CMS rules.  

It's been a long time since I've reported on any significant cybersecurity problems at any of the ACA exchanges. The last one I can think of off the top of my head was nearly a decade ago, and even that was about how some early flaws had been fixed.

Still, this story by Julie Appleby of KFF definitely isn't good news:

Unauthorized enrollment or plan-switching is emerging as a serious challenge for the ACA, also known as Obamacare. Brokers say the ease with which rogue agents can get into policyholder accounts in the 32 states served by the federal marketplace plays a major role in the problem, according to an investigation by KFF Health News.

via Connect for Health Colorado, Colorado's ACA exchange:

Insurance Brokers and Enrollment Assisters Available across Colorado

DENVER— One way the state’s health insurance Marketplace serves Colorado’s health coverage needs is by providing a diverse network of experts who can help residents enroll in the best plan for them – and who can help for free any time of the year.

These experts are Connect for Health Colorado-certified Insurance Brokers and Enrollment Assisters, and they live and work everywhere across the state.

“Our certified experts are a valuable source of support for Coloradans,” said Connect for Health Colorado’s Chief Executive Officer, Kevin Patterson. “But they don’t just provide enrollment services; they offer a continuum of assistance. I encourage anyone who needs health insurance help to use a Connect for Health Colorado Assistance Site. We’re here to help you navigate anything that changes your situation, so that you can stay covered.”

More Assistance and Resources Than Ever Before

via the Centers for Medicare & Medicaid Services:

Today, the Centers for Medicare & Medicaid Services (CMS) posted Frequently Asked Questions (FAQs) regarding compensation paid by issuers to agents and brokers who assist consumers with enrollment during a Special Enrollment Period (SEP) or during Open Enrollment Periods (OEPs). The Biden-Harris Administration has made it a priority to provide those who are uninsured and underinsured with quality, affordable health care coverage and recognizes that agents and brokers play a vital role in helping consumers enroll in coverage that best fits their needs and budget.