federal and ‘partnership’ exchanges”
“Similarly,” Mr. Miller added,
“NAIFA will work with the states to
help them create health insurance
exchanges that incorporate a mean-
ingful role for the agent.”
Jessica Waltman, senior vice
president of government affairs for
the National Association of Health
Underwriters, said that the group was
pleased that agents and brokers are
permitted to enroll independent of
the Navigator program.
She said that NAHU always interpreted the Patient Protection and Affordable Care Act always interpreted
PPACA as mandating that, but this
clarifies it.
She cautioned that what remains
open, however, is whether agents and
brokers will be allowed to determine
consumer eligibility for tax credits or
cost-savings, or whether the exchanges will be the sole determinant
of eligibility.
But, another legal analysis explicitly states that the final rule does not
allow agents or brokers to determine
eligibility for premium tax credits
or subsidies, but agents and brokers may assist with the application
process.
Waltman noted that the rules
involving agent participation are
interim final ones, with a 45-day comment period.
She said NAHU will concentrate in
its comment letter on ensuring that
this provision is proposed. “A priority will be ensuring that agents and
brokers will be able to determine
eligibility for cost-savings or subsidies,” she said.
Charles Symington, senior vice
president of government affairs for
the Independent Insurance Agents
and Brokers of America, added that
the IIABA was encouraged by the
administration’s recognition of the
important role agents and brokers
play in the health care marketplace,
and that the regulations give states at
least the option of allowing consum-
National Underwriter Life & Health • April 2012 46
ers access to trained, professional,
and accountable health insurance
advisors.
“The irony is that meanwhile,
consumer access is being severely
restricted to these advisors by the
administration’s Medical Loss Ratio
regulations,” Symington said.
At the same time, he said the IIABA
does have a number of initial concerns and questions regarding the
handling of the Navigator programs
in the exchanges.
“We will be seeking clarity on these
issues in the near future,” he said.
“A priority will
be ensuring
that agents and
brokers will be
able to deter-
mine eligibility
for cost-savings
With Great Power
Comes Great Flexibility
or subsidies.”
and with most Democratically-con-
trolled states placing an emphasis
on initial insurer participation rather
than restrictive control, “we think that
this rule sets the framework for more
market-driven exchanges than some
have feared.”
They cautioned that the regulation
merely provides a regulatory floor, and
