Brokers and other experts shot down an initial vision for “navigators” to assist consumers purchasing insurance under federal health reform, suggesting the new advisors will be ill equipped to grasp the sheer volume of knowledge they will need to steer buyers on the right path.
A panel is addressing how insurance agents and brokers will operate with the Connecticut Health Insurance Exchange under development, which will function as a central marketplace for buyers and sellers of insurance.
The federal Affordable Care Act envisions groups of navigators out in the marketplace ”“ the law allows for compensated or volunteer individuals or organizations ”“ helping companies and workers through the new system that will be in place as of January 2014, if not before.
There would be two tiers of navigators ”“ those who are out raising awareness and distributing materials to include premium tax credits, as well as a group that could actually facilitate enrollment in health plans.
Those navigators would be required to complete a certification with the Connecticut Insurance Department, a requirement involving testing but not as rigorous as the licensing requirements brokers and agents must complete.
Several panelists warned that the Connecticut Health Insurance Exchange is putting too large a set of expectations on those in the first tier.
“If you have someone who doesn”™t know health insurance and you are going to provide them (what) looks like a two-day training program and expect them to deal with items one through nine there ”“ it ain”™t happening,” said Mickey Herbert, the former CEO of ConnectiCare Inc. who is chairing the panel. “It”™s way too complex a subject for someone to grasp all of that in a simple, two-day training program unless they”™ve got a heck of a background in insurance before they even walk in.”
Claudia Epright, a Meriden resident with extensive experience in training programs for the state Medicaid and HUSKY insurance programs, said state workers required a full month of training to master the topic of determining HUSKY eligibility alone, and estimated it will take six months to prepare a navigator workforce.
The Connecticut Health Insurance Exchange envisions a list of approved brokers that navigators could steer queries to for complex, technical questions they are not equipped to handle. Navigators would be prohibited, however, from providing any specific recommendation that relates to either a carrier or a specific plan, according to Jason Madrak, director of consumer marketing for the Connecticut Health Insurance Exchange.
Madrak added that the state will likely rely on third-party organizations to recruit and manage navigators. Barbara Saxton, a benefits practice leader for HUB International Ltd., suggested the Connecticut Health Insurance Exchange was overlooking an obvious candidate for the job in member enrollment companies that help insurance carriers sign up workers into their health plans.
“If an organization ”¦ is already set up and established and wants to knock on our door and say that they would love to serve as a navigator in that capacity, we won”™t be turning folks away,” Madrak said.
Madrak said it would be up to the organizations selected to recruit a navigator workforce, with some worried about quality control given the uncertain funding pipeline for the Connecticut Health Insurance Exchange after it uses up its allotted federal funding.
“You could have some interesting scenarios arise out of that,” said Barbara Saxton, a benefits practice leader for HUB International Ltd., an insurance brokerage company.
“People really just don”™t understand any of this. So how do you manage that, monitor that?”
Even as they impart advice on insurance, navigators should have their own insurance policies in place ”“ on the errors and omissions liability front, anyway, according to John Calkins Jr., vice president of Watertown-based Bozzuto Associates Inc.
“We are dealing with some very sensitive (information), not only HIPAA but financially sensitive information ”¦ that could be used and abused,” Calkins said.
