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Producers play a role in educating consumers about available insurance programs and guiding employers and employees through a critical period of change in the health care marketplace.
Qualified employers and employees may look to producers to help them enroll in coverage through the state or Federally-facilitated marketplaces. According to the Center for Consumer Information and Insurance Oversight:
"Agents and brokers intending to work with consumers in Federally-facilitated and State Partnership Marketplaces will be able to assist consumers in two ways: (a) an issuer-based pathway, through which an agent or broker uses an issuer’s website to assist the consumer; or (b) a Marketplace pathway, through which an agent or broker assists the consumer using the Marketplace website...both pathways will transmit to the Marketplace an agent’s or broker’s identifying information to the appropriate issuer to facilitate the issuer’s payment to the agent or broker for each enrollment transaction."
- States continue to license and regulate agents and brokers, including those who assist consumers in the Marketplace. States also continue to establish licensure and continuing education requirements for agents and brokers, and may require additional state-specific training as a condition of licensure.
- CMS is responsible for registering agents and brokers and conducting Marketplace-related training. Upon completion of the registration and training, agents and brokers complete a privacy and security agreement and obtain a Federally-facilitated Marketplace user ID.
- Agents and brokers who assist qualified small employers in enrolling through a Federally-facilitated SHOP use the Marketplace pathway; however, agents and brokers are not be required to obtain a Federally-facilitated Marketplace user ID. The SHOP application includes a field in which the employer or agent/broker can enter a Federally-facilitated Marketplace user ID (if applicable) and/or NPN. This information will be transmitted to the QHP issuer selected by the employer as part of the group enrollment.
- "The amount and terms of compensation (including appointments) will be negotiated between the agent/broker and issuer."
- "Agents/Brokers participating in an FFM or FF-SHOP should expect to be paid the same commission that issuers pay outside an FFM or FF-SHOP."
- "States that run their own Marketplace may appoint agents/brokers and pay commissions directly to producers."
Dominion continues to offer the provider networks, systems and products that you need today, and the administrative ease and peace of mind you will appreciate tomorrow. Contact your Dominion Sales Executive or our Group Service Center at 877.559.9624 for more information.