Navigators – Coming to a Town Near You

At the beginning of the year I wrote about the turmoil facing the health insurance agents as the dawn of the “Obamacare” system was upon us.

The thinking has not changed. Articles have been popping up all over about what to expect and the changes that are coming. For our reps who are health agents the future is murky at best and dire at its worst. That is why we have been running a highly successful “transition training” class for all health agents who want to be prepared for the coming changes. This article from “Employee Benefit News” outlines one of the changes, Obama’s plan to use “Navigators” to guide consumers and educate them on their choices for health care.

Brokers Accepting Navigators as Reality

 By Gillian Roberts

June 26, 2013

Kelly Fristoe is an independent agent in Wichita   Falls, Texas. The outgoing president of the Texas Association of Health Underwriters has been engrained in his community selling insurance for nearly 23 years and knows the heart of his Texas towns. He can’t imagine a navigator being placed anywhere near his business area — a more rural part of Texas. “We have $8 million for navigators in Texas … I don’t expect that there will be a navigator in communities that’s less than 50,000,” he said during an interview at the National Association of Health Underwriters meeting in Atlanta this week.             

“Even if there is a navigator out by me, they’re not going to be able to handle the ranchers in remote areas,” he continued. “My opinion is that navigators will be focused on the inner city, focusing on the people who are not as interested in buying health insurance as the rural ranchers who also will qualify for subsidies.”

In April, the Obama administration announced $54 million in grants for the navigators, whose job will be to provide information about people’s options for coverage under the law, but not provide advice on which coverage to take. The navigators will not be licensed and will be paid hourly at a rate of around $28 – $46 per hour, according to NAHU leadership. CMS has repeatedly assured brokers and agents that they can become navigators if they would like, but they could not receive a commission for any insurance carrier from that point forward. CMS official Gary Cohen, head of the insurance oversight division, said in April that he’s confident brokers will continue to add value in the advice they give to U.S. citizens and employers of all types going into 2014.

At the NAHU conference this week, numerous brokers said that navigators couldn’t begin to replace the roles that they’ve held in their communities for years. Their question: What’s the point of them at all?

“My suspicion is that they won’t play a significant role in most marketplaces,” said NAHU’s new president, Tom Harte of Landmark Benefits in New Hampshire. “They’ll be accessible to those who need it, it may be that they’re more accessible to those people who are Medicaid eligible or need help with subsidies, but ultimately the broker is going to be providing that same service.”

Harte cautions that the details of the navigator program are still being rolled out state-by-state, but most state insurance commissioners will have a disclaimer that navigators will have to hand to a consumer stating that “I can’t tell you to pick plan A or plan B.”

Fristoe says it will be brokers like him who know the ins and outs of communities across the nation who will be taking care of people in remote areas, like the ranchers he discussed. He says he’s considering advising on a fee-based commission model and will take people like them to the public exchanges or find other appropriate private options for them.

About Jeffrey Berson

40 years in and around the industry has made Insurance a part of my DNA. I have had the pleasure of working with and for some of the greatest minds in our industry. My "Bersonal" View is an attempt to capture some of the best ideas, the best concepts and the best practices in a way that can lead to success for others. It will certainly be my point of view, so please...don't take it "Bersonal".
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