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Some clarity, some unknowns on the professionals connecting people with coverage

In a session at AHIP’s Exchange Conference at Institute 2013 filled with as many questions as answers, Phil Boyle of Connecticut’s public exchange Access Health CT said stakeholders are in for an interesting year as major provisions of the Affordable Care Act are enacted. He and Diane Boyle (no relation), a vice president with the National Association of Insurance and Financial Advisors, sought to shed light on the roles of agents and brokers, navigators, in-person assisters and certified application counselors, all of whom will be involved with connecting people and policies. Uncertainties persist because states are still wrestling with the question of who does what and how, but Diane Boyle and Phil Boyle drew some important distinctions between the roles of agent/brokers and those of navigators and others who work to bring the uninsured into exchanges. Some key points: For agents and brokers, enrolling a consumer in insurance is really just the beginning of the relationship. Producers provide a host of other services that cannot be addressed by navigators and in-person assisters such as serving as claims advocates, handling benefits communications, helping consumers understand and possibly enhance their coverage, and helping place a policy in a larger financial planning context. This is a valued role that sets producers apart and is not going away. A primary goal of navigators and in-person assisters will be reaching populations whom producers may be unable to reach. “The role of the navigator is indeed to get people exposed to this whole new world that we have,” Diane Boyle said. Conversely, as subsidies become available to those who previously were unable to afford coverage, agents and brokers may be able to make inroads in these previously unreachable populations, the panelists said. Compensation “really is going to remain as it is today, as a relationship between the carrier and the agent,” Diane Boyle said. What exactly that looks like and whether it will trend down at all is still subject to uncertainty, and the panelists said the overall picture is evolving as states struggle to get exchanges up and running. Some channels will see little change. Diane Boyle contrasted established private exchanges used by producers with public marketplaces, indicating she didn’t expect the “tried and true” private exchanges to go anywhere. Similarly, producers will play a central role in Small Business Health Options Programs, she said. The overall competition landscape in states may change less than some people predict, Diane Boyle said, suggesting that public exchanges will mirror what individual states are accustomed to.