Filed Under:Your Practice, Regulatory

5 Questions: Are You Prepared for Health Insurance Exchanges?

Your expertise will help set you apart from your upcoming competition

The Patient Protection and Affordable Care Act (PPACA) passed by Congress in 2010 mandates that every state establish a health insurance exchange by Jan. 1, 2014, or default to a national program. This requirement will dramatically alter the health insurance marketplace, creating opportunities for some brokers and challenges for others. The Congressional Budget Office estimates that eight million people will buy insurance through these exchanges in 2014, and participation is expected to triple by 2018.

Are you prepared to thrive in this environment, along with whatever else develops? Ask yourself these five questions to find the answer (ask them at least once a month to keep in step with future changes).

What am I doing to position myself with my clients as the "go-to" expert?

While exchanges will be selling directly and through a still-undefined network of navigators, the broker’s expertise and knowledge will be more important than ever in providing the information and unbiased recommendations employers need to make well-informed decisions. Brokers will also be called upon to provide service for everything from routine issues to serious policy interpretations. The time to start positioning yourself as that expert is now. In every conversation with clients, talk about exchanges — what they are, how they work and whether or not they are the right solution to a client’s health insurance needs. Discuss what is meant by “defined contribution,” what tax credits may be available and how exchanges can provide choice to employees while providing employers ease of administration. If you can begin to get your clients interested now, you’ll be the person they turn to when the time is right.


Do I have the online savvy necessary to compete?

The brokers who will be most successful need to be comfortable in the online world because that’s where the action is going to be. That means having powerful and reliable information technology support, top-notch online quoting engines, a robust and inviting website and the intelligent use of select social media tools that drive volume and share important information on a timely basis.

Have I kept my options open?

While state-run exchanges are getting all the attention, their creation in no way eliminates the existence of private exchanges. In fact, many private exchanges that already exist in select markets are being met with great acceptance. CaliforniaChoice, for example, has been operating for 15 years and serves more than 150,000 members and more than 10,000 small employers. Smart brokers will keep their options open, looking at both state-run exchanges and private exchanges to find the right match for their clients.







Have I truly distinguished myself from my competition?


Now more than ever, brokers need to take an objective look at their business and evaluate their strengths, weaknesses and differentiating characteristics. What are you known for? Why you instead of someone else? What do you do best? Do you have the people, technology and funding necessary to succeed? Do you have an exchange partner that will assist you in selling and administering the exchange product in the most efficient and customer-friendly way? It’s time for a reality check.

Am I doing all I can to remain current?


While the PPACA calls for the establishment of state exchanges by January 2014, much flexibility remains relative to exchange design. States even have flexibility in defining what constitutes a small business: some may designate groups with 100 employees or fewer while others may put the number at 50. As they weigh their options, many states are still considering whether they will create a state exchange or default to the national model. With so many moving pieces, nobody can predict with certainty what any state’s health exchange will look like. That’s why it’s so important for you to keep abreast of the marketplace through webinars, conferences, reading and research. Stay current and stay informed; you can be sure that’s precisely what your competitor is doing.

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Nichole Morford

Nichole Morford
Managing Editor

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