Filed Under:Health Insurance, Individual Health

Feds make issuer guidance letter final

CCIIO Director Gary Cohen (CMS photo)
CCIIO Director Gary Cohen (CMS photo)

Federal health insurance exchange system managers have taken paragraphs about federal agent and broker oversight out of a batch of advice for health insurers.

The Centers for Consumer Information and Insurance Oversight (CCIIO) released the final version of the guidance for health insurers today.

CCIIO (pronounced "Sih-Sighyo"), is an arm of the Centers for Medicare & Medicaid Services (CMS), which is, in turn, an arm of the U.S. Department of Health and Human Services.

In both a draft issued in early March and the final version, CCIIO officials said "federally facilitated exchanges" (FFEs) -- exchanges run fully or partly by HHS hope to work as closely with agents and brokers as state laws allow.

CCIIO said state insurance regulators, not HHS, will be in charge of applying any agent and broker compensation standards.

The only thing HHS has to say about exchange broker compensation is that the health insurers selling coverage through an exchange should pay the same commissions for a plan sold both inside and outside the exchange, officials said.

In the original draft, CCIIO officials included two paragraphs talking about how an exchange-specific agent-broker agreement would govern producers' access to the exchange. 

"CMS will monitor and oversee agents and brokers to confirm ongoing compliance  with the terms of the agent-broker agreement," CCIIO officials said in the original draft. "CMS anticipates that this monitoring and  oversight will be limited to the terms of the agent-broker agreement not covered by state law,  such ast he exchange’s privacy and security requirements and standards for obtaining consumer  consent."

In the final version of the guidance, officials have deleted those passages and several related passages.

Officials have kept passages stating that issuers must ensure that exchange-related marketing activities conducted by their producers "comply with applicable federal and state requirements."

Any marketing materials must comform to the requirements in the exchange health plan issuer's agreement with the exchange, officials say in both the draft version of the guidance and the final version.

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Nichole Morford

Nichole Morford
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