Filed Under:Health Insurance, Individual Health

5 ways industry trailblazers are preparing for PPACA

As the new public health insurance exchanges come to life, the learning curve remains a long, windy road toward smooth running. The history of health reform has been filled with surprising twists. In California, for example, the governor signed a “play or pay” employer mandate bill into law in 2003 – then employers succeeded at going to court to block the law.

At the federal level, Republican leaders have been fighting implementation of PPACA with lawsuits, repeal bills and de-funding attempts ever since the act was signed into law in 2010.

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1. Education

Many individuals, employers and even brokers are still scratching their heads when it comes to PPACA and the exchanges. Which are private? Which are federal? Do I qualify? What will the plans cover? Is it expensive?

You get the point. And as we know, the only way to combat ignorance is with education.

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2. Communication

The importance of relationships is a critical aspect to just about every business in every industry. Without them, there are no clients and, thus, no revenue. The same goes for relationships under the PPACA umbrella. The communication needed to build them — and keep them — became a critical tool as agents prepared for Oct. 1.

Twadell and her team spent countless hours interpreting and digesting PPACA legislation in an effort to turn it into a concise and easily understandable format for clients. “This allows us to advise our clients with a uniquely tailored message and action plan,” said Twadell, who advises clients on private insurance options, provides avenues for employees to use call centers, and warns about the possibility that employees may not be eligible for a premium tax credit in the exchange.

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3. Advisors

Americans are confused about PPACA and the exchanges, as illustrated by countless national surveys. A September poll by WellPoint pointed out that only one-quarter of adult Americans know that state exchanges will only offer health insurance coverage, while more than half of respondents incorrectly believed disability income insurance and life insurance will be offered. A surprising 24 percent thought auto insurance would be available while an even more disappointing 14 percent were hoping pet insurance was included. In the group markets, “most employees are thoroughly confused,” said Tim McGill, vice president at Colonial Life. “There’s a lot of fear about what the market will look like.”

These types of questions, along with the more complex issue brought about by brokers, have all warranted the need for professional advisors on the matter.

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4. Technology

Many exchanges are integrated with the federal government’s data hub, which enables the determination of a consumer’s tax credit eligibility, along with online enrollment processes. Technology is also aiding agents in lessening the confusion. “While we do expect an increase in both the number and complexity of the questions raised by consumers regarding their options, our approach will continue to be the same — use our technology and people to plainly explain their options and help choose the right coverage for their needs,” said Mahoney.   

Because PPACA is so big, the technology that the exchanges use will advance more rapidly than ever. But that doesn’t mean it will be perfect. “The undertaking is so big in a very short timeframe that I think we will experience some delays and hiccups that will be blamed on the technology,” said Crisan. “The marketplace does have a delay right now in some aspects because of technology. Some states are worried about data security. Also, the true defined contribution model for the SHOP marketplace is delayed because of the size and complexity.

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5. Optimism

Though many professionals are skeptical about the mechanics of the exchange, some are trying to remain positive in the face of the inevitable. “We are optimistic because we need to deal in the reality of health care reform as it is today,” said Crisan. Though many Republicans are staunchly opposed to PPACA, some do see the benefit of more uninsured people having access to coverage through exchanges. “My brother is 60 years old, retired with no retiree health care and a diabetic,” said Crisan. “PPACA will help many people in the same situation have access to insurance where they may have been deemed uninsurable before. That is a good thing.”

But it will take time and patience to get a complete understanding of how the laws will fully affect everyone in a day-to-day execution, and some are doubtful. Starkman feels technology gaps and a lack of carrier competition may cause problems, while McGill sees many employers adopting a wait-and-see approach. “Many employers are open to the exchanges as an option … but they don’t want to be the pilot project.”

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Nichole Morford

Nichole Morford
Managing Editor

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