Local News

July 14, 2013

New health law brings opportunities, challenges for insurance agents

In less than three months, Americans will be able to buy health insurance on new state and federal exchanges.

The exchanges promise to provide health insurance to those who no longer have it, and they’ll also have a big impact on those who make their living selling insurance. Across the nation the businessmen and businesswomen who run those insurance agencies are keeping a close eye on the exchanges and trying to figure out how they’ll affect their firms.

Local insurance agents and brokers say the exchanges open up a new market for them, while at the same time creating a new source of competition.

They say the ultimate impact on their businesses will be determined by the details of how the exchanges work and the role the agents and brokers will play in steering consumers through those exchanges, details that are still being worked out.

“The federal exchange, which we will have in Georgia, has indicated it wants to work with brokers to help folks enroll, and I think they see brokers playing a valuable roll in increasing enrollment in the exchanges,” said Brian Peters, managing director at Advance Insurance Strategies, an insurance agency based in Dalton.

The Patient Protection and Affordable Care Act, also known as Obamacare, set up exchanges where American citizens and legal residents can purchase health insurance. Those who meet certain income requirements and who are not covered under Medicare or Medicaid or whose employers do not provide health insurance that meets certain standards for coverage and affordability may receive federal subsidies to help them pay for insurance in those exchanges. Enrollment in those exchanges starts Oct. 1.

Georgia and 26 other states refused to set up exchanges, citing potential costs. In those states, the federal government will run the exchange.

“Every state is different, but here in Georgia we are supposed to be able to market on the exchange,” said Blake Adcock, president of Dalton’s Adcock Financial Group, an independent insurance agency focused on life and health insurance. “There will be some licensing requirements and some training that will be required.”

But Adcock says the government hasn’t yet made it clear what all of those requirements will be.

“We really haven’t gotten any of the details,” he said.

He said there will probably be an overall certification for the exchange and each insurance company selling on the exchange will likely have its own training and certification.

“There will be a good deal to do, especially since the information isn’t there yet,” he said.

Adcock said he expects the law will actually expand business for insurance agents and brokers. The law requires everyone to have health insurance, and it says that insurance companies can no longer reject customers because of pre-existing health conditions.

“If we write half the people we’ve declined in the past it would be a pretty big increase in business for us. In general, right now, about 40 or 45 percent of the applications we file get declined,” he said.

The law also provides subsidies for those earning up to 400 percent of the federal poverty level, allowing some people who couldn’t afford health insurance to buy it.

“The devil is going to be in the details. You have to buy the subsidized insurance on the exchange, and we expect there will be a lower commission on the exchange products. But even if they decrease the commission, with the increased number that will be covered it could be a potential increase in revenue,” Adcock said.

But with an increase in the potential market comes increased competition.

“The exchanges themselves aren’t competition for agents, but some of the people who will work around the exchanges may be viewed as competition,” said Russell Childers, an Americus-based insurance broker and past president of the National Association of Health Underwriters.

The law provides funding for organizations that will assist people enrolling in the new exchanges. Those grants are expected to be awarded in August.

“They are calling them several different things. The most common is navigators,” Childers said. “Georgia, in this past legislative session, passed a bill that requires navigators to be licensed. The (federal) law and the Georgia law both specify that navigators and other personnel who work with the exchanges can’t actually recommend a health insurance plan because they aren’t licensed insurance agents.”

Navigators are supposed to help consumers fill out forms, answer questions about coverage and help consumers determine if they qualify for federal subsidies. They aren’t supposed to direct people to particular plans or be paid by insurance companies.

In addition, consumers will be able to sign up directly for coverage on these health care exchanges by going to www.healthcare.gov, and avoid dealing with an insurance agent or broker.

But Childers noted that insurance agents have been competing with online options for many years now and while many consumers do choose to purchase online, many others see value in maintaining a relationship with an agent.

“We help them select a plan. But we also help them with claims issues. We sometimes help them with treatment questions. For example, sometimes a doctor will suggest they need to see some sort of specialist who is in their network,” he said. “We are going to make sure that people know we can work with the exchanges and we can help them determine what subsidies they qualify for. And on top of that, we can also help them later with any claims they may incur.”

1
Text Only
Local News
  • Kiwanis Club3.jpg Kiwanians get a lesson in money and banking

    Money.
    It makes it easier for us to buy and sell goods and services. It is the measure by which we judge the relative value of those goods and services, and it allows us to “store value,” by placing it away and using it when we need it.

    July 28, 2014 1 Photo

  • Sheriff: Inmates don’t ask to vote

    In his 21 years of service, Whitfield County Sheriff Scott Chitwood said inmates have never asked for the opportunity to vote.

    July 28, 2014

  • Little library 1 mlh.jpg Little Libraries, big goal

    Whitfield County just received a new library.
    And better yet, 26 more are on the way to the region.

    July 27, 2014 1 Photo

  • Picture 3.jpg Rock solid

    A great number of things have come and gone since 1974.
    One that hasn’t: a small Dalton school founded by parents wanting a unique learning environment for their children.

    July 27, 2014 2 Photos

  • Vann House Day '14 6 mlh.jpg History comes alive at Vann House

    SPRING PLACE — In the early 1800s, the 1,000-acre plantation belonging to Cherokee Indian leader James Vann was a bustling place.

    July 26, 2014 5 Photos

  • Local officials agree with Deal

    Regarding news last week that approximately 30 unaccompanied minors from Central America, who had crossed the southern border into the United States, were sent without warning to Dalton last year and enrolled in Dalton Public Schools, Republican politicians representing portions of Murray and Whitfield Counties agree — state and local school officials deserved to know in advance, they say.

    July 26, 2014

  • Former chamber location 2 mlh.jpg Plan could cut flooding, stormwater damage in Dalton

    On a recent day, McClellan Creek flowed gently through Harlan Godfrey Civitan Park. But some park goers who live near the area say that even a mild rain can turn the creek into a torrent that eats away at their property.

    July 26, 2014 1 Photo

  • Civil War anniversary: The Battle of Crow Valley, May 9-12, 1864

    The Atlanta Campaign began during the first two weeks of May 1864 in and around Dalton. Union Maj. Gen. William T. Sherman’s strategy was to target two of his armies, about 80,000 men, against Confederate Gen. Joseph E. Johnston’s Army of Tennessee at Dalton. Then, while Johnston’s attention was diverted by these forces, he would secretly send his third army, about 25,000 troops under Maj. Gen. James B. McPherson, in a flanking movement to the southwest through Snake Creek Gap. Sherman’s goal was to break Johnston’s railroad supply line some 15 miles south at Resaca and trap Johnston’s Confederates in Dalton.

    July 26, 2014

  • New church being  built mlh.jpg Church construction continues

    July 25, 2014 1 Photo

  • Avans.jpg Three arrested in arson plot to claim insurance money

    Three people have been arrested for their role in a fire at a Chatsworth home as part of an insurance scam to collect money, officials said.

    July 25, 2014 3 Photos