Survey: How Health Insurance Brokers, Navigators Perform Under Obamacare

Insurance brokers play an important role in helping people obtain non-group health insurance from the health insurance marketplaces established under the Affordable Care Act (ACA) and tend to serve different people than the navigators and other market assistance programs, according to a new survey.

A Kaiser Family Foundation survey of marketplace assister programs and health insurance brokers found that a majority (66 percent) of insurance brokers say it takes more time to sell a non-group policy in 2015 compared to before the marketplaces launched in 2014. More than half (57 percent) say revenue per policy is down, but six in 10 (60 percent) brokers say they sell more non-group policies now than before 2014.

Insurance brokers in the survey, most of whom sold non-group policies before the ACA, are split on whether they’re receiving more overall commission revenue now than before the ACA: 40 percent say their overall revenue went up, 40 percent say it went down, and 20 percent say it didn’t change much.

Brokers also continue to help consumers buy coverage outside of the ACA marketplace. On average, brokers sell one policy outside for every two marketplace policies they sell, according to the survey.

Survey Participants

The survey has in the past covered only market assister programs. This is the first year that the survey included insurance brokers.

The online survey was designed and analyzed by researchers at the Kaiser Family Foundation and was administered online from March 31 through May 13, 2015. Kaiser said it surveyed assister programs nationwide including navigators, federally qualified health centers, certified application counselors, and other recognized programs; 713 out of 4,680 programs responded. In addition, a sample of 9,700 brokers nationwide was surveyed and 662 responded.

Different Populations

Insurance brokers and assister programs appear to serve somewhat different populations, with brokers less likely to serve Latinos, uninsured people and low-income consumers eligible for Medicaid.

Brokers and assisters generally engage in similar activities to help consumers but they emphasize different services. For example, the vast majority of both brokers and assisters said they help consumers compare and select qualified health plans, apply for premium tax credits and resolve post-enrollment problems.

Brokers are less likely to engage in outreach and public education activities and less likely to help consumers appeal marketplace eligibility decisions.

Compared to assisters, however, brokers are more likely to help small businesses select coverage (34 percent vs. 9 percent).

“The implication for marketplaces would seem to be that brokers and assister programs are not interchangeable. To ensure that all consumers who need help receive it, both types of professionals will need to continue their key roles,” the report says.

Some brokers are busier than others. Sixty percent said they helped up to 50 consumers during this open enrollment period, while 20 percent of brokers said they helped more than 100.

Most returning brokers and assistance programs said they thought the 2015 open enrollment went better than the first one in 2014.

Brokers reported higher rates of client continuity and were more likely than assisters (47 percent vs. 29 percent) to say most of the consumers they helped this year were people whom they had also helped last year.

Time Spent

Most brokers and assisters said that on average it takes about one-to-two hours to help each client applying to the marketplace for the first time, and about one hour to help clients who are returning to renew or change their coverage.

To sell non-group or small group health plans offered through a state marketplace, brokers must register with the marketplace annually, sign a participation agreement, and complete required training. Brokers who sell non-group policies through the marketplace help consumers complete an application for financial assistance and explain coverage options. Brokers are paid a commission by the health insurance company offering the policy that the consumer selects. Brokers also offer ongoing services to consumers once they’re covered, including help with post-enrollment questions and help buying other insurance products or financial services.

Source: Kaiser Family Foundation

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