NAIFA releases ACA survey

NAIFA Survey Examines Agent and Broker Role in Affordable Care Act Implementation

SAN ANTONIO, TX (September 26, 2013) — With enrollment for health insurance plans available through state and federally facilitated marketplaces just days away, a new survey of NAIFA members shows that agents and brokers are unwilling to sit on the sidelines and instead will take an active role in helping consumers navigate the complex world of the health insurance marketplace under the Affordable Care Act.

According to the survey, more than half (56 percent) of NAIFA members who sell health insurance said they plan to sell plans through state or federally facilitated marketplace when enrollment opens to consumers on Oct. 1. Of the 54 percent who live in states with a federally-facilitated marketplace, 50 percent of respondents said they have participated in government training for agents from the Centers for Medicare & Medicaid Services (CMS), and 29 percent said they plan to take the training. The survey of 600 NAIFA members, conducted Sept. 10-12, 2013, was released here during the NAIFA Career Conference and Annual meeting.

“It’s not surprising our members are taking the time to participate in training so they can continue to serve clients with expert advice on health insurance plans that will be available in the group and individual market,” said NAIFA President-Elect John F. Nichols, MSM, CLU.  “While the thousands of ‘navigators’ hired will help consumers enroll for plans through the marketplace, consumers and businesses will require assistance that goes far beyond registering for a plan. That’s what our members can best provide.”

Sixteen states plus the District of Columbia will run a state-operated exchange; 26 states will operate under a federally facilitated exchange, and seven states have chosen a model that involves partnership between the states and the federal government.

With enrollment set to open Oct. 1, field reports from NAIFA members reveal widespread confusion among consumers about how the law will impact them.

Small business owners are particularly concerned about how the health care overhaul will affect premiums and other costs, according to respondents. NAIFA members say they are fielding numerous questions about businesses’ requirements under the law and what types of plans will be available on the state and federal exchanges.

“Most small business owners are so confused and discouraged that they don’t know what to ask other than, ‘How much will it cost me?’” says one NAIFA member from Winston Salem, N.C.

Many of the brokers and agents (44 percent) are reaching out in their communities, beyond their existing client base, to assist consumers with questions about health insurance and the ACA. Some report providing briefings at town hall meetings, while others are visiting senior centers, churches and other community centers. At least one out of 10 respondents said they have secured referrals from hospitals, pharmacists, doctors and other organizations that believe consumers will need expert advice in the healthcare marketplaces.

For example, one hospital system in Southwest Missouri officially will refer its patients to NAIFA members for advice, and the Tennessee Hospital Association is listing NAIFA members as reliable and trusted resources for consumers.

“When purchasing a plan from a marketplace, the companies that sell health insurance should immediately assign consumers an agent,” Nichols said. “Coverage does not begin and end with enrollment. Consumers benefit from the expertise that brokers and agents provide in servicing the plan throughout the year. They need to be involved, or customer service will be a missing element in healthcare reform.”

Individual Mandate
Some NAIFA members believe that the Affordable Care Act’s individual mandate is likely to increase business, with 30 percent saying their health care business will grow because of the individual mandate. However, 40 percent think their business will shrink as the government implements more ACA provisions, while 18 percent anticipate no change; 13 percent are uncertain.

Of those who expect growth, 54 percent believe their business will increase by 10 percent or more. Nearly a quarter (23 percent) expect to hire additional staff.

“While the ACA already has presented many challenges for healthcare providers, consumers and agents and brokers, NAIFA members realize there are opportunities to leverage their expertise. In the end, we want consumers and agents to benefit from the added time, training and talent invested in learning the complexities of this new law as it goes into effect in the months and years to come,” Nichols said.

NAIFA has launched an ACA resource site ( for members and their clients. The site includes FAQs addressing questions about the exchanges, essential benefits, taxes, the individual mandate, Medicare Advantage and other ACA provisions.