Lee Martin: Health insurance exchanges: More consumer protections needed

This past session, state legislators passed a bill defining the permitted scope of activities for individuals who will soon help Florida consumers navigate the complicated maze of health insurance exchanges established under the Patient Protection and Affordable Care Act (PPACA).

These individuals, who work for the federal health insurance exchanges, are called “navigators,” and it’s their job to help the uninsured enroll in approved health insurance exchanges. It’s not their job, as solidified in SB 1842, to assist qualified individuals, employers, or employees in purchasing qualified health plans; only an insurance agent or broker may sell, solicit, or negotiate health insurance.

SB 1842 requires navigators to undergo criminal and regulatory background screening before they may be registered, and enables regulators to assess fines or suspend or revoke a license if a navigator engages in improper conduct, commits fraud, or violates state marketplace and consumer protection requirements. These protections are a good first start, but they don’t go far enough.

This sentiment is shared by members of the Florida Cabinet. At a recent cabinet meeting, CFO Jeff Atwater, whose agency regulates the state’s insurance agents, called the navigator program “mission creep of the worst sort.” Originally, Navigators were meant to provide public outreach and education about new coverage opportunities made possible by the PPACA. If not for SB 1842, that task would have morphed into navigators acting essentially as an unlicensed insurance agent for the federal government.

But still, mission creeps. Beyond navigators, the Feds created newer still positions called “application assistors” and “counselors.”  All of these groups will likely have access to consumers’ tax, health and other personal information. It’s imperative that lawmakers act to strengthen the consumer protections created in SB 1842 by widening the scope of the law to regulate not only navigators, but also any of these new federally created entities. Additionally, although the PPACA prohibits states from requiring navigators and other entities to be licensed or from carrying liability insurance, Florida lawmakers can and should require them to be bonded to better protect consumers. If we require the guys who maintain our lawns to carry a bond, doesn’t it make sense to at least do the same for people handling your most sensitive information?

Legislative changes or not, consumers need to learn about the three ways in which they will be able to access the exchanges when they roll out Oct. 1:

·       Through an online marketplace,
·       Through an entity employing navigators and other “counselors,” or
·       Through a licensed independent insurance agent.

Licensed insurance agents are required to take prelicensing classes, pass a test, maintain their license with continuing education, and carry professional liability insurance—none of which are required of navigators or other, recently created helpers. This may be why at a recent Cabinet meeting, Insurance Commissioner Kevin McCarty essentially said it best by stating, “that consumers should seek the services of a licensed agent, where safeguards are already built in.