- Covered California, California’s public health exchange, may make participating plans' pay sales commissions to insurance brokers to ensure that sicker and costlier people aren’t excluded, Kaiser Health News reported.
- The proposed commissions, which could take effect next year, would apply to both regular and special enrollment periods. The exchange was expected to discuss the proposal at its February board meeting.
- If implemented, California would be the first state to set specific rules for paying commissions.
The concern is payers may steer agents away from more costly customers by cutting commissions at certain times or in certain situations.
“When one health plan says during special enrollment, for instance, we won’t pay commissions, they are hoping insurance agents won’t sell them and they will sell sick people into another plan,” Peter Lee, executive director of Covered California, told KHN.
Under the Affordable Care Act, health plans are barred from denying coverage to people with preexisting medical conditions and allows people who experience certain life-changing events, such as childbirth or loss of employer insurance, to sign up for Obamacare even after open enrollment has closed — sparking criticism by payers that people could avoid enrolling until they are sick.
Separately, Covered California released new enrollment data this week showing more heated competition and better prices for consumers.
As of the Jan. 31 when the current open-enrollment period closed, more than 439,000 new people signed up for Obamacare, the exchange said. Of those, the percentage that chose plans other than Anthem Blue Cross of California, Blue Shield of California, Health Net and Kaiser Permanente nearly tripled from a year ago.
Covered California attributed the results to a good risk mix that forced payers to compete on price and quality.