Calif. Owes Payments to Agents Who Helped With Exchange Sign-Ups
California owes commissions to thousands of insurance agents who helped individuals enroll in Medi-Cal and small businesses select health plans through Covered California during the first open enrollment period, according to a report presented to the exchange's board, the Los Angeles Times reports.
Medi-Cal is California's Medicaid program.
More than 12,600 insurance agents are certified to sell health plans through Covered California. Agents assisted 40% of all individual enrollees during the exchange's first open enrollment period, according to the Times.
The exchange pays commissions to agents who help enroll small employers and residents eligible for Medi-Cal, but insurers pay commissions to agents who help individuals enroll in private coverage through the exchange.
Details of Issues
In the report to the exchange board, Covered California Executive Director Peter Lee said the state is months late in paying commissions to agents for assisting small businesses.
Further, about 2,200 insurance agents who helped individuals enroll in Medi-Cal are owed a total of about $2 million. Officials said some of those payments likely will not be made until January 2015.
Meanwhile, insurance agents also said that the exchange's phone line for insurance agents is overwhelmed with callers.
Sam Smith, former president of the California Association of Health Underwriters, said, "Everything would be forgiven if Covered California's service level got up to industry standards" (Terhune, Los Angeles Times, 11/26).
Covered California's Response
According to AP/KPCC's "KPCC News," Lee has apologized for Covered California's inadequate service to insurance agents. He also has touted agents' efforts in recent public statements.
In addition, Dana Howard -- an exchange spokesperson -- said the exchange has hired more call center staff and phone-line wait times for agents were down to about 30 minutes last week ("KPCC News," AP/KPCC, 11/27).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.