Michael Gomes's blog

Insurance Agents/Brokers Role as a “Trusted Advisor” Gains NAIC Attention

When the Affordable Care Act was initially passed, there was quite a bit of concern on the part of insurance brokers and agents throughout the country. How would this effect the industry? What would be the impact on business and commissions?

The Act calls for “Navigators” to help educate the public and provide impartial information on plans. A big worry that arose is the qualifications of these Navigators asking the question whether consumers would be put at risk by having unlicensed, minimally-trained Navigators in place performing part of the function that has traditionally been done by agents and brokers.

To prevent this from happening, the National Association of Insurance Commissioners (NAIC) just passed a resolution recognizing brokers’ and agents’ roles in the country’s health care delivery system. This will limit the Navigator’s role to directing Exchange consumers to government agencies and licensed insurance professionals.

Author: Michael Gomes
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Government Launches Quality Care Website

Part of the problem facing our health care system is lack of information. The federal government launched a website late last month to help alleviate this issue – healthcare.gov.

The site was developed to provide information on both health insurers and providers with the thought that Americans can make better decisions and lower health care costs if they have access to the data. Currently, most of the data regarding quality of insurers and providers is not available to the public.

Insurers, who now provide little information when it comes to quality of care, would be forced to submit information regarding their data. Providers already offer up this information to some extent but now it will be available to the public.

Author: Michael Gomes
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Medicare Rate Cuts

When it comes to health care, Congress proved once again, that they are out of touch with the public’s best interests. They spent a week arguing over a bill that would have prevented Medicare reimbursement rates from being cut. The rate cut amounts to 21 percent.

Under a 1990s law, Medicare rates were cut for budget purposes. Congress has routinely waived these cuts but this time lawmakers concerns over adding to the deficit prevented them from waiving this exception in a timely manner.

Author: Michael Gomes
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Funding Quality of Care

One of the big issues that came up during the health care reform discussion was the growing lack of availability of physicians and other health care professionals. Without a significant amount of physicians who can take care of the extra people the new law intends to cover, the quality of care will suffer throughout the entire medical system.

Author: Michael Gomes
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Voluntary Benefits Grow as an Employer Solution to Legislation

It remains to be seen what effect legislation will have upon employer groups, and just how much costs will be driven up. To make up for the costs, some employers are now looking at voluntary benefits as a way to offer an employee benefit at no cost to the employer.

Several studies have come out backing this notion up. A Mercer study showed that a quarter of employers responding feel that complying with the Patient Protection and Affordable Care Act will add at least 3% to next year’s costs. Employers are now looking at voluntary benefits as an option.

Author: Michael Gomes
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Broker and Agent Commission Structure to Change

Much has been made of how the new health care regulations will affect different groups of Americans. The one group that hasn’t been mentioned much but is about to become one of the first to feel the effects of the new law are insurance brokers and agents.

Under the new law, insurance companies must use at least 80% of their premiums to cover medical care for patients. This limits profits and administrative costs, which covers sales commissions, to a maximum of 20%.

Author: Michael Gomes
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States Unsure of How Bill Will Impact Them

Poll after poll is still showing that a majority of Americans still haven’t changed their minds and do not support the health care reform law. On the other hand, they also oppose the efforts of Republicans to repeal the law.

Author: Michael Gomes
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New Staff Picks May Impact Health Care Industry

Unionization can hit the health care industry faster than you think, thanks to President Obama’s latest hiring decision. He recently appointed two pro-union lawyers - Craig Becker and Mark Pearce - to the five-person National Labor Relations Board (NLRB).

This will affect every industry but it will particularly affect the health care and life sciences industries. Unlike most other industries, it’s not as easy to outsource or move jobs offshore. These two industries are hands-on, due to their patient-service provider nature and will continue to stay domestic.

Author: Michael Gomes
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Health Care Spending to Increase

One of the promises made when President Barack Obama was pushing his health care reform initiative was that there would be no increased health care costs. Well, now that it’s passed, things are starting to look a bit different.

 

Author: Michael Gomes
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Weeks Later and Still Confusing

It’s now been several weeks since the health care reform bill was passed and many Americans are looking for answers on how the bill will impact them. They are not the only ones that express confusion towards the bill. Members of Congress don’t quite understand it either.

Case in point? The new law inadvertently kicks some Congress members and staffers off their health plan. Currently, federal government employees, including members of Congress receive their health coverage through the Federal Employee Health Benefit (FEHB) system.

Author: Michael Gomes
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