This past weekend, insurance commissioners and their staff, along with insurance companies, brokers, other industry representatives, and a few intrepid consumer representatives gathered at the Spring meeting of the National Association of Insurance Commissioners (NAIC) in Houston. While the meeting did not hold as may controversies as in the past, there were discussions on a few important topics that give us an idea of what insurance departments are thinking about as we near open enrollment and full implementation of the ACA.
The Consumer Information working group has turned their attention to developing materials for insurance departments’ use in working with consumers on questions and complaints. Through a collaborative project with consumers, insurers, and regulators, that committee compiled a list of likely questions from consumers and is working on drafting responses. The goal is to finalize this information by July.
The NAIC is also starting to look at their role in overseeing the insurance market as the ACA rolls out. One of the most important jobs of state insurance departments is to conduct oversight of health insurers and make sure they comply with the law. But right now, most insurance departments don’t have the processes and structures in place to collect data (e.g. consumer complaints), track and analyze the data, and conduct audits for ACA-specific reforms. A small working group at NAIC will attempt to develop a market oversight framework that DOIs can implement in their own states.
Finally, discussion at a number of working groups turned back to the role of Navigators. As we have discussed in this blog, Navigators play a critical role in providing unbiased information about health plan options to consumers and in working with people through the application and enrollment process. Exchanges must train and certify Navigators to ensure they are capable of performing these duties. A recent proposed rule clearly outlines the differences between Navigators and brokers.
However, the broker community continues to pursue further regulation of Navigators at the state level, some of which could have a chilling effect on the number of community-based organizations that apply to be Navigators. For instance, many argue that Navigators should be required to be licensed or carry errors and omissions coverage to practice in a state.
A number of consumer representatives responded to the broker arguments, arguing that while it is true that Navigators must be trained and certified, additional state requirements could be duplicative or overly onerous. Navigators already must pass an exam and undergo extensive training. The consumer representatives underscored the need for unbiased help with the numerous options available in the ACA and, with millions newly eligible for coverage, there will be more than enough work for everyone to have a role. Unfortunately, not all of the commissioners are yet on board with the consumers’ perspective.
The NAIC will continue to work on these issues between now and their next meeting over the summer. There is much to do in a short time frame – stay tuned.