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Health Care Reform

PIA supports a healthcare system that preserves the role of independent agents and brokers, builds on the private market and utilizes the successful state-based regulatory system.

Official ACA Training & Registration


The ACA requires agents and brokers who wish to utilize a Federally-Facilitated Marketplace (FFM) to complete online training and registration.

Official ACA Training – Part IAgents and brokers are required to complete training from the federal government before they are eligible to sell health insurance policies in a FFM. Training can begin immediately by clicking the above link. You must start by creating an account, which will provide you with a Login ID and Password to access the training.

Official ACA Identity Proofing – Part IIAfter you have completed Part I (above), please allow 48 business hours for your training/testing results to be transmitted to the CMS Enterprise Portal, where Part II occurs. Agents and brokers must register on this website and complete the identity proofing process.

Training Resources


December 10, 2013 WebinarThe U.S. Department of Health and Human Services (HHS) has opened up a one hour agent-focused webinar explaining the recently modified enrollment process for the Federally-Facilitated Small Health Options Program (FF-SHOP) Marketplace. Register for the Agent/Broker SHOP Webinar at https://www.regtap.info/.

Presentation Slides from the July 9, 2013, Webinar — HHS conducted a private webinar for PIA members on July 9, 2013. The webinar was not recorded, but the presentation slides are available.

Presentation Slides from the September 27, 2013, WebinarHHS conducted this webinar for PIA members to explain the registration and training that agents/brokers need to complete before they can participate in a FFM or a Small Business Health Options Program (SHOP).

If your state has opted for a state-based marketplace (check here to find out), please refer to your state PIA association to assist you with training requirements.

HHS/CMS Resources


January 28, 2014, New Resource From CMS
— The CMS has released a new resource titled Federally-Facilitated Marketplace Enrollment: Tips for Agents and Brokers in the Individual Market. This new resource from the CMS is designed to help agents/brokers as they assist consumers enrolling in Qualified Health Plans (QHPs) in the FFM. The document provides tips on some of the key screens for agent/brokers assistance during enrollment in the FFM. This resource can be found here.

November 2, 2013, Email NoticeThis email notice (1) makes note of the CMS Enterprise Portal being unavailable on November 2, 2013 – November 3, 2013, and (2) informs agents that CMS is aware of some agents receiving an error message on the CMS Enterprise Portal. CMS is working to resolve the issue.

Enrollment Operational Policy & Guidance (Federally-Facilitated Marketplace) — The HHS released this document on October 3, 2013, with an effective date of October 1, 2013. The 44 page document covers the types of Marketplaces and enrollment processes, including information on premium payments, cancellations, and terminations.

October 4 Email Announcement from HHS — This email notice is intended for agents/brokers who are participating in a FFM or Small Health Options Program Marketplace (FF-SHOP) and makes the following announcements: 1) It references an updated FAQ on Medicare and Marketplace enrollment. This document can be found here; 2) The memo reinforces that an agent/broker should work to ensure that the consumer enters the accurate agent/broker's NPN in the FFM. It also notes that the NPN that is included on the application will be sent to the issuer so the compensation can be facilitated.

September 30 Email Announcement from HHS — This email notice is intended for agents/brokers and makes the following four announcements: 1) On Tuesday, October 1, the FFMs and State Partnership Marketplaces will open. Agents need to ensure that consumers enter the agent's NPN into the FFM; 2) On Tuesday, October 1, a listing of health plans will be made available. The list is accessible via this announcement; 3) A reminder that agents/brokers need to complete the CMS identity proofing process and; 4) Agent/broker questions, as they relate to FFM registration, can be submitted to FFMProducer-AssisterHelpDesk@cms.hhs.gov.

Agent/Broker Registration Process FAQ — This document was created by the HHS and covers frequently asked questions as they related to agent/broker registration for a FFM.

HHS Resources — The HHS has created a website specific for agents and brokers. Official marketplace training and registration information can be found on this page.

Additional Resources


Healthcare Reform FAQ Prepared By the NAIC
— The National Association of Insurance Commissioners (NAIC) has prepared this webpage to assist consumers and employers with common questions.

Guide to HHS HIPAA Omnibus Rules — A PIA member agency only guide to gaining a better understanding of the ins & outs of the recently enacted HIPAA Omnibus Rule.

Employer Notification by October 1, 2013 — The ACA requires that employers covered by the Fair Labor Standards Act (generally, businesses that have at least one employee and at least $500,000 in revenue) notify their employees about the Health Insurance Marketplaces, regardless of whether or not the employer offers health coverage to its employees. The notice should be sent to both part-time and full-time employees. Click here for additional information. Click here to view a sample employer notification for businesses that do not offer health coverage or click here for a sample employer notification for businesses that do offer health coverage.

    ACA & the IRS — The IRS has a new website that is designed to assist the public and businesses understand the tax provisions that are part of the ACA. Information on this page ranges from tax credits for individuals to employer responsibilities.



    Archive


    PIA National Newsline Special Edition: Agents and the ACA: Week 1
    — Released on 10/04/2013, this special edition Newsline covers changes created by the release of the ACA and all of the need-to-know information related to it. (Login required)

    Map of Healthcare Marketplaces — The ACA requires each state to develop a healthcare marketplace (commonly referred to as an exchange) or default to a marketplace run by the federal government. Some states have opted for a partnership marketplace that includes involvement from both the state and federal government. This map will show you what each state has opted for.

    ACA Timeline — Curious to see what will happen next? Check out PIA's timeline of the ACA implementation.

    Supreme Court Rules on Heathcare Reform — In a landmark care, the United States Supreme Court issued a much-anticipated decision on June 28, 2012, that upheld most of the ACA. This document is PIA's initial analysis.

    Impact of the 2012 Election on Agents and Brokers — The 2012 election sent President Obama into a second term, making implementation of the ACA near inevitable. Written immediately following the election, this is PIA's first-take at what the results meant for agents and brokers.

    Obama vs. Romney — In this hotly contested 2012 race, see where these two candidates stood on healthcare reform.