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Healthcare Frequently Asked Question

Can agents be part of the health exchange?...
March 13, 2013

Can agents be part of the health exchange?


Yes, licensed agents and brokers can be part of the health exchange. The federal regulations make it clear that, with proper training, agents and brokers can enroll individuals, employers and employees in Qualified Health Plans (QHPs) through an exchange, as well as outside the exchange. In fact, in some states agents are represented on the governing board of the exchange.
Agents and brokers who assist consumers with an exchange must have entered into an agreement with the exchange that requires the agent or broker to, at a minimum:

  • Register with the exchange in advance of assisting qualified individuals enrolling in QHPs through the exchange;
  • Receive training in the range of QHP options and insurance affordability programs;
  • Comply with the exchange’s privacy and security standards.


Regulations allow agents or brokers to use their own website to complete the selection of a plan inside an exchange, as long as the website:

  • Meets all the standards for disclosure and display of QHP information set out in law and regulations;
  • Provides consumers the ability to view all QHPs offered through the exchange;
  • Does not provide financial incentives, such as rebates or giveaways;
  • Displays all the QHP data provided by the exchange;
  • Maintains audit trails and records in an electronic format for a minimum of 10 years;
  • Provides consumers with the ability to withdraw from the process and use the exchange website.

Additional details, including that of compensation, are still being worked out. PIA is working to ensure agents earn fair and just compensation.

To view more healthcare FAQs, visit: http://www.pianet.com/faq/health-care-reform-faq

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