GoHealth Team Member,
The 2016 Open Enrollment Period is off to a great start. In the first three weeks of November, the GoHealth Marketplace technology has helped facilitate enrollments and is supporting agents throughout the country. GoHealth is working hard to understand your needs and we want to remain as a flexible and collaborative partner to help make your open enrollment as successful as possible. Together we have been able to enroll a significant number of consumers in on- and off-exchange plans, making a significant impact on not only the agent community but the health and financial outcomes of countless Americans.
Technology Service Update:
GoHealth strives to not only be a technology vendor, but also a strategic partner that helps work with you to address changing market conditions and to adapt to the regulatory landscape. On Friday afternoon, the Department of Health and Human Services released their annual regulation clarifications and proposed regulatory changes for the 2017 plan year. While there are many important items in this 381-page document, we are extremely excited that HHS is formally indicating that they are considering building the web service APIs that will enable GoHealth to submit on-exchange enrollments through a formally-documented and well-supported interface. We anticipate that GoHealth will be one of the first companies to integrate to these APIs and this will enable all enrollments to complete on our website at nearly a 100% submission success rate. This will also make it much easier for GoHealth to support all enrollment scenarios in a streamlined fashion, including DIY Consumer Enrollments. This will empower brokers and consumers to quickly determine QHP, APTC and CSR eligibility through the GoHealth Single-Site Enrollment platform and submit enrollments without the need for enrollment assistance calls. This is extremely exciting news and we look forward to helping you integrate to these APIs in 2016.
Unfortunately, this Notice of Benefit and Payment Parameters document also states that the current Single-Site Enrollment process is not to be used for the time being and we must wait until these APIs are available before we take these QHP eligibility applications on our site. While GoHealth believes our platform is asking all required application questions, is correctly determining eligibility, and is properly protecting consumer data, we believe there are other companies who are not being as diligent in their process. Since CMS likely doesn’t currently have the resources to review and regulate the various processes used by all of these companies, we believe they are prohibiting this for all issuers and web brokers until they can formally support this capability for everyone. Further direct communication with CMS this week also indicated that they are requiring everyone to stop using alternate enrollment processes immediately. Unfortunately, this means that GoHealth must disable the Single-Site Enrollment product on your site before Monday, November 30th.
After a face-to-face meeting with CCIIO last week and after reading this guidance on Friday, GoHealth spent the weekend and early this week testing the regular Direct Enrollment flow. You may know this as the Double-Redirect process. The results are very encouraging and indicate that the temporary process to use the regular Direct Enrollment will not have a negative impact on your success as agents and may be a better process for many. With the updates healthcare.gov has made available through Direct Enrollment flow this year, we have found that the total enrollment time for agents is very similar to the Single-Site Enrollment. The agents surveyed about this process also reported a high level of customer satisfaction due to the confidence that every enrollment scenario can be supported through a single process.
While GoHealth is committed to being the industry-leading shopping and enrollment platform for all health insurance and related products, we take compliance and our relationship with CMS very seriously. We understand that this information comes with a very short notice and the holiday weekend makes communication and broker training difficult, but we will be following up this message with many training opportunities that will be available starting next week. However, the switch in application process should be painless, as the submission processing flow is natural and easy to follow.
We are also committed to getting your platform plugged into the new CMS APIs as soon as they are made available to us. As the President of the Association and Web-Based Health Insurance Brokers, our CTO is working very closely to collaborate with CMS to build these web services as quickly as possible. As soon as we have more information regarding the design or the timeline for this next-level integration, we will be sure to keep you informed.
We look forward to helping you through this transition and we will publish more information as it is known.
Your Partner,
Michael Owens
General Manager, Agent Services