With November just around the corner, it is time for brokers dealing in under 65 health plans to complete their annual Affordable Care Act (ACA) certification. The 2021 certification process is set to open by the end of August. All brokers must complete their annual ACA certification to sell any ACA-related policies during the 2021 open enrollment period, which runs from November 1 to December 15.
Mandatory Annual Certification
Fall is a busy time for agents and brokers, as everyone gears up for the coming open enrollment periods. During this time of year, preparation is key. Every agent looking to sell ACA plans through the Health Insurance Marketplace must prepare by completing their annual certification, or else they are ineligible to help clients receive the ACA care that they need.
Those who fail to complete their certification may be subject to have their Marketplace Agreement(s) suspended or terminated. All contracting ACA carriers require a 2021 certification, including Ambetter, Anthem Blue Cross Blue Shield, Bright Health, Christus, Molina, Oscar, Pivot, National General, UnitedHealthOne, and IHC Group.
Brokers can gain certification through a free training course from the Centers for Medicare & Medicaid Services’ (CMS) Marketplace Learning Management System (MLMS) or through a U.S. Department of Health and Human Services (HHS) verified vendor. Brokers will need to pay to access vendor training, but these third-party programs may include continuing educations courses that the MLMS does not.
On the MLMS site, new and returning agents must log in and update their CMS Enterprise Portal profile. Returning users who have forgotten their usernames or passwords are asked not to create new accounts, but to contact the help desk and reset their information. The certification curriculum includes courses on ACA and Marketplace basics, individual Marketplace eligibility and enrollment, and privacy standards and information screening. Agents and brokers who completed the 2020 certification are eligible to complete a shorter “What’s New for Agents” training for 2021.
Health Insurance Exchange
ACA compliant plans are found in the Health Insurance Exchange, also known as the Health Insurance Marketplace. The CMS maintains the federal Marketplace, but some states have their own marketplaces, like California and New York. The Health Insurance Exchange on Healthcare.gov is where all health insurance shoppers applying for coverage during the open enrollment period shop for plans.
In 2019, agents and brokers helped over 3.6 million individuals find medical plans through the Marketplace. That equates to 43 percent of all enrollments during the 2019 open enrollment period.
The Affordable Care Act
The Patient Protection and Affordable Care Act, also known as the ACA or Obamacare, was enacted by Congress in March of 2010. The act encompasses three main goals: to provide affordable healthcare options to more people, to expand the Medicaid program, and to support innovative medical care advancements that lower the general cost of healthcare services. To be considered ACA compliant, plans must include ten essential health benefits, including emergency services, hospitalizations, and preventative and wellness services.
Empower Brokerage is dedicated to helping you educate your clients on the insurance they need and staying on top of their health. Whether it’s through webinar training, one-on-one calls, seminars, or marketing plans. We want you to be successful.