Agents and the ACA – Week One Concludes, Week Two Begins

As the first week of the Affordable Care Act (ACA) came to a close and the second week began, the White House reported that www.healthcare.gov had more than 8.6 million unique visitors but was unable to confirm how many people actually signed up...
October 9, 2013

As the first week of the Affordable Care Act (ACA) came to a close and the second week began, the White House reported that www.healthcare.gov had more than 8.6 million unique visitors but was unable to confirm how many people actually signed up. There were glitches reported, including long wait times and, on occasion, a crashed website. While the Administration isn’t planning on releasing enrollment numbers until November, as of last Friday, 52,000 insurance applications have been started online on the websites of the 24 state-based marketplaces.

PIA members have been calling PIA National to request help. Many agents report they are still having trouble registering for the Federally-Facilitated Marketplaces (FFM). There have been delays in online enrollment in the Federally-Facilitated Small Health Option Program (FF-SHOP). But by far, the most common question asked by agents involved compensation.

Late Friday, the Centers for Medicare and Medicaid Services (CMS) sent a message intended for agents and brokers who are registering for the FFMs — including State Partnership Marketplaces (SPMs). In it, they addressed the issue of commission payments for placing coverage in an Exchange. Apparently, federal officials had not originally contemplated payment being made to insurance agencies rather than to individual producers providing assistance to consumers. In response to questions from many PIA members, we raised that issue with HHS and on Friday, HHS issued this clarification.

The statement from HHS confirmed the information we distributed earlier that day in a special edition of PIA National Newsline (login required):

  • Compensation agreements need to be worked out between agents and the issuers selling the marketplace policies.
  • There is one window of opportunity to submit a National Producer Number (NPN) to the issuer and it is when the application is being completed. When the application is being filled out, the agent or customer must submit a NPN on the application. Please double check the NPN for accuracy, as there is no room for error on this step! If a NPN is not submitted on the application, you may not be compensated!
  • If you wish for your corporate NPN to be submitted to the issuer (as opposed to your individual agent or broker NPN), then make sure that the corporate NPN is the one submitted on the application. We believe that the NPN will be transferred to the issuer so compensation may be facilitated.


The special edition of PIA National Newsline (login required) also included answers to other agent questions and additional resources.

PIA National Healthcare Reform Resource Center


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