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NABIP Responds to CMS Statement Regarding Unauthorized Plan Switching on ACA Marketplace

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The NABIP expressed frustration at CMS’ statement for placing blame on brokers and agents and not acknowledging evidence that switches were made by automated programs.

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The National Association of Benefits and Insurance Professionals (NABIP) responded to a recent statement from the Centers for Medicare & Medicaid Services (CMS) that focused on the issue of unauthorized policy and plan changes on the ACA Marketplace.1 The statement from CMS came in response to reports that users’ plans had been changed without their knowledge or permission. The new plans did not always include the patients’ doctors or required prescriptions.

In a press release, NABIP CEO Jessica Brooks-Woods said, “We are deeply troubled by the portrayal of health insurance agents and brokers in the CMS statement. What was not addressed is the possibility that a large number of these unauthorized plan switches are due to technological vulnerabilities that allow automated systems to make the switches, not the unethical practices of agents and brokers."

According to CMS’ statement, it received an estimated 40,000 complaints of unauthorized plan switches in the first three months of 2024.2 CMS states that it is working to terminate brokers who defraud consumers and is looking into taking stronger actions against brokers and agents who are involved in unauthorized switches.

Brooks-Woods believes that these switches are not the result of individual brokers or agents. "We have presented evidence of systems switching thousands of consumers within mere minutes—a task impossible for humans. This clearly indicates a need for enhanced security protocols within the systems used by CMS," Brooks-Woods said.

She continued, "One of our members lost several thousand clients in less than three minutes due to these vulnerabilities. These incidents not only represents a significant revenue loss but also disrupts the trust and relationship established with healthcare consumers."

Eric Kohlsdorf, president of the NABIP, shared in Brooks-Woods frustration, saying, “As a broker committed to helping consumers access affordable insurance while adhering to extensive government regulations, it's frustrating for our profession to be blamed. NABIP members adhere to a strict ethical code designed to support, protect, and advocate for Americans and our industry. NABIP is eager to collaborate with all stakeholders to find solutions and protections that Americans deserve."

In March of this year, the NABIP launched a campaign promoting its Healthcare Bill of Rights.3 This program outlines the organization’s view on what rights each American citizen should have when it comes to healthcare.

In a press release issued at the time, Brooks-Woods said, “NABIP's Healthcare Bill of Rights articulates the core values and principles of the association. They represent not just our beliefs but NABIP's commitment to ensuring that every American is empowered with the right to high-quality, affordable healthcare. These rights stand as the pillars by which we define our mission, measure our progress, and drive toward a future where equitable healthcare is not a privilege but a standard for all. The announcement of NABIP's Healthcare Bill of Rights took place at our recent Capitol Conference, showcasing NABIP's dedication to shaping a healthcare system that prioritizes the well-being and rights of all Americans. This significant milestone is a cornerstone in our commitment to creating a healthcare landscape that is privately accessible and affordable for every citizen."

Sources

  1. NABIP Responds to CMS Statement on Plan Switching in the ACA Marketplace. NABIP. May 14, 2024. Accessed May 15, 2024. https://www.prnewswire.com/news-releases/nabip-responds-to-cms-statement-on-plan-switching-in-the-aca-marketplace-302144459.html
  2. CMS Statement on Agent and Broker Marketplace Activity, Update. CMS. May 6, 2024. Accessed May 15, 2024. https://www.cms.gov/newsroom/press-releases/cms-statement-agent-and-broker-marketplace-activity-update
  3. NABIP Launches Groundbreaking Healthcare Bill of Rights Campaign to Revolutionize the American Healthcare System. NABIP. March 12, 2024. Accessed May 15, 2024. https://www.prnewswire.com/news-releases/nabip-launches-groundbreaking-healthcare-bill-of-rights-campaign-to-revolutionize-the-american-healthcare-system-302086864.html
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