Here's How Much HealthCare.gov Agents Earned Last Year

News April 28, 2023 at 10:37 AM
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HealthCare.gov — the federal government's commercial health insurance distribution system — says that it now has 66,893 registered agents and brokers, and that they appear to earn a mean hourly wage of $33.34.

Officials at the Centers for Medicare & Medicaid Services, the arm of the U.S. Department of Health and Human Services that runs HealthCare.gov, put those details in a new batch of health insurance regulation parameters for 2024 that appeared Thursday in the Federal Register.

HealthCare.gov helped about 12 million of the 16 million people using an exchange plan this year get their coverage.

What It Means

It's possible that many federal policymakers are learning most, or all, of what they know about health insurance agents — and possibly financial professionals in general — from reports on HealthCare.gov.

HealthCare.gov

Congress included the provisions that led to the creation of HealthCare.gov in 2010 when it passed the two laws that make up the Affordable Care Act package. HealthCare.gov helps consumers shop for health coverage from private health insurers, and use ACA premium tax credits to pay for the coverage, for 33 states.

Other states and the District of Columbia have locally run exchange programs.

Agent and Broker Details

Officials included the details about HealthCare.gov agents and brokers in an analysis of the impact of a recordkeeping requirement change on producers. CMS will now require producers to keep an indication that consumers reviewed and approved the information in an application, and that the information appears to be correct, for 10 years.

The annual ACA open enrollment period, or time when it's easiest for people to sign up for exchange plan coverage, now lasts 76 days and runs from Nov. 15 before a plan year starts up until Jan. 15, during the first month of the plan year.

Producers submitted 4.9 million applications for exchange plan coverage during plan year 2022, up from 3.6 million in plan year 2021. Officials did not say how many people were covered by the average application.

The top 1% of producers, or about 668, submitted 1.2 million of the applicants received throughout all of 2021, or 32% of the 2021 total. If those producers worked five days per week year-round, they may have submitted an average of about seven applications per day each, officials estimated.

During the open enrollment period for 2022, all participating producers submitted an average of 38 applications for the entire open enrollment period.

The top 1% of producers accounted for 689,149 open enrollment period applications, or 27% of the open enrollment period total, and they submitted an average of 18 applications per day during the 2022 open enrollment period.

Those top HealthCare.gov producers might have received an average of $16,500 in exchange plan-related commissions for the entire open enrollment period, based on the estimate that they earn $33.34 per hour, according to CMS officials.

CMS lists Brian Gubin as the contact for sections of the parameters document related to agents, brokers and web brokers.

HealthCare.gov Fees

HealthCare.gov charges insurers a fee equal to the percentage of premium revenue they generate from providing coverage through the system.

The program charges a higher user fee in states where HealthCare.gov provides all exchange services, and a lower fee in states where states do some of the work.

The user fee in HealthCare.gov-only states will fall to 2.2% of an insurer's premium revenue in 2024, from 2.75% this year.

In states where the states share the work, the user fee will fall to 1.8% of premium revenue, from 2.25% this year.

The Gathering

Early on, some of the members of Congress and other policymakers who developed the exchange system suggested that it would take the place of human producers.

Now, HealthCare.gov appears to get more than 40% of its business from agents and brokers.

One sign of its reliance on producers: It will hold a 2023 CMS Agent and Broker Summit starting at 9 a.m. May 24, in Washington.

Sessions on the agenda will cover topics such as compliance, health equity and ways producers can expand their reach.

(Image: Centers for Medicare and Medicaid Services)

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