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Member Research & Reports

Member Research & Reports

GW Report Describes Differences in Health Benefits Advisors Under Health Reform

A new report by researchers at Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University describes the differences among six different categories of benefits advisors that are now operating in the individual health insurance market:  commercial agents and brokers; Medicaid enrollment brokers; certified applications assisters; navigators; non-navigator (in-person) assistance personnel; and health center outreach and enrollment assistance workers. The brief looks at the role of each benefits advisor; the health plans that advisors are authorized to work with; the training requirements and compensation for advisors; and cases in which conflict-of-interest might influence an advisor’s ability to objectively give advice to consumers in the new Marketplaces.

The report describes the impact that benefits advisors have on consumers, finding that most people required help in order to successfully enroll.  The brief found that in the post-ACA world, commercial agents and brokers will continue to play an important role in getting consumers the answers they seek to make important decisions about health insurance, raising questions about their compensation model and conflicts of interest.

The report, “Health Insurance Benefits Advisors: Understanding Responsibilities, Regulations, Restrictions and the Relevance to Implementing the Affordable Care Act­­”, was authored by associate professor of health policy Ms. Alexandra M. Stewart, research scientist Ms. Marisa A. Cox,  and professor of health policy Dr. Leighton Ku.