The Centers for Medicare & Medicaid Services is about to publish final regulations to set rules for Web brokers that help consumers use the public exchanges.
The new rules also allow traditional agents and brokers to use the websites to sign consumers up for coverage.
Another provision lets states unable to set up individual exchange programs next year to seek federal permission to set up Small Business Health Option Program exchanges that serve only small groups.
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Still other sections of the final regulations cover topics such as whether health insurance premiums are fair; standards for the new risk management programs meant to shield the Patient Protection and Affordable Care Act from floods of sick consumers who could wipe out carriers; and eligibility appeals.
In the section on Web brokers, state-based exchanges are allowed to choose whether to work with Web brokers.
In states with CMS-run exchanges, Web brokers can open up their sites to outside agents and brokers, CMS says.
"The Web-broker must cooperate with HHS in taking compliance actions against a non-compliant agent or broker, including facilitating a shut-down of any connection to HHS systems while privacy and security incidents and breaches are investigated," CMS said.
In a discussion about states that want to set up SHOP-only exchange programs, CMS acknowledged some commenters argued individual-SHOP programs are better.
CMS will compromise by limiting use of the SHOP-only exchange option only to states uunable to set up an individual-SHOP program, officials said.
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
