HealthSherpa, insurers launch initiative to stop unauthorized ACA sign-ups
Highmark Blue Cross Blue Shield and other insurers have teamed up with HealthSherpa to launch the Member Defense Network, an initiative to thwart unauthorized Obamacare sign-ups and plan switches.
In a significant step toward ensuring the integrity of Affordable Care Act (ACA) enrollments, HealthSherpa, the largest ACA quoting and enrollment platform that brokers use to enroll people in ACA plans, is partnering with insurers to thwart unauthorized Obamacare sign-ups and plan switches by launching a new initiative, Member Defense Network (MDN).
Of the more than 16 million people who enrolled in ACA coverage for 2024, nearly 80% worked with an agent to navigate the complexities of the health insurance enrollment process. However, a significant problem has emerged in the form of unauthorized plan switching, a form of fraud where consumers are unknowingly switched to another plan or have their agent of record changed without their consent.
At least 90,000 Obamacare customers have filed complaints about unauthorized enrollments or plan switches since the beginning of the year, according to federal regulators.
HealthSherpa will cut off commissions for unscrupulous insurance brokers who are believed to be signing up thousands of Americans for health plans they don’t need or switching their coverage without their consent. The company is one of more than a dozen private sector brokers allowed by the federal government to directly link to healthcare.gov to sign people up for ACA coverage.
Participating insurers, which represent over half of ACA enrollment during Open Enrollment 2024, include Ambetter, BlueCross BlueShield of North Carolina, CareSource, CHRISTUS Health, Group Health Cooperative of South Central Wisconsin, Highmark BlueCross Blue Shield, Molina Healthcare, and Mountain Health Co-Op.
Last week, the Centers for Medicare & Medicaid Services set new rules requiring agents to log in to their own ACA enrollment accounts every 12 hours, instead of every 30 days, as a security measure.
Related: Biden’s record-high Obamacare sign-ups tainted by the ACA ‘plan switching’ scheme
MDN will launch in Florida in July with the support and cooperation of the Florida Department of Financial Services ahead of a national launch in the fall. Agencies representing over 45,000 insurance agents and brokers are also participating in the launch.