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Resources for Agents and Brokers in the Health Insurance Marketplaces

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PLAN YEAR 2017 REGISTRATION AND TRAINING IS NOW LIVE – Check out the Kick-off Message from Kevin Counihan!

CMS is excited to announce FFM Agent and Broker Registration for the plan year 2017 is now live! Click here to learn more about the important role agents and brokers play in assisting consumers in the FFMs and highlights on plan year 2017 registration and training from Kevin Counihan, CMS’ Chief Executive Officer of the Marketplace and Director of CCIIO.

Registration for the Federally-facilitated Individual Marketplace (FFM) and the Small Business Health Options Program (SHOP) Marketplace

Plan year 2017 FFM agent and broker registration and training is now available on the CMS Enterprise Portal at https://portal.cms.gov. Training is offered by CMS on the Marketplace Learning Management System (MLMS) as well as through the CMS-approved vendors listed here.

  • Annual FFM Registration Requirements

    All agents and brokers participating in the FFM must complete registration on the CMS Enterprise Portal at https://portal.cms.gov (i.e., create an FFM user account, select the agent/broker role, and complete identity proofing) if they have not done so previously.

    To continue participation in the Federally-facilitated Individual Marketplace each year, agents and brokers must also complete a Marketplace Learning Management System (MLMS) profile, complete the required training and exams, and execute the Individual Marketplace Agreements (i.e., General and Privacy & Security Agreement). To begin this process, agents and brokers must log in to the CMS Enterprise Portal at https://portal.cms.gov.  Agents and brokers who have previously participated in the FFMs already have a CMS Enterprise Portal account and must use their existing credentials to log in to the portal to access the MLMS.

    To continue participation in the SHOP Marketplace each year, agents and brokers must also complete an MLMS profile and execute the SHOP Marketplace Agreement, and are strongly encouraged to complete the associated training and exams.  To begin this process, agents and brokers must log in to the CMS Enterprise Portal at https://portal.cms.gov with their existing credentials.

    Agents and brokers who participated in the FFMs for the Individual Marketplace for plan year 2016 are eligible to take a streamlined Refresher Training either through the MLMS or a CMS-approved vendor regardless of how they completed the plan year 2016 training.

    For plan year 2017, agents and brokers can complete the CMS-developed training on the MLMS or through a CMS-approved vendor. Agents and brokers will access both the CMS-developed training and CMS-approved vendor training via the CMS Enterprise Portal at https://portal.cms.gov.

    CMS-approved Vendors Offering Plan Year 2017 FFM Agent and Broker Training

    CMS is pleased to announce that it has approved the following vendors to offer plan year 2017 training to agents and brokers in the FFM:

       America’s Health Insurance Plans, Inc. (AHIP) : for more information go to 
       https://www.ahipexchangetraining.com/file.php/1/public/About.html

       National Association of Health Underwriters (NAHU) : for more information go to 
       http://www.nahu.org/education/ffmtraining/index.cfm

    Completion of a training curriculum, including the associated exams, through one of the above CMS-approved vendors will fulfill the FFM training requirement for agents and brokers registering to participate in the Individual Marketplace for plan year 2017. CMS-approved vendors are required to cover, at a minimum, the same topic areas as are covered in the CMS training, and pursuant to 45 CFR 155.222 are required to offer continuing education unit (CEU) credits in a minimum of five states where the FFMs are operating. The number of CEUs and the states where they are available vary by vendor. Vendors may charge a fee for taking their training.

    If you complete FFM training through a CMS-approved vendor, you will still need to execute the applicable Agreements with CMS on the MLMS prior to assisting consumers seeking to enroll in health coverage through the FFMs.

    CMS-approved vendor training needs to be accessed via the CMS Enterprise Portal at https://portal.cms.gov/.

    If you require assistance with any of the CMS-approved vendor training options, please contact the vendor’s help desk directly:
    • AHIP:
      Phone support: 800-984-8919 from 8:00 AM – 12:00 AM ET, Monday through Friday and from 8:30 AM – 5:30 PM ET, Saturday and Sunday
      Email: support@ahipinsuranceeducation.org
    • NAHU:
      Phone support: 844-257-0990 from 9:00 AM – 6:00 PM ET, Monday through Friday
      Email: nahu-ffm@nahu.org

Key Registration and Training Resources


Application Posted for the Plan Year 2018 Federally-facilitated Marketplace Agent and Broker Vendor Training Program

  •  For a third consecutive year, the Centers for Medicaid & Medicare Services (CMS) is continuing the vendor training program for Marketplace agents and brokers. Under this program, the Department of Health & Human Services (HHS) recognizes an agent’s or broker’s successful completion of a Marketplace training program from an approved vendor as sufficient to satisfy the requirement to receive training in the range of qualified health plan options and insurance affordability programs. Entities interested in hosting Marketplace training for plan year 2018 must comply with all requirements outlined in 45 C.F.R. § 155.222.

  • The plan year 2018 vendor application is now available. Prospective vendors must submit all application materials to AgentBrokerVendor@cms.hhs.gov via email by 11:59 PM Eastern Time on November 23, 2016. For more information about the vendor training program and application process, please reference the Questions and Answers for the Plan Year 2018 Vendor Training Application. All questions and application materials should be directed to CMS at AgentBrokerVendor@cms.hhs.gov 


Background

To the extent permitted by states, licensed agents and brokers may assist consumers in applying for qualified health plans (QHPs) and insurance affordability programs including premium tax credits and cost-sharing reductions. They play a crucial role in educating consumers about the Health Insurance Marketplaces, both during annual open enrollment and throughout the coverage year.

Some states have set up a State-based Marketplace, while other states work with the federal government in a State-partnership Marketplace or Federally-facilitated Marketplace (FFM). Agents and brokers can help consumers, no matter what state the consumers live in, as they apply for and choose insurance options. Agents and brokers who wish to participate in the FFM must first complete a two-part registration process (see “Registration for the Federally-facilitated Marketplace” below for more information on this requirement). This page contains resources for agents and brokers who are assisting individual market consumers in the Marketplaces, as well as small group market employers and employees in the Small Business Health Options Program (SHOP) Marketplace.


General Resources

Guidance

Regulations


News for Agents and Brokers

News for Agents and Brokers is an electronic source of information for Federally-facilitated Marketplace (FFM) agents and brokers. As with other communications to our agents and brokers, this monthly newsletter is disseminated electronically to agents and brokers on our e-mail listserv. We are committed to keeping agents and brokers informed about upcoming webinars/trainings, registration resources, relevant guidance and regulations, important announcements, and other useful information. Please take a moment to read the latest issue.


Agent and Broker Webinars

Join us during our scheduled webinars to learn more from CMS experts on key topics.

Upcoming topics for October and November 2016 include:

  • Plan Year 2017 FFM Registration and Training for Agents and Brokers
    • Friday, October 28 from 1:00 PM – 2:30 PM ET register here
    • Wednesday, November 9 from 1:00 PM – 2:30 PM ET register here
    • Brief Description: This webinar will walk new and returning agents and brokers through the registration and training steps for Plan Year 2017, highlight changes since Plan Year 2016, and describe the options for completing training either through the CMS Enterprise Portal via the MLMS or through one of the CMS-approved vendors. The webinar will also briefly review the SHOP Marketplace registration requirements.
  • Health Insurance Marketplace 2017 Open Enrollment Operational Updates and Announcements for Agents and Brokers
    • Wednesday, November 16 from 1:00 PM – 2:00 PM ET register here
    • Brief Description: This webinar will provide agents and brokers with key updates and announcements related to assisting consumers during Plan Year 2017, including topics such as upcoming deadlines, operational updates, answers to common questions, and marketing opportunities.

Webinar Registration Instructions

To register for a webinar complete the following steps (agents and brokers returning to REGTAP should start at step 3):

  1. If you are new to REGTAP, visit https://www.REGTAP.info and "Register as a New User." You will receive an email to confirm your account
  2. Click on the link in the email to complete the process of creating a user account
  3. Log in to your account at https://www.REGTAP.info
  4. Select "Training Events" from "My Dashboard."
  5. Select the "View" icon next to the event title for the webinar you are interested in attending.
  6. Select "Register Me."

If you require assistance with webinar registration, you may contact the Registrar at 800-257-9520 or registrar@REGTAP.info. The registrars are available by phone from 9:00 AM – 5:00 PM ET, Monday through Friday. Registration closes 24 hours prior to each event.


Agent and Broker Federally-Facilitated Marketplace (FFM) Registration Status Lists

    • The Agent and Broker FFM Registration Completion List (RCL) contains the National Producer Numbers (NPNs) for agents and brokers who have completed FFM registration for the following plan years: 2014, 2015, 2016 and 2017. CMS posts this list as frequently as daily. All NPNs are self-reported by the agent or broker during FFM registration, and should be validated against state and/or other The National Association of Insurance Commissioners records to confirm state licensure.
    • The Agent and Broker FFM Registration Termination List (RTL) contains the NPNs for agents and brokers whose FFM agreements and registration for the 2016 plan year have been terminated by CMS. Termination is described in regulation at 45 CFR 155.220(f)-(g).
    • Issuers, web-brokers, and agents and brokers can access the RCL and RTL by following the link here Data.Healthcare.Gov Registration Status Lists Landing Page
    • Issuers, web-brokers, and agents and brokers can access the RCL and RTL data dictionaries by following the link here RCL Data Dictionary RTL Data Dictionary
    • For more information on the new RCL and RTL, review the slides from the June 15, 2016 “New Registration Completion and Termination Lists” webinar.

Web-broker Application Process

A web-broker is an individual agent or broker, a group of agents and brokers, or a company that is interested in providing a non-Federally-facilitated Marketplace (FFM) website to assist consumers in the qualified health plan (QHP) selection and enrollment process as described in 45 CFR.§ 155.220(c)(3). FFM web-brokers must meet CMS’ regulatory and technical requirements and establish an Internet website with an Application Program Interface (API) connection to the FFM.

Web-brokers must be able to implement the technical requirements to connect with the FFM through the Direct Enrollment pathway. These technical requirements include understanding how to create and digitally sign a Security Assertion Markup Language (SAML) response and how to invoke Simple Object Access Protocol (SOAP) web services.
For more information on the web-broker requirements and application process, please contact CMS at webbroker@cms.hhs.gov. Interested parties should also review the guidance document “Role of Agents, Brokers, and Web-brokers in the Health Insurance Marketplaces.”

Key Web-broker Resources

2016 FFM Web-broker List

Public 2016 FFM Web Broker Entity List

This list contains the names of web-brokers participating in the Federally-facilitated Marketplace (FFM) who have signed 2016 Web-broker Agreements with CMS and completed FFM registration for the 2016 plan year. This list contains web-brokers whose requirements have been verified as of September 15, 2016. CMS will update this list on a periodic basis.

Eligibility Application and Enrollment

When assisting individual market consumers in completing the eligibility application and enrolling in health care coverage online through the FFM, an agent or broker may use one of two pathways:

      • The Direct Enrollment Pathway: In this pathway, registered agents and brokers affiliated with certain QHP issuers or web-brokers may connect to the Federally-facilitated Marketplaces through the QHP issuer’s or web-broker’s web site. The agent or broker logs in to the QHP issuer’s or web-broker’s website with their agent/broker account, and “drives” the application and enrollment process; the consumer does not log in, but must consent to giving their personally identifiable information (PII) to the agent or broker.
      • The Marketplace Pathway (via HealthCare.gov): In this pathway, registered agents and brokers help consumers to complete the eligibility application and enroll in coverage directly at HealthCare.gov. The consumer creates an account, logs in to the site with a consumer account, and “drives” the process; the agent or broker does not log in to HealthCare.gov.  Agents and brokers must obtain consumers’ consent before accessing or viewing the consumer PII.

Key Eligibility Application and Enrollment Resources

SHOP Marketplace-specific Resources

When assisting employers and employees in completing the eligibility application and enrolling in coverage online through the SHOP Marketplace, an agent or broker will use the SHOP Marketplace Agent/Broker Portal.

  • Licensed and registered agents and brokers will connect to the SHOP Marketplace through the SHOP Marketplace Agent/Broker Portal available through HealthCare.gov or by visiting https://healthcare.gov/marketplace/small-businesses/agent
  • The agent or broker logs in to the SHOP Marketplace Agent/Broker Portal with their User ID and password. The agent or broker establishes an authorization with an employer, and assists with the application, enrollment process, and case management for employers in the SHOP Marketplace.
  • An employer must create their own log in through HealthCare.gov and confirm the authorization of an agent or broker before the agent or broker may gain access to their account.  
  • All agent and broker authorizations in the SHOP Marketplace will be established at the employer-level, employees can not authorize a separate agent or broker but can enroll with the assistance of their employer selected and authorized agent or broker.

Key SHOP Marketplace Resources