BIP Winter 2024

Voices

At the forefront of consumer protection Ethical brokers drive accountability in health insurance, urging regulators to expose bad actors and protect consumers. By Joshua Brooker

sign-ups and plan changes, with many involving individuals never before insured under the ACA. Ethical brokers, such as those affiliated with NABIP, have been instrumental in reporting such cases to CMS. In many ways, ethical brokers are the reason these bad actors are finally being exposed. The core mission of ethical brokers remains unchanged: to serve as advocates for their clients, ensuring that consumers receive the coverage they need and deserve. Brokers are vital in navigating the complex world of health insurance, providing transparency, guidance and expertise that most consumers would not have on their own. As we move forward, it’s crucial that the public and the media recognize the distinction between the few bad actors and the many ethical professionals who are committed to protecting consumer interests. NABIP will continue to work closely with CMS to develop better oversight mechanisms and ensure that unethical behavior is swiftly addressed. But we also urge the media to take a more nuanced view of the issue — one that acknowledges the critical role ethical brokers play in the system. Ethical brokers are not the problem — they are part of the solution.

Individual health insurance has undergone significant changes in recent years, leading to increased scrutiny of brokers. The Centers for Medicare and Medicaid Services (CMS) and media have highlighted concerns about “bad actors” in the broker community, sometimes framing insurance brokers as part of the problem. However, this narrative fails to tell the whole story. At an increasing pace over the last five years, NABIP has engaged in closed-door meetings with CMS, consistently highlighting the rise in unethical behaviors. In fact, NABIP’s ethical brokers first brought these concerns to light, requesting stricter oversight to protect consumers. Our organization has stronger enforcement measures. We recognized early on that a few unscrupulous agents were exploiting regulatory loopholes to the detriment of consumers. Since the fall of 2023, CMS has asked ethical brokers to shift from private internal reports to more public and formal reports to the call center of any instances of unethical conduct. The natural progression is an uptick in documented complaints against consistently advocated for greater transparency and

Joshua Brooker is immediate past chair and a member of the NABIP Individual Markets Working Group.

TIP: The conversation should not

bad actors. Unfortunately, many of these complaints have been misinterpreted as a systemic issue with brokers. As a result, we’ve seen a growing public perception that brokers are a problem rather than a solution. The real story The truth is that the vast majority of health insurance brokers operate with the highest ethical standards, striving to provide consumers with the best possible coverage options. Some brokers have exploited the system to boost commissions, misleading vulnerable consumers with “free cash” promises in exchange for switching insurance plans. CMS reports receiving over 208,000 complaints in 2024 alone regarding unauthorized

be about whether brokers as

a whole are trustworthy; it should focus on how we can continue to improve the system and root out those who harm consumers.

18 bip magazine Winter 2024