Health reform has changed the way a lot of producers do business, but it turns out it hasn’t really changed where they get that business from. A recent release from California’s state exchange, Covered California, suggests that an overwhelming majority of healthcare shoppers in the Golden State have chosen plans from the biggest participating carriers.
Anthem, Kaiser Permanente, Blue Shield of California and Health Net claimed 96% of the enrollees in California, exchange officials said. By contrast, smaller carriers like Valley and Sharp saw just single-digit signups.
Oakland-based producer Denise Lombard said her experience with clients has been even more drastic—and with good reason.
“Actually, 100% of my clients have chosen those plans,” Lombard said. “I do business statewide, and the fact that Anthem has UC hospitals in its network is a big thing for people. It’s a place people want to have access to—it’s the ultimate in insurance.”
Neil Crosby, director of sales at Warner Pacific insurance industry and spokesperson with NAHU, echoed Lombard’s sentiments, adding that the same trends probably apply for producers nationwide.
“The benefits are pretty much the same between all the plans, so it’s a matter of pricing and providers,” Crosby said. “Really, the agents are talking about who [the client’s] doctor is, and finding a plan that has that doctor in it.”
Because the bigger carriers have larger provider networks, they’re coming out on top, Crosby said.
Name recognition also has a big role to play in where producers are making the most sales.
“People just know the names, versus the smaller, more regional carriers,” he said. “A lot of [clients] are qualifying for premium assistance subsidies, and if someone is paying for a great portion of your premium, why not choose a name you’re aware of?”
Steven Hurd, owner of San Diego-based Pacific Health Brokers, added that preconceived notions of producers themselves may be at play.
"I think part of it is the brokers and agents," Hurd said. "I don't think there's anything wrong with the small regionals, but we don't want to get into figuring out where those [provider] directories are and the nuances of enrolling people there. It's difficult in this business right now, and if we're not familiar with the small regionals, we tend to shuffle to the big name carriers."
Crosby stressed that where producers make sales doesn’t have great bearing on their pocketbooks, as commission for all exchange sales is the same. However, Lombard expressed a wish for the smaller state carriers to succeed with Covered California and ramp up greater competition in the market.
“I’d love to see them all succeed,” she said, adding that she was “not happy” with any of the bigger networks, who are “really hard to work around.”
“I have complete empathy with my client who’s seven-months pregnant. I could find her a doctor in one plan, and a hospital in another plan,” Lombard said. “I can’t find a solution for her. That’s painful. That hurts.”
Lombard said producers are “trying to do the best we can with the networks that are available,” but that independent agencies could really benefit from more options in the long run.
