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The Health Insurance Open Enrollment Period

by John Hansen

Before the implementation of Obama Care in California, health insurance enrollment lasted all year long. There was no Open Enrollment Period. Consumers could purchase health plans and Agents could sell them throughout the year. However, since the Affordable Care Act (ACA), a three month Open Enrollment Period has been established.

For consumers, this means you have to be on your A-game. No longer can you purchase health insurance throughout the year. If you do not apply during the Open Enrollment Period, you will have to wait until next year to get coverage, or you will have to find a way to get health insurance through an employer sponsored plan.

Open Enrollment Period in California

For Open Enrollment 2016, the three month period was from November 1, 2015 to January 31, 2016. In 2017, we expect the enrollment period to be the same. These dates match the time frame for the Healthcare.gov enrollment period as well. At some point, leaders in the health care industry expect the Open Enrollment Period to decrease down to 45 days. For more information, see Covered California Open Enrollment.

What’s an agent supposed to do the rest of the year?

How do agents deal with the heavy influx of business during those three months, and what do they do with their business during the rest of the year?

At a Blue Shield of California meeting in May 2016 with top California individual and family health insurance agents, the agents were asked this question. They responded by sharing how they deal with the complexities of being in an industry with an Open Enrollment Period.

  • Sell Other Products: Many health agents sell other products as well. Outside of Open Enrollment, they focus on auto, casualty, homeowners, life insurance, etc.
  • Take Vacations: Everyone needs a break sometime. Health agents make sure to schedule their vacations outside of the Open Enrollment Period.
  • Service Clients: Enrollment may be done, but often servicing these clients has just begun when Open Enrollment comes to a close. Lots of service issues for existing clients arise related individual plans, group plans, Covered California and Medi-Cal complications, etc. As the market steadies, customer retention becomes a key issue for agents, and the services provided for customers often happen outside of the Open Enrollment Period.
  • Keep Selling During the Special Enrollment Period (SEP): Consumers with qualifying life events can still enroll outside of Open Enrollment. In 2016, there are expected to be 300,000 SEP enrollments, so there is still work to do. Around 50% of new sales are coming through brokers. Covered California is writing a lot of direct business. Navigators and counselors are only doing 10% of the business. Obviously, there is still a large amount going direct to Covered California or to the carriers, but there’s a lot of opportunities for brokers both during Open Enrollment Period and the Special Enrollment Period.
  • Sell Dental and Medicare: Top Blue Shield representatives said that their agents sell a lot of dental and Medicare outside of Open Enrollment Period. As a health plans that only offers medical and dental, that made a lot of sense. However, most agents, due to the low commissions on dental, tend to steer away from focusing on that product unless it helps them sell other plans.

How do agents deal with the demands of Open Enrollment?

The majority of new enrollments and plan changes happen each year during the California Open Enrollment Period. The workload for an agent increases tremendously during this time. So, how do agents deal with these increased responsibilities?

  • Hire Temps: During Open Enrollment, often agents need extra help servicing clients. It can be difficult to get licensed temporary workers, but some of the agents used strategies like hiring retired agents just for the enrollment period.
  • Work More: During Open Enrollment, many agents put in more hours. Some work 6 days/week instead of the typical five. Then, outside of Open Enrollment they take more time off. Agencies are happy to pay their brokers overtime during Open Enrollment. They find it’s worth it because the opportunity for new sales is so great.