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Exchange board focusing on customer service concerns

Exchange board focusing on customer service concerns

Idaho Freedom Foundation staff
August 15, 2013
[post_thumbnail] Chairman of the Idaho State Health Insurance Exchange Board, Stephen Weeg (center), during a board meeting Tuesday listed a hypothetical conflict where customer services representatives would only sell a portion of available plans to consumers.

During a four-hour meeting Tuesday of the state’s insurance exchange board, board members spent a good deal of time focusing on the character and qualifications for the exchange’s customer service agents.

Alberto Gonzalez, operations project manager for the exchange, presented to the board a plan for a three-tiered customer service system that will begin when the exchange launches Oct. 1 and will remain in place at least until the beginning of 2015. The plan includes trained telephone-based customer service agents, existing health insurance agents throughout the state who choose to sell their insurance plans through the exchange and select “In Person Assistants” (IPAs), who will represent the insurance exchange at certain hospitals, clinics and district health centers throughout the state.

Gonzalez also noted that existing health insurance agents in the state will provide most of the customer service for the exchange, adding that IPAs and telephone customer service agents will be secondary.

Gonzalez presented a list of qualifications and training requirements for the customer service professionals, including: the completion of a high school diploma; the completion of a 20-hour two and one-half day training course; passage of a certification test with an 85 percent or better score; and the submission and passage of a background check.

Board member Hyatt Erstad, speaking of the customer service agents, asked Gonzalez, “Will they be bonded? If there is a data breach with one of these people, we don’t want the insurance exchange to be legally liable.”

“That is a good question,” Gonzalez replied. “We’re consulting with our legal counsel on this.” Gonzalez also presented a list of both criminal and misdemeanor convictions that would disqualify a prospective customer service agent from working in the position for up to five years.

“This has me concerned,” noted Sen. Jim Rice, R-Caldwell, also an exchange board member. “If, say, we have somebody who has committed identity theft, we want to disqualify them from working with the exchange for more than five years. We would be putting a person who has violated the law in touch with personal information of not just one, but many other people. I think we need to disqualify one for more than five years. I’d say we should double that number.”

Bill Deal, director of the Idaho Department of Insurance who serves on the exchange board in an advisory capacity, noted that the five-year disqualification provision was consistent with the policies that regulate employees in his department as well as the licensing of insurance agents statewide.

Board member Margaret Henbest asked, “Are we legally liable if our requirements (for customer service agents) are different from those of insurance agents?”

“If our requirements are stricter, I think we should be fine,” Gonzalez responded.
The board did not finalize a precise set of disqualification criteria for customer service agents, pending a consultation with its legal counsel.

Board member Tom Shores reported that he and Gonzalez had emailed nearly all of the approximately 6,000 health insurance agents throughout the state, inviting them to participate in the exchange. Thus far, he said, approximately 700 of them have chosen to participate.

“We are relying heavily on broker agents for this,” board chairman Stephen Weeg said. “Thus far only about 10 percent have agreed to participate. That is not especially encouraging at this point.”

Shores told Weeg that “it’s actually a pretty good number at this point,” and gave assurances that more agents would join with the insurance exchange.

Weeg also asked the board members about a potential legal and ethical dilemma with the exchange. Citing a hypothetical scenario in which a customer calls the exchange, is referred to an agent and the agent only distributes a fraction of all the insurance plans that the exchange distributes, Weeg wondered if that agent would actually tell a customer about all the array of insurance plan offerings that the exchange has available. “The enabling legislation (the law that established the creation of the exchange) requires that we maintain neutrality of all our insurance plans,” Weeg noted.

Shores explained that the exchange’s website will detail which insurance plans any one individual agent will be selling and, in his view, Weeg’s concerns were not problematic.

The board voted to allocate $1.7 million for training and hiring of the exchange’s customer service representatives. Weeg also announced that the logo and website address of the insurance exchange will probably be revealed next week.

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