Reform Alert - News from the Blues' Office of National Health Reform

CMS releases data collection efforts

March 14, 2013

On February 7 the Centers for Medicare and Medicaid Services (CMS) released materials related to Marketplace data collection efforts.

Agent/Broker Data Collection

Section 1312(e) of the Affordable Care Act (ACA) and Section 155.220 of the Marketplace Final Rule describe the requirements necessary for agents/brokers to enroll eligible individuals, employers, and employees in qualified health plans through the Marketplace. To participate as facilitators to enrollment, the Marketplace Final Rule requires agents/brokers to register with the Marketplace, complete a training course covering eligibility and enrollment criteria for assisting in QHP enrollment, and sign an agreement that formalizes their understanding and commitment to adhere to the rules of the program. The proposed data collection for agents and brokers includes the necessary data elements agents and brokers will be required to provide to the Marketplace in order to meet the above requirements. This includes personal identifying information as well as professional information such as the agent/broker’s affiliated company name, national producer number, appointment data, licensure status, and whether the agent/broker will be assisting with Marketplace enrollment, SHOP enrollment, or both. This proposed data collection has a comment period of 60 days, with comments due by April 8, 2013.

The information in this document is based on preliminary review of the national health care reform legislation and is not intended to impart legal advice. The federal government continues to issue guidance on how the provisions of national health reform should be interpreted and applied. The impact of these reforms on individual situations may vary. This overview is intended as an educational tool only and does not replace a more rigorous review of the law’s applicability to individual circumstances and attendant legal counsel and should not be relied upon as legal or compliance advice. As required by US Treasury Regulations, we also inform you that any tax information contained in this communication is not intended to be used and cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.