Kyle J. Kautzmann, GBA Quoted in Crain’s

New York City’s largest health plan delivered a blow to insurance brokers when it became the latest to cut commissions.

Empire BlueCross BlueShield will no longer pay brokers to sign members for its individual plans after April 1, it said Tuesday in an email sent to insurance agents. Brokers who signed members for plans before April 1 will continue to receive $12 per member per month through the end of the year. But a $6 per member per month bonus that was offered for brokers who enrolled new 2016 members into 2017 Empire plans won’t be honored.

“We recognize that this change will present an additional challenge to you in a difficult market, as carriers adjust to the rapidly changing individual market,” Empire wrote. “We remain committed to the individual market, and we thank you for sharing your expertise with your clients—our members—in this demanding environment.”

An Empire spokeswoman declined to comment beyond the statement released to brokers.

Empire is the third insurer to cut commissions in recent months, following similar moves by UnitedHealthcare and Oscar. Oscar said it would lower commissions, but not end them altogether in the individual market.

Last year, Oscar announced it would start paying $6 per contract this month, regardless of the number of family members enrolled in a plan, down from its earlier commitment of $14 per contract each month for individual subscribers and up to $26 for enrolled families. Earlier, UnitedHealthcare cut rates to $10 per contract per month from $15 for plans sold on the exchange, as well as for Oxford off-exchange plans

The changes follow the collapse of Health Republic last year, which left about 200,000 members statewide looking for a new option for coverage among the state’s remaining health plans.

“Throughout the state, there’s a number of carriers, particularly in light of the Health Republic failure, that are looking at profitability and trying to figure out a way to cut corners,” said Craig Hasday, president of Frenkel Benefits, an insurance brokerage in Manhattan. “Unfortunately, brokers are an easy target.”

Hasday’s company is unaffected by the change, but as legislative chair of the New York State Association of Health Underwriters, he represents other agents who are affected.

Lower commissions have led many brokers to reconsider working with customers in the individual market. Kyle Kautzmann, president of EBNY Insurance Services in Manhattan, said he doesn’t plan to take on any more new business in the individual insurance market following cuts by carriers and the chaos caused by Health Republic’s failure.

“There’s a lot of overhead involved in any business, and how do you expect me to work for free? We’re providing value to clientele in checking out all these different options. It’s not right,” Kautzmann said. He plans to focus more on the small-group market.

Richard Varney Jr., owner of Insurance Suffolk in Amityville, L.I., echoed that sentiment. Both Oxford and Aetna have raised commissions for enrollments in the small-group market, leading him to pursue more business in that area.

While most people get health insurance through their employer, several hundred thousand have turned to the New York State of Health marketplace to sign up for non-Medicaid coverage.

Empire had 2.9 million members in New York City as of Sept. 30, according to Crain’s list of the city’s largest health insurers. Only a small fraction are signed up through the individual market. Empire BCBS had about 41,500 members of this type in February 2015, according to the New York State of Health’s 2015 enrollment report.

Those individuals can sign up through New York’s exchange website, nystateofhealth.ny.gov, or can enroll through the insurer or a broker. There are also navigators and certified application counselors, who can assist with enrollment for free.

The navigators are required to be unbiased and can’t steer people to a specific policy. Given the complexity of the market, Hasday said he thinks brokers provide a vital service to clients.

“You need a Ph.D to figure out some of this stuff,” he said. “The essence of the problem is we’ve developed this highly complex system and we haven’t addressed a way for information to get out.”

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