Agent/Broker Data Collection in Federally-facilitated Health Insurance Exchanges (CMS-10464)

The Center for Consumer Information and Insurance Oversight (CCIIO), the agency within Centers for Medicare & Medicaid Services (CMS) charged with helping implement many provisions of the Affordable Care Act including the establishment of Affordable Insurance Exchanges (Exchanges), needs to collect data from individual agent/brokers to register them with the Federally-facilitated Exchange (FFE) and provide the required training in Exchange enrollment policies and procedures. Both section 1312(e) of the Affordable Care Act and 45 CFR ?155.220 permit States to allow agent/brokers to enroll individuals, employers, and employees in Qualified Health Plans (QHPs), including through the Exchanges; and assist individuals in applying for advance payments of the premium tax credit and cost-sharing reductions. Agent/brokers will serve as additional access points to the Exchange for individuals or SHOP employers/employees requiring or desiring agent/broker assistance. Agent/brokers must register with the FFE and meet training requirements that enforce their understanding of eligibility and enrollment in Exchanges prior to enrolling individuals or SHOP employer/employees in QHPs through the Exchanges. They must also apply this understanding to the development of any non-Exchange Web site used as a tool for enrollment. Agent/broker designed and administered web sites or tools will improve the flow of information to the FFE, and State-based Exchanges may also find these tools useful toward streamlining data submissions and easing the burden on the Exchange. The collection of information from agent/brokers described in detail below is needed to register and completion training with the FFE. Collected information will be used by CMS/CCIIO to verify the completion of the training requirement, provide the public with a list of registered agent/brokers trained in Exchange enrollment requirements and functions, and perform oversight of agent/brokers operating through the FFE.

The latest form for Agent/Broker Data Collection in Federally-facilitated Health Insurance Exchanges (CMS-10464) expires 2022-07-31 and can be found here.