The state uses an army of certified agents to guide around 40% of the people who enroll in Covered California, the state’s subsidized health-care system. And like any army, this one would like to get paid.

That hasn’t been happening, although you wouldn’t know it from the Covered California Agent Commissions FAQ, where everything is pretty chipper. The webpage answers the question “How will agent commissions be paid?” but doesn’t say when.

The Los Angeles Times reported last week that many of the 12,600 insurance agents haven’t been paid for months. Around 2,200 agents are owed around $2 million for shepherding Med-Cal patients through the system and the state doesn’t intend to pay them before January.

Backlogs of payments back to June exist for agents who helped sign up small employers. They might get paid in December.

These are probably the wrong people to piss off at the beginning of Covered California’s second annual enrollment, coming on the heels of a somewhat tarnished launch last year. The largest complaint about the health insurance exchange, although by no means the only one, is the lack of information about the system and help navigating it.

Agents signed up four times as many people as the 6,000 certified enrollment counselors hired and trained by the state. But agents who talked to the Times indicated that if they aren’t paid and the state doesn’t fix its glitchy website and phone services that keep them on interminable hold they will find something more productive to do with their time.

Before the Affordable Care Act (Obamacare) was passed by Congress, agents dealt directly with insurance companies. In search of a healthcare system that would provide more services to more people more efficiently at a cheaper price, government added another layer of bureaucracy to the layers of bureaucracy already in place.

“We need healthcare reform, but no one is particularly excited about dealing with Covered California,” insurance agent Kevin Knauss told the Times. “It's the necessary middleman we have to hold hands with.”

It’s necessary because the country opted for more complexity and more business involvement rather than a single-payer system to simplify matters and remove avaricious capitalism from healthcare delivery.

Knauss expressed displeasure with Covered California in an online Q&A with himself about a survey sent to agents in May. He was a bit miffed that the exchange asked if his work for them had increased his business. That was irrelevant, he wrote. “Most of us would take one smooth enrollment over ten new clients whose applications became hopelessly mired in technical glitches supplied by the enrollment system.”

Knauss was surprised Covered California didn’t ask about his experience with insurance carriers. “From issues with lost applications at the carrier, nightmares with clients being able to make their first premium payment, lack of commissions and not being appointed, the hassles with the carriers posed an equally large challenge for agents,” he wrote.   

But his favorite question was about wait times. “Twenty minutes plus was the highest time selection. I would have been happy with a 20 minute wait during open enrollment. Where was to two plus hours response that most of us experienced?”

He didn’t complain about not being paid.

–Ken Broder

To Learn More:

Many Agents Still Waiting to Be Paid for Covered California Enrollments (by Chad Terhune, Los Angeles Times)