About the Standards of Excellence
NCOA convened an expert Consumer Advisory Panel to develop Standards of Excellence for consumer education and health insurance brokerage services for people with Medicare. NCOA Services is responsible for ensuring that Aon Retiree Health Exchange™ and Via Benefits™ meets all of these standards, which fall under 7 key areas:
Agent Compensation and Anti-Steering Standards
Agent Compensation and Anti-Steering Standards are designed to ensure that consumers are not inappropriately “steered” to buy insurance products. Unlike many insurance brokers, only a small fraction of an agent’s total compensation will be tied to sales volume, and agents won’t be paid differently based on the specific company or plan they recommend.
Agent Training and Quality Assurance Standards
Agent Training and Quality Assurance Standards are designed to ensure that consumers are assisted by agents who are highly trained and continually monitored for excellent performance. These standards go beyond what is required for licensure and include additional modules specified by NCOA.
Carrier Representation Standards
Carrier Representation Standards are designed to ensure that consumers can choose from a broad range of the best coverage options available to them. If there are high-quality plans not represented by the brokerage service, NCOA will inform consumers of what they are and how to contact the plans directly. The brokerage service may not discourage consumers from pursuing coverage from carriers not represented by the broker.
Consumer Advocacy Standards
Consumer Advocacy Standards are designed to ensure that customers get additional assistance when they have difficulties with issues such as access to care and prescriptions; claims denials; incorrect payments, authorizations and referrals; and Medicare coordination of benefits. This assistance is provided free of charge to customers of the brokerage service who are in complex situations where traditional support channels have not been successful.
Consumer Education and Decision-Support Standards
Consumer Education and Decision-Support Standards are designed to ensure that consumers (via the website and telephone) will have comprehensive information about coverage options and plan choices that is logical, clear, consumer-focused, unbiased and based on individual needs, preferences and circumstances.
Customer Service and Support Standards
Customer Service and Support Standards are designed to ensure that customers receive excellent and prompt service that is available in many languages and accessible for the hearing impaired.
Regulatory Compliance Standards
Regulatory Compliance Standards are designed to ensure that the brokerage and its agents comply with all relevant Centers for Medicare & Medicaid Services and state insurance regulations and notification requirements.