CMS Releases Reminders on Broker Use of Personally Identifiable Information (PII)

CMS released another slide deck to help brokers understand and comply with Marketplace Requirements. The newest deck is titled “Part II: Marketplace Privacy & Security Requirements for Agents and Brokers.” The slide deck addresses the use and protection of Personally Identifiable Information (PII). This latest information updates materials and guidance published last September.

PII is defined as “information that can be used to distinguish or trace an individual’s identity, either alone or when combined with other information that is linked or linkable to a specific individual.”  Examples of PII include everyday information; a person’s name, their address, email address, date of birth and Social Security number.

A broker must make available a Privacy Notice Statement prior to obtaining a person’s PII. The statement must be provided electronically or prominently displayed on a public-facing website. The statement should be on any paper form used to request or gather PII.

While CMS doesn’t provide a model Privacy Notice Statement, the slide deck provides some basic language for a statement. The statement is meant to inform applicants about any uses or disclosures of the information that will be collected. The statement does not require a signature by the consumer.

Proper security control to protect consumer PII is a responsibility of those collecting the data. This includes physical safeguards to the data as well as operational and administrative steps to protect the privacy of the information. Any submission of PII electronically must be done in a secure manner such as encryption.

Many of the suggested steps to secure PII should already be familiar to brokers who are accustomed to handling Private Health Information (PHI).

The CMS slide deck can be reviewed here.

NAHU has developed a sample notice titled Personally Identifiable Information PII) Privacy Notice.  This notice in intended to be used as a template. It has not been approved by CMS. The template should not be used without review and revision that represents your practices and specific situation. NAHU believes any documents of this nature should be reviewed by legal counsel.

These recent slide decks likely reflect recent analyses by CMS that indicates that brokers play a significant role in Marketplace enrollments. The 2018 Trends Report shows the following:

  • For plan year 2018, 49,100 agents and brokers registered with Federal platform Exchanges, supporting 42 percent of overall enrollments.
  • The biggest concerns for agents and brokers are lack of competition in the individual market and availability of commissions from insurance carriers.
  • To date, CMS has implemented 93 percent of recommendations from agent and broker partners.
  • CMS increased efforts to leverage the capabilities of the private sector by expanding the role of health insurance agents and brokers who supported 3,660,668 health plan enrollments, 42 percent of plan year 2018 open enrollments on Federal platform Exchanges. In contrast, Navigators enrolled less than 1 percent of total enrollees.

The 2018 Trends Report can be reviewed here.

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