5.04 Brokers

General rule.93 A broker may: Facilitate enrollment of an individual, employer, or employee in any QHP as soon as the QHP is offered; Subject to paragraphs (b) and (c) of this subsection, assist an individual in applying for a QHP with financial assistance; and Subject to paragraphs (b) and (c) of this subsection assist an employee or an employer in enrolling in any QHP. Agreement.94 Prior to enrolling a qualified individual, employee, or employer in a QHP through VHC, or assisting an individual in applying for a QHP with financial assistance, a broker must have an executed 93 45 CFR § 155.220(a); 33 VSA § 1805(17). 94 45 CFR § 155.220(d); 33 VSA § 1805(17). General Provisions and Definitions Part 1 – Page 36 (Sec.5.00, Sub.5.05) agreement with AHS, and must comply with the terms of that agreement, which includes at least the following requirements: Registering with AHS in advance of assisting a qualified individual, employee or employer, enrolling in QHPs through VHC; Receiving training in the range of QHP options and health-benefit programs; Complying with AHS’s privacy and security standards adopted consistent with § 4.08; and Maintaining a physical presence in the service area, so that face-to-face assistance can be provided to applicants and enrollees. Payment mechanisms.95 A broker who facilitates enrollment of an individual, employer, or employee in any QHP may charge a reasonable fee for assisting with the enrollment of qualified individuals and qualified employers in any QHP offered through VHC for which the individual or employer is eligible; and assisting a qualified individual in applying for financial assistance for a QHP purchased through VHC. A QHP issuer may not pay any part of a broker fee.96 Web broker prohibition. Vermont does not permit a broker or any entity that is not a QHP issuer to develop and host a non-exchange website to assist consumers with direct enrollment in a QHP offered through VHC.97