Washington Health Benefit Exchange (WAHBE) conducts monthly reviews with all carriers who offer on-exchange plans. This includes a review of producer of record information that WAHBE sends to Kaiser Permanente Washington with the electronic enrollment files. During a recent review, some discrepancies were identified. What Kaiser Permanente maintained in our system was inconsistent with what was initially transmitted to us from WAHBE. The inconsistencies were primarily due to naming conventions, use of terms such as agency “doing business as” (DBA), agents who were listed from agencies that are not appointed with Kaiser Permanente Washington, agents with no active producer of record status with WAHBE, and inaccurate Washington state Office of the Insurance Commissioner (OIC) agent IDs or agency tax IDs.
Our records need to match those of WAHBE. Here’s how we plan to address the discrepancies:
- We’ll notify affected producers by email, letting them know what the inconsistency is — such as the removal of producer of record, a change in the agency, transfers of book of business that were not updated with WAHBE, and mismatched OIC agent IDs or agency tax IDs.
- We’ll provide affected producers with the steps required to correct the producer of record with WAHBE so that we’ll receive the correct information, or we’ll be notified of the change on a future WAHBE enrollment file.
- Producer of records will be pending until discrepancies are corrected and Kaiser Permanente receives updates from WAHBE. Delays in addressing the inconsistencies could result in a delay in applicable commissions and bonuses.
Notification of discrepancies will occur throughout Q1 2023
In general, if there are agent changes, book of business buyouts, mergers, or changes, those should continue to be communicated to the Kaiser Permanente Washington Producer Operations team — but you’ll also need to communicate the change to WAHBE so, going forward, we can receive this information on the enrollment files. Note: This process change does not affect off-exchange Individual and Family or Medicare Advantage. These notifications should continue to be sent to the Kaiser Permanente Washington Producer Operations team at email@example.com.
Update: Change to when a new producer of record is required
Effective February 1, a change to when a new producer of record is required will be put in place. This change will align the requirements for both on- and off-exchange producer of records, ensuring commissions are paid accurately. For the following scenarios, we’ll need to receive a new producer of record to continue the producer of records on file and pay commissions as well as any applicable bonus:
- Client is moving from an off-exchange plan to an on-exchange plan
To ensure no gap in your producer of record designation, the change must be completed through WAHBE since we’ll no longer be able to roll over producer of record from off-exchange to on-exchange.
- Client is moving from an on-exchange plan to an off-exchange plan
The producer of record must be indicated on the application since we’ll no longer be able to roll over producer of record from on-exchange to off-exchange.
In both the above scenarios, failing to establish the producer of record with WAHBE for on-exchange — or listing the Producer of Record on the KPIF application for off-exchange — will result in a delay in payment of applicable commissions and bonuses.
Hint: When reviewing your KPIF book of business online through the Kaiser Permanente producer portal at kp.org/wa/producer, you can separate on-exchange and off-exchange clients by referring to the group number on the book of business. Please note:
- Group numbers starting with 901 and 902 will be on-exchange clients
- Group numbers starting with 903 will be off-exchange clients
If you have questions regarding this information, contact the KPIF Sales and Producer Support team at 1-800-474-1079 or firstname.lastname@example.org.