FAQ

What Does A Health Insurance Broker Do? – Forbes Advisor

If you’re in the market for health insurance, you may want to consider purchasing a plan through a health insurance broker. While they are by no means the only option, health insurance brokers are a popular resource for a variety of customers looking for help finding the right policy for them. So what exactly do brokers do and how can they help you? Read on to learn more about health insurance brokers and how to find one.

what is a health insurance broker?

runner basics

Health insurance brokers play a unique role within the health insurance ecosystem. They serve as intermediaries between consumers and insurance companies (or “carriers”), providing customers with expert guidance, access to policy information, and a selection of personalized and recommended options. brokers must be licensed by the state in which they work and are paid by commissions from carriers rather than clients.

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who should use a broker?

Brokers are popular with the self-employed and others who lack employer-sponsored insurance. They can also be important for business owners offering a group plan to employees, as small businesses often lack the resources to fully address insurance issues internally in a comprehensive manner. Brokers assist clients of state and federally run marketplace exchanges and can offer guidance on public programs, premium tax credits, and other government-based cost-saving options. they can also direct clients to non-market plans that comply with the Affordable Care Act.

brokers vs. agents

While health insurance agents are also licensed professionals who connect customers with insurance companies, the role of a broker differs in some ways. Agents typically represent a single insurance company and rely only on that company’s options when recommending plans. brokers, meanwhile, represent the client. in many states, they have a legal obligation to help customers find the plan that’s right for them, regardless of the company that sells it.

how health insurance brokers can help you

browsing the market

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The value of a broker comes in part from the unique challenges of navigating the US. uu. landscape of health insurance, where the information available to customers is often incomplete and the products are particularly complex. Health insurance markets are generally considered to have high “search friction,” meaning that it is relatively difficult to match consumers with the right products.

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Naturally, this challenge increases the value of skilled brokers. One of the most important roles of a broker is simply to reduce the burden of collecting information from the client, helping them navigate a sea of ​​options and variables. Furthermore, because a broker is “watching” the customer, his expert eyes are a line of defense against exploitative schemes or misleading billing.

expert guidance

Brokers offer expertise throughout the insurance buying process. While they provide plan information and quotes to the customer, they also provide an insider’s perspective on the industry. By working to understand the client’s unique situation, they can learn if a particular plan that is great on paper would be a good fit for the individual. Brokers answer questions, discuss alternatives, and make recommendations based on factors such as a client’s budget, healthcare needs, and provider preferences.

what to expect from a health insurance broker

general information

One of the main responsibilities of a broker is to help educate the client about the health insurance market and explain how one’s personal situation affects obtaining insurance. For starters, brokers are there to answer common questions, like the differences between plan types and the meanings of industry-specific terms. Brokers must also be up to date with applicable insurance laws and regulations, which vary by state and are updated frequently. brokers also offer valuable insight into which policies tend to select certain types of clients and how these decisions play out in the future.

several plans to compare

after knowing the client’s budget, needs and general situation, brokers offer quotes, usually a short menu or a couple of select options. these selections may include several types of plans from a particular carrier, as well as several comparable plans from different carriers. Brokers typically provide brochure-style information about the plans they recommend and discuss the pros and cons of each option with the client.

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continued support

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Brokers are still available as a resource to clients after enrollment if issues or questions arise. customers sometimes want clarification on the details of a new policy and may find they are unsure about things like network limits or the claims process. Staying available to clients while they actually use their new insurance is an often overlooked but important part of a broker’s role as well.

free services

Most services offered by health insurance brokers are essentially free to the customer. Like agents, insurance companies pay commissions to brokers, which tend to be based on a percentage of the premiums of the plans they sell. In other words, the cost of a broker is built into the cost of health insurance in general, so clients should only expect a broker to charge them if they accept additional services that go beyond the traditional role of a broker. /p>

how to find an insurance broker that is right for you

choosing the right broker

The most important factor in the broker-client relationship is trust. In this sales model, the same person acts as personal advisor and salesperson, and although brokers represent the interests of the client, they may still have some level of incentive to sell a particular product. clients must feel confident that their own interests come first. Will the broker proactively explain the downsides of a plan? Are they open to comparing your recommendations with alternatives?

another important component is communication, not only the way a broker interacts, but also their ability to translate their experience into a language the customer can understand. While brokers are sought after for their knowledge of the industry, it’s only useful if they can meet clients midway. A good broker listens carefully to understand the client’s situation and makes sure that their offerings are tailored to the client’s unique needs.

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how to find a broker

One of the most common methods is to seek referrals from trusted sources, such as friends, family, an accountant, or a personal attorney. there are many resources online that can also help, although it is important to know who is funding the website and for what purpose. The same goes for broker-sponsored websites, which are easily found in online search results.

You can visit healthcare.gov’s search assistance program, which allows customers to search for government-funded brokers, agents, and enrollment assistants in an online directory. it also allows users to submit a request to be contacted by a broker through helpondemand.com or the online exchange of a status. Other entities not affiliated with an insurance company, such as a local chamber of commerce or association of health insurers, can also be helpful resources.

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sources

  • glossary: ​​corridor. insurancehealth.org. consulted on 06/19/2022.
  • I’m self-employed. Is it better for me to buy health insurance through a broker or through the exchange? insurancehealth.org. consulted on 06/19/2022.
  • karaca-mandic p, feldman r, graven p. the role of agents and brokers in the health insurance market. national bureau of economic research. working paper no. 19342. 2013.
  • resources for agents and brokers in the health insurance markets. medicare centers & Medicaid services accessed 06/20/2022.
  • glossary: ​​agent and broker (medical insurance). insurancehealth.org. consulted on 06/20/2022.
  • runners. health coverage guide.org. consulted on 06/19/2022.
  • Step 3: Find a broker. health coverage guide.org. consulted on 06/20/2022.
  • allen m. Insurers give cash and gifts to brokers who sell employer health plans. npr. February 20, 2019.
  • Enroll in or switch 2022 plans, only with a special enrollment period. health.gov. consulted on 06/20/2022.
  • special registration periods for complex topics. health.gov. consulted on 06/20/2022.
  • change plans in 2022: what you need to know. health.gov. consulted on 06/20/2022.
  • medicaid & health.gov chip coverage. consulted on 06/20/2022.
  • How does an insurance broker make money? investopedia. consulted on 06/20/2022.
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