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Health insurance agents represent health insurance carrier companies.

Insurance agents specialize in selling health plans and guide individuals or businesses in picking the most appropriate coverage for their requirements. As agents representing numerous health insurance carrier companies, they will basically meet you to discuss your options. The types of insurance offered may comprise health coverage and other types of policies, like dental and vision insurance and short-term and long-term disability. Working with agents can be beneficial since they have access to multiple health insurance coverage plans, so they can offer you several choices based on factors like price, coverage, renewal choices, and limitations.

Brokers work as a type of intermediary agent between the health insurance carriers and their consumers. A health insurance agent’s work is to help an individual or a family choose a health insurance policy that fits their very personal health coverage needs. They will not only set up and arrange a consumer’s coverage, but they may also process claims and offer post-sales service and support, responding to questions or making changes and revisions to your plan. 

The cost of a health coverage DOES NOT change if a broker or an agent assists you in enrolling in a plan.

 Insurance carriers pay brokers and their agents. If your broker/agent works with a lot of insurance organizations (like we do here at Health Insurance Plans Org), they are better positioned to help you find a plan that’s right for you.

Healthcare Insurance Agents – Your Personal Shopper

There are two things people must do to become a health insurance agent or broker:

• 1) Become licensed to sell health insurance, which necessitates them to study for and pass a state examination. 
• 2) Receive training from any insurance carrier that wants the agent to sell their products

Agents can work for one insurance organization, selling only that company’s plans, or they can work as a broker representing several insurance companies.

Health Insurance Agents Vs. Brokers

The term “agent” is sometimes utilized interchangeably with the term “broker,” but they can have different meanings.

• What is a licensed agent? An agent may represent one or more health insurance carriers and may be employed by a health insurance broker from time to time.
• What is a broker? Brokers normally represent two or more insurance companies, which gives the broker and their agents more ways to help a consumer find the health insurance plan that best matches their needs.

The price of a health plan does not change if a broker or an agent helps someone enroll in a plan. Insurance organizations pay brokers and agents.

The 2018 Changes

Brokers and their agents help consumers find health insurance plans that best match their needs.

The “navigators” who assist clients at government-run health insurance exchanges were not necessarily licensed agents. This limited what they could do to help customers. Nevertheless, things changed in 2018, where navigators working at Healthcare.gov were required to provide consumers with:

• Post-enrollment help
• Help with filing eligibility appeals (though not representing the consumer in the appeal
• Filing for shared responsibility exclusions
• Offering basic information concerning the reconciliation of premium tax credits
• Understanding basic concepts related to the utilization of health insurance coverage.
• Navigators will also be needed to offer targeted support to vulnerable or underserved populations.

References and Resources

• Healthcare.gov
• Role of Health Insurance Agent