What is a health insurance broker?

There are so many roles in the healthcare industry, and it’s easy to get overwhelmed. An important one is that of the health insurance broker. Who is this person?

Health insurance brokers, who may be referred to as “health insurance agents” or “independent agents,” are licensed professionals well-versed in all things related to health insurance. While they do not offer and administer health insurance plans themselves, these brokers have relationships with insurance carriers, and can provide advice about which medical, dental, and vision plan(s) a specific business should offer to its employees.  Whether someone buys directly from the insurance company or from an independent broker, the rates quoted will be the same. Identical commissions are either paid to the health insurance broker or to the representative at the insurance company who makes the sale.

In order to become licensed, all brokers must pass a series of college-level exams in each state they wish to work in. These exams cover insurance terminology, policies and provisions at both the state- and federal- level, tax considerations, individual and group insurance differences, and HMOs (health maintenance organizations).  Many states also require several hours of continuing education throughout the year in order to maintain licenses. All in all, you can trust your broker to have the knowledge needed to help you find a great plan.

Why should a small business work with a health insurance broker?

Here are some reasons why a small business might want to work with a broker like SimplyInsured:

  • Stay up-to-date on market changes. The health insurance industry is changing everyday. Carriers are adding and removing plans, entering and exiting the federal insurance exchanges, and changing their pricing and regulations. The government is issuing executive orders and debating about the fate of Obamacare. It’s practically a full-time job to keep up with what’s going on. A health insurance broker is required to understand market dynamics and is rigorously tested on it during the licensing process. 
  • Get unbiased expert recommendations. While some insurance carriers will let you go directly to them to buy insurance, their recommendations will be biased towards the plans they offer. Health insurance brokers work with multiple carriers, and are typically not paid more by one carrier vs. another. They are truly invested in finding you the right plan to maximize your employees’ well-being. They know the ins and outs of deductibles, copays, doctor and hospital networks, prescription drug coverage, and catastrophic care. Based on your specific needs, they should be able to find you the best match.
  • Get assistance with the application and enrollment process. Like securing a personal loan or a mortgage, applying for health insurance isn’t exactly a walk in the park. You need to fill out a company application, an application for each employee (whether they are accepting or declining insurance), upload documents such as wage reports and articles of incorporation, and provide bank information. Brokers are application specialists, and can help you navigate requirements so that you can enroll as quickly as possible.
  • Troubleshoot issues with the carrier. Some top-producing ones like SimplyInsured have “preferred” status with major carriers. This means that when you have issues with your insurance such billing discrepancies or reimbursement delays, your broker can get a representative at the insurance company on the phone quickly. If you work with a competent, well-reputed broker, you should never have to call the insurance company yourself. You can trust them to handle all correspondence on your behalf.
  • Provide all of the above for free! Small businesses do not need to pay brokers any fees to use their services.

Overall, yes, health insurance brokers are salespeople who want your business and make money when they help you. But they also have your best interests at heart, and truly want your employees to be healthy, happy and productive!