One of the most important decisions you will ever make is choosing the best Health Insurance Broker. Finding the right one can be a challenge, but it is well worth the effort. With the right advice and information, you can find a broker that will not only help you find the best plan, but will also be able to explain the ins and outs of it to you. This is particularly true if you are a first-time health insurance buyer.
On-exchange vs. off-exchange plans
Off-exchange health insurance plans can be a good option for people who don’t qualify for premium subsidies. They can be cheaper, and they may offer more benefits. However, they don’t provide the government benefits of on-exchange plans. So, what are the differences between these two types of health plans?
On-exchange plans are health insurance policies that are offered through a public health exchange. The primary goal of a health exchange is to make insurance more affordable for consumers.
The quality of coverage in the individual market has improved under ACA. Insurers are required to comply with certain adequacy standards and must provide consumers with uniform coverage summaries. This includes explaining coverage options in plain language.
Off-exchange health insurance products are not eligible for tax credits. Those who receive premium subsidies do have the opportunity to purchase silver-level plans off-exchange.
As with any type of insurance, there are differences between the two. For example, PPOs are more common in on-exchange plans at higher metal levels, while on-exchange plans are more common at lower metal levels.
Licensed or unlicensed?
You will want to work with a licensed health insurance broker to make sure you have the coverage you need. Licensed brokers can help you with questions about your health insurance benefits and can even locate subsidies that can help you pay for your coverage. They can also assist you with plan changes.
There are a few different types of health insurance brokers. Licensed brokers are licensed by the state where they operate. The types of licenses vary from state to state, so it is important to know what you are getting into. Licensed brokers must also comply with all state laws and regulations. Some states don’t require agents to take a written exam, so make sure you check with your local health insurance department to make sure you are in compliance.
Navigators, on the other hand, are authorized individuals that can represent your company in the Marketplace. These agents receive training for the state exchanges.
Online brokerages
Health insurance brokers are independent third parties who can help you find a health plan that suits your needs. Some brokers represent multiple health insurers, while others specialize in one or two companies. These professionals can advise you on selecting a plan and offer advice on filing claims and qualifying for premium tax credits.
Brokers typically earn commissions from insurance companies. Commissions vary from three to six percent of the total premium. This is not a large amount when compared to the savings the broker can make.
The average cost of employer-sponsored health insurance has tripled in the last 20 years. Whether you are an employee, self-employed, or an employer, having a broker guide you through the health insurance market can make the process less confusing.
Online health insurance brokerages are similar to Expedia or Orbitz. They have the same goal: to help consumers find a health plan that will fit their needs.
Navigators
Navigators help you understand how the health insurance marketplace works and enroll in a plan. They provide free services to customers. However, there are some things you should know about navigators before you decide to use their services.
Navigators are paid by state grant programs, not by health insurers. Because of this, navigators are not allowed to recommend specific plans or make personal recommendations. Moreover, they cannot help consumers determine whether they qualify for subsidies or tax credits.
Insurance brokers can provide clients with a more in-depth level of help. These are usually licensed by state departments of insurance. Brokers can also offer personalized recommendations based on your needs and circumstances. The broker will represent multiple health insurers. This can help you find a better plan. If you have a problem with the approval of a claim, a broker can help you negotiate with the insurer.
Navigators can also be found at a community-based nonprofit organization or civic service group. In many states, these groups operate separate efforts to educate consumers about the Affordable Care Act.
