Health Insurance Broker: Friend or Foe?

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istockphoto.com

If you own a small business and provide health insurance to your employees, good for you! Many of your peers do not. But if you do, chances are good that you use an insurance broker or agent. This licensed professional helps you sort through your options year to year, explaining the differences between plans and helping you purchase a policy. The best agents and brokers also provide lots of assistance to you after the fact, helping nudge insurers who don’t pay claims promptly and answering questions about your policy. A story in the New York Times on Friday spent a good amount of space explaining how helpful brokers and agents can be to self-employed folks as well.

Indeed, the services provided by brokers and agents are extremely valuable and they don’t come cheap. Even if an insurance company pays the agent or broker directly, that cost is passed along to customers in the form of higher premiums.

One major goal of the new Affordable Care Act is to make buying small group and individual insurance policies more transparent and simpler, and maybe even eliminate the need for agents and brokers altogether. Not surprisingly, agents and brokers are not exactly on board.

By January, the law will require insurers to spend 80 or 85% of the premiums they collect on medical care, leaving just 15 or 20% for overhead. (The percentage limits depend on whether the plans are for large groups, small groups or individuals.) Insurance agents and brokers are fighting hard for their commissions to be excluded from the overhead category. But they face an uphill battle for another reason.

Beginning in 2014, every state will have what’s called a health insurance exchange. This will essentially be a website portal where people can review and compare plans and get quality ratings and quotes. To the chagrin of those worried about government intervention in the health care market, the new law will also require every plan sold in the exchanges to have a federally designed “minimum benefit package,” a baseline of standard medical needs every plan must cover. This will result in far less variation in the types of health insurance plans available, furthering decreasing the need for an agent or broker.

I said in a recent story that insurance agents and brokers could be one of the first “victims of health care reform.” The head of the lobbying group that represents agents and brokers didn’t really like this too much.

But the pushback raises an interesting point. How much are health insurance consumers willing to pay for customer service? Would you rather buy cheaper insurance through a website and be dependent on your insurers’ 800 number if you have questions or complaints? Or would you rather pay more and know you have someone besides your insurance company to call if you need help?

Comments are welcome.

Related Topics: exchanges, insurance agent, insurance broker, Health Insurance, Policy & Industry
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  • http://covepj.wordpress.com covepj

    I am one of the licensed professionals that stand to be unemployed by the cavalier way in which the new Affordable Care Act was put together. First off… there is nothing within this act that will mak health care any more affordable. The costs of medical care are dictated by the realities of a free enterprise economy. Doctors charge for what they feel their time is worth; hospitals charge what they need to run a very costly enterprise which includes many employees and much high tech machinery; pharmaceutical companies charge what they need to cover costs to develop and market medicines that work and the costs of law suits for those that do not. Much of the world rides the coat tails of the United States after the U.S. develops new medical procedures; equipment; and medications. Americans as a population are using costly medications to control stress related ailments of anxiety and depression. Americans consume vast quantities of fat laden; salty or sweet snacks meals that play havoc with the digestive system and heart and can also lead to diabetes; stroke; and cancer. Americans also consume large quantities of alcohol; tobbaco; and many authorities point to the problems of sexually transmitted diseases as adding to costs associated with our health care system. I’m really tired of hearing how by eliminating the ” unnecessary expense” of the insurance agent health insurance costs will decrease. The legislation that was recently passsed in Washington is nothing more that a cheap attempt to push insurance companies and agents out of the way so that a government run system for all can be implemented. I hope the new system is not run by the Post Office; the Social Security Administration; or the guys that were supposed to fix the mess created by Hurricane Katrina or prevent an attack such as happened on 9/11.

  • amberglows

    I too have been a PROFESSIONAL independent insurance agent for over 24 year. I have worked diligently with my clients, offering great service. So far I have been able to work off my referrals but I have already lost 40% of my business due to the economy…groups lost due to closings. I am limping along trying to make a living. I get NO unemployment benefits so I will not be counted among those filing for the first time. All of us who have worked very hard will be kicked to the curg just because of one “jerk” that wanted to fundamentaly changed America. I do hope that those who voted for him will be hit too. I agree with covepj, this is just a rue to get closer to Govt healthcare. The exchanges will kill us off. Also where are the insurance companies??? They have also kicked us to the curb implementing the rules before they even need to go into affect. Saving their own a–. I am VERY disappointed in them and feel sad that my hours of study, cost, certification for AEP period and my heart and soul will be for NOTHING. I do not see how we will make it. I am praying for a miracle.

  • amberglows

    One other coment, this statement in your article makes me very angry…..”Even if an insurance company pays the agent or broker directly, that cost is passed along to customers in the form of higher premiums”.

    Since when is it a crime how an insurance company makes money, pays out its money, etc. I have been hosed many times by an attorney…..accountant…..doctor…..hospital,,,,car dealers…..dentists…..what about a mortgage broker making 7%, are they really worth it? I think it is time we say what this really is…..a major joke! Paying a doctor to do good work is good enough for the doctor but eliminating an insurance agent for doing good work is not acceptable expecially when the agent does at times find mistakes in claims and is an advocate for the client in keeping them from getting screwed. Somehow this President has totally changed the minds of alot of the American people. He has totally ruined what it means to be an American and work hard. Oh by the way…..an agent will never be able to retire and live in renewals. Thanks again “O”!

  • bacotawordpress

    To those of us who do not work in the insurance industry, it seems that agents and brokers are a band aid for problems in the industry — insurance is too complex and the relationship between insurance companies and their customers is often adversarial. If the problems are corrected, then the need for agents and brokers would be reduced.

  • amberglows

    And the Government can run a post office with efficiency too! That is not going to fly with me, sorry. We go to school and get an education for this career, so if the tort reform would be in place then we would no longer need personal injury attorneys either?? This is our career…..no one has a right to demean what we do, offer and give to our clients. Have you ever spoken to an 800 number when Peggy answers from India? Good luck to quality service.

  • http://txslasher.wordpress.com txslasher

    You don’t buy or sell a house alone, you have to get two Realtors’, an inspection, an appraisal, a closing attorney, all have been trained on the different aspects of owning and closing on a contract between two parties.

    You don’t want to do your taxes alone, there are 200-500 new laws and amendments per year, you get a guarantee and have someone to blame if the IRS comes knocking.

    You don’t get married alone, you don’t get divorced without representation. You don’t buy anything without exploring all of your options and talking to someone who has this knowledge.

    Would you want to purchase a lifetime product from a government or contractor over the phone or internet and never talk to the same person twice.

    Well we have done a great job of destroying the economy and here is one more place to make a million or more job cuts. The writing is on the wall we are trying to destroy America for some new political agenda.

  • amberglows

    Thank you txslasher for your comments. At least someone understands.

  • bacotawordpress

    Wow. If this is the attitude of American workers then our economy really is toast.

    Tell you what, let’s not have these exchanges. But you better not be using an on-line booking site or tax preparation software, and you better be buying your books at the local bookstore — not amazon. Don’t even dream of looking for things on craigslist – -the newspapers need those ads. Come to think of it, what are you doing reading this online? Go to your local drugstore and buy the magazine.

    Did you really think that you would get to study for a profession and that profession would remain unchanged for the rest of your lives? Welcome to the 19th century, folks. Change is scary, but you don’t have a right to be protected any more than the rest of us. You have to figure out how to continue to provide value in a changing world. Come to think of it, I did not notice craiglist putting realtors out of business, or Quicken putting accountants out of business. I don’t know how travel agents are doing, though.

    Well, I look forward to the new exchanges and wish you all luck in adapting your business models.

  • http://covepj.wordpress.com covepj

    I would like to suggest that you and all who like change for change’s sake. Spend some time reading about how Massahusetts did and is doing after having adopted almost verbatim what has been pushed on to the American nation recently. There are many articles talking about waiting times to see a doctor rising from days to weeks. Escalating costs. Increased use of emergency rooms etc.

    Change is good when the majority benefits not when things just get juggled around; mixed up; and spit out in a new concoction that has not improved things one bit.

  • amberglows

    Yes, I do believe that my profession would last for my lifetime…..all other professions as well. This Admin is hell bent on crashing the United States and making us socialistic peons. Liberals are anxious for their handouts….for your information, Massachussetts health care is really in bad condition. the Govt has had to prop it up financially during the HC votes…Romney is responsible, which I hope he never wins President.I am not apposed to change, but theft no. We are all having our business stolen, sent over seas, eliminated and the Admin does not care. I am very much for change but not the elimination of my career. I think that is more than a fair statement. Nothing stays the same forever. Just look at the quality of Presidents…that should tell us alot.

  • bacotawordpress

    The merits of the health plan can certainly be debated. But providing information and alternatives directly consumers is not “theft”. If I can choose from a small set of standard health insurance policies directly from the insurer to save me money, that is probably what I’m going to do.

    But if the customer service/advocacy/advice provided by an independent broker is really that important, then you’ll still be in business. If not, then surely the skills acquired over years of retailing one of the most complex consumer products in our society are transferrable to another business.

  • amberglows

    My “theft” was not directed to health care…it is directed to bureaucrats. We are all going to lose in their “theft” of our freedom and jobs.

  • http://covepj.wordpress.com covepj

    A few years ago, the Federal government standardized Medicare supplement plans. This was done with the intention of saving Senior Adults money and making choices easier. In my NYC area all it did was chase insurance carriers out of the marketplace so that for all intents and purposes, there is only one choice left – the plan being sponsored by AARP. Can anyone say… Monopoly ?

  • amberglows

    You go, covepj, someone who speaks my language. AARP has been in “bed” with the Prez every since he has been in the office. They have always been kissing a– just to be the number one carrier. I see the writing on the wall…..I refuse to sell AARP here…I won’t “whore” myself to make a $. I am in hopes that the Congress changes to get the cleansing we need. Things will never be the same again but at least we don’t have to roll over without a fight.

  • http://covepj.wordpress.com covepj

    I really think that it is time for those of us who have many years invested in helping and guiding people’s health insurance to undertake a national campaign for the repeal of the PPACA. National insurance oragnizations are not doing it; some states are fighting -about 23 the last time I looked; as you have noted insurance companies are not doing it; DOCTORS – the ones who should be protesting the loudest – are quietly accepting this law as a done deal – while they quietly complain about the end of small medical practice as Obamacare pushes for consolidation and grouping of medical specialites under one roof so that a one payor system will be easier to implement – eventually. So who is left but us ?

  • amberglows

    Cool, covepj. I have been watching the insurance carriers. They have not only not “squealed” at this monstrosity but they have been excelerating the adjenda. They sure did stir up quite a controversy during the Clinton years. I thought we would have time prior to 2014 but they are getting ready faster than necessary. I thought they would balk and purposely stall, but full steam ahead with them. The doctors are just like lambs being let to the slaughter. I guess their education and the $$ they spent on becoming a doctor isn’t as important as I thought. Where is NAHU? Where are the lobbyists? You are right, only a handful of states are concerned…..

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