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Archive for November 28th, 2007

What Role Does Your California Health Insurance Agent Or Broker Play?

Wednesday, November 28th, 2007

First, what is the difference between a  broker and an agent? These terms are often interchanged in  conversation. Officially, an Agent is an  individual or company that acts on behalf of the  carriers to market, sell, and service insurance.  The Agent has a contract with the carrier in  order to transact this business. A broker is  person who also contracts with carriers but  officially acts on behalf of the client. In  practical terms, they are not that different  when dealing with California health insurance. For example, Goodacre Insurance Services is a  California agent but our goal is to find the  right plan for a individual or company across  the major carriers. If Blue Cross has the right  option and better pricing for a given person or  company, then that’s where we will go. We are  independent agents which is important because we  do not have interest in pushing one particular  company or plan. We do have knowledge from  dealing with the carriers every day in terms of  which companies are easier to deal with, more  stable, or better priced. There are dozens of  plans on the market so this can really be  important. Just looking a rate quote and benefit  summary is only half of the story when choosing  health insurance. Some plans exclude certain  benefits or apply caps to other types of  coverage. We know the lay of the land and I  would personally not want to purchase health  insurance just based on a rate quote. Some companies (though not the majors) use  “captured agents”. This is a person who sells  only one carrier’s insurance plans. They are  essentially employees for that company. I would  avoid such companies as they may not have the  best interest of the client at heart. If a  company cannot quote multiple carriers, beware.  The major carriers in California are Blue Cross  of California, Blue Shield of California, Health  Net, Pacificare, and Kaiser. Beyond these five,  we do not feel very secure about the others. How are agents or brokers paid? Agents are paid  a commission by the carriers for policies issued  and in force. The commission tends to be about  the same from carrier to carrier. This  commission does not affect the rate. The  insurance rate you will get through an  agent/broker is the same as you would get going  directly through the carrier. The benefit of the  agent relationship is that they navigate the  carriers to expedite processing, help with  service issues once enrolled, and act a third  party. Again, a carrier’s main interest to keep  you enrolled as policy subscriber but your  interest may actually lie with another carrier  or plan. An independent broker can help bridge  the two at no additional cost to you. Also, the  carriers are big companies. Some of the reps are  very knowledgeable and others are…let’s face  it…newer. By dealing with California health  insurance daily, we are a wealth of information  and guidance that you may not get by going  directly. What to expect from your broker/agent and  especially Goodacre Insurance Services? Goodacre Insurance Services provides service  across three main areas. California health plan selection. This really is the most difficult part and it is  the reason that people put off getting health  insurance. There are many plans and the language  is pretty technical. Most people glaze over when  they see the brochures or instant quote results.  Let’s face it….health insurance is not a  common purchase. Typically, people have not  needed to shop health insurance in years…if  ever. Goodacre Insurance Services has been  dealing solely with California health insurance  for over a decade now. I can guarantee that with  a few targeted questions, the plan selections  can be narrowed down significantly. We want you  to be informed. On a daily basis, we hear from  our clients that they wish they would have  called earlier rather than try to navigate the  volumes of information provided the plans. Let  us help. We do not sell. We listen, advise, and  then it’s up to you what you wish to do. California application and enrollment. The health application is one more reason that  people procrastinate. There are sections in  there are mandated by law but which are  thoroughly confusing such as the HIPAA  qualification. Small Group can be equally  difficult in terms of qualification for Small  Group health coverage in California. We are  happy to walk you through the application once a  plan has been decided on. This is also the time  to ask about the process, payment options,  cancellation options, time table for enrolling  in coverage. Based on your situation, we can  give you a benchmark of what to expect for a  normal processing. Health Insurance Service and Membership. Once the plan is in effect, we are your point of  contact for membership issues, claims, and  future changes.

We go in at the end of each  month and make sure that faxed changes,  additions, and requests have been processed  correctly. The carriers are pretty good but 1  out of 100 requests do not show in the system.  You do not want to be that one with such a  critical issues as health insurance. We can also  advise for ways to reduce costs when the rate  increase occur based on your changing health  insurance needs. Keep in mind that you can always contact the  carrier directly if you choose but why would  you? Let us do the work for you since there is  no additional cost to you. Agents and brokers are required to have a  license and continuing education by the  California Department of Insurance. You can  always research an agent’s history, carrier  contracts, and other information through them.  There are different types of licenses. The two  most common are Life/Health which is used to  transact California health insurance and  Property and Casualty is used to transact  insurance such as auto or home insurance. Some  agents do both health and P&C but it is  increasingly difficult to this well and keep up  with the ever-changing industries. This is why  we choose to concentrate on health insurance  solely. We know the carriers, the plans, and  changes in the market. This makes us invaluable  to you. As we say on the phone here at Goodacre  Insurance Services..