Health Insurance Broker: Roles and Responsibility

A health insurance broker is no different from a stock broker or any other broker; he or she just specializes in the health sector. A health insurance broker helps you find the most suitable insurance company by matching your requirements with the provisions offered by the various policies offered by health insurance companies.

If you do not currently have an insurance policy or you do not belong to any group insurance, you may well benefit from seeking the help of a health insurance broker. Self-employed or people with medical conditions typically seek the help of a health insurance broker. A health insurance broker also works for the benefit of the coordinators of a group insurance. The health insurance broker is given a list of benefits sought by an individual or a group coordinator. What a broker does is search for individuals or coordinators which best match those needs. Then he presents his recommendations and if both parties agree, the broker formulates a contract between the two parties.

Does a health insurance broker work for any specific company?

Usually a health insurance broker does not work for any specific company. A broker’s job is to gather information about the policies offered by the various companies in the vicinity, the rates they charge, how they treat policy holders who submit medical claims very often and any other information. However, many a times it does happen that a health insurance broker is given a financial incentive for promoting a company among the health insurance seekers.

Will it be costly to get a policy through a heath insurance broker?

The answer to this question cannot be generalized. Many times a health insurance broker makes an individual a member of a group plan offered by the state or trade union or organization. In this case, the individual will find rates lower and coverage better than if he had opted to go alone and seek the policy from the issuer company. Health insurance brokers usually get a commission, which is given only if both parties reach an agreement. This implies that one party or the other, and sometimes both, are responsible for the payment of broker’s fee or share.

The rates, laws and rules related to health insurance keep on changing very frequently, hence health insurance brokers are few in number. Moreover, most of the states require that health insurance brokers be licensed before they can work. Also, these requirements are not uniform throughout the nation and differ from state to state.

You should seek the help of a health insurance broker if you are mired in the health insurance bureaucracy. In such a situation a health insurance broker might turn out to a great source of help for you.