The Role of the Health Insurance Broker

A Health Insurance Broker is just like any other type of broker; this one just happens to specialize in the field of health insurance. A broker is somewhat like a matchmaker. His responsibility is to match up those seeking health insurance with health insurance companies that most closely match that person or group's needs.

Health insurance brokers are sought by those individuals who, for various reasons, do not belong to a group insurance policy. These individuals are often the self-employed, or those with pre-existing conditions. However, a health insurance broker will also work with the coordinators of group insurance benefits in much the same way he works with an individual. The broker is given a list of desired benefits, either by an individual or a group coordinator, and the broker shops around to find the best match. The health insurance broker then presents what he feels is the best plan based on the list of needs, and if the person or group benefits coordinator agrees, the broker usually works to get a contract signed by both parties.

Who Does the Health Insurance Broker Work For?

It's important to understand that a health insurance broker does not work for a health insurance company. Instead, a broker makes it his business to know all about the different health insurance companies in the area including their reputations, their frequency of rate increases, and even such things as the way they treat policy holders who submit a lot of medical claims. But even though the health insurance broker is different from a health insurance company, it often does happen that a broker is given an incentive (usually a financial incentive) to recommend one health insurance company over another.

Will it Cost More to Use a Broker?

Does the cost of health insurance differ if it is secured by a broker? That's difficult to answer in general terms. A health insurance broker might be able to get an individual included in a group plan that is offered by the state or a trade union or organization and in such a case, an applicant might find the rates are lower and the coverage better than if he had attempted directly applying via a health insurance company. Most health insurance brokers work on commission and only make money when they've matched up insurer and insured. That means that one party or the other (and in some cases, both parties) typically is responsible for paying the broker's fee.

Because the rates and the rules regarding health insurance are continually changing, health insurance brokers are few and far between. Most states do have licensing requirements that brokers must meet before they're allowed to work as a health insurance broker. And because these requirements are issued at the state level, they differ from state to state. But if you find yourself lost in the tangled web of health insurance red tape, consider working with a health insurance broker. That person might just turn out to be your best ally.