What Does a Health Insurance Broker Do?

I’m an independent health insurance broker helping individuals, families, seniors and small businesses find, evaluate and apply for health insurance. I work with Medicare, with the WaHealthPlanFinder and direct with most of the health insurance carriers here in Washington State.

As A Health Insurance Broker, What Do I Do?

There are 3 main things –      1 I educate                  2 I help clients evaluate          3 I advocate

What does that mean?

Julia Cooke is Highlands Insurance Solutions, Health Insurance Specialist.  She loves working one on one with her clients, travel, cooking and a great cup of coffee.

Julia Cooke is Highlands Insurance Solutions, Health Insurance Specialist. She loves working one on one with her clients, travel, cooking and a great cup of coffee.

Educate –

The other day I did a mini session for 3 ladies who have been best friends since kindergarten. They will all turn 65 in 2015 and wanted to know about Medicare. I explained what to expect, what is generally covered, what more importantly isn’t covered and how we would look to cover those parts. We went over what to look for in the mail and when, how to sign up and set follow up appointments for each.

It was personal. It was professional. It was comfortable for these ladies.

Evaluate –

What I don’t do is make a decision for a client. What I do is lay understandable information in front of him or her, narrow down the options to reasonable choices, outline the salient issues or deciding factors and demonstrate the way the different plans answer those issues.

When Stan and Stella came to me saying they thought they were paying too much for their coverage. We looked at how often they went to the doctor a year on average and what their medical expenses were the past couple years to see if they were even hitting their deductible, and if it was worthwhile for them. After looking at the plans they chose a Bronze level plan with a high deductible, but just a low copay for doctor visits. Then a week later Stella injured her elbow and had surgery scheduled for just after the first of the year. They asked should they switch plans. We looked at the numbers, she got an estimate on the cost of the surgery. It turned out that their total expenses would be less on the bronze plan even with the high deductible because the premium was so much lower all year. It was still worth it.

 

Advocate –

Sometimes things go wrong. An electronic application malfunctions, documents need to be uploaded or sent to underwriting. Your situation is complicated and the prefilled boxes don’t tell your story. A claim isn’t processed correctly. You get the wrong information from a well-meaning, but newly hired customer service rep…. or The WAHealthPlanFinder hasn’t sent your premium money to the insurance carrier and the carrier is telling your doctor you aren’t covered. You need an advocate.

One frustrated couple began their attempt to get covered on the WAHealthPlanFinder after switching from Employer Health coverage to individual coverage at the end of June. After months of nearly unbelievable errors, and thankfully no major medical incident, they finally got covered in January. However they’d been paying for months and months of coverage in 2014. I was able to get the WAHealthPlanFinder to admit they’d made the errors, refund the 2014 premium money and issue a letter allowing for a hardship exemption and thus no penalty on their 2014 taxes. It took hours on the phone over the past 5 months, stern letters, threats, and just never taking wait and no for an answer. It also took knowing what to ask for and speaking the language of insurance and what would actually be the best outcome.  It took being an advocate.

 

Clients and potential clients often ask how I get paid. It never costs my clients anything to use me. If someone enrolls in a plan through me I get paid a commission by the insurance company – whether it is through the WAHealthPlanFinder or directly with the company.   That doesn’t mean I can only take new clients looking to change their plans. Regence, Bridgespan Premera, Lifewise, Moda and Group Health all allow for current clients to either list or change the broker on their account just by filling out a simple form. If you have a current plan with one of these companies and don’t have a broker who educates, helps you evaluate and advocates for you I’d love to be your broker. Again, it doesn’t cost you anything, but you get the additional resource of me.

Posted on May 18, 2015 in Uncategorized

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