Health Insurance Agents

Affordable Care Act

Health Insurance Agents

Updated on November 14, 2019

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Health Insurance Agents and Navigators

The price of a health plan DOES NOT change if a broker or an agent helps your enroll in a plan.
Brokers and their agents are paid by insurance companies. If your broker/agent works with a lot of insurance companies (like we do here at eHealth) they’re in a better position to help you find a plan that’s right for you.

A health insurance agent’s job is to help an individual or a family select a health insurance policy that fits their very personal health coverage needs.

Health Insurance Agents – Your Personal Shopper

There are two things a person must do in order to become a health insurance agent or broker:

  • 1) Become licensed to sell health insurance, which requires them to study for and pass a state exam. Once licensed, the agent has to…
  • 2) Receive training from any insurance company that wants the agent to sell their products

Agents can work for one insurance company, selling only that company’s plans, or they can work as a broker representing multiple insurance companies.

Health insurance agents vs brokers

The term “agent” is sometimes used interchangeably with the term “broker”, but they can have different meanings.

  • What’s a licensed agent? An agent may represent one or more health insurance companies and may sometimes be employed by a health insurance broker.
  • What’s a broker? Brokers typically represent two or more insurance companies, which gives the broker and their agents more ways to help a customer find the health insurance plan that best matches their needs.

The price of a health plan doesn’t change if a broker or an agent helps someone enroll in a plan. Brokers and agents are paid by insurance companies.

Changes coming in 2018

The “navigators” who assist customers at government-run health insurance exchange aren’t necessarily licensed agents. This limits what they can do to help consumers. However, things may change. In 2018 navigators working at Healthcare.gov will be required to provide consumers with:

  • Post-enrollment assistance
  • Assistance with filing eligibility appeals (though not representing the consumer in the appeal)
  • Filing for shared responsibility exemptions
  • Providing basic information regarding the reconciliation of premium tax credits
  • Understanding basic concepts related to using health coverage.
  • Navigators will also be required to provide targeted assistance to vulnerable or underserved populations.

Health insurance agents vs. navigators

Insurance Agents vs Navigators

The graphic below outlines the difference between health insurance brokers and navigators.

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