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Health Insurance – Including Major Medical Through ACA

Find the Best Health Insurance for Your Client

Health insurance is vital to your clients to protect them financially in the case of injury or illness. Alongside retirement plans, health insurance is considered one of the most important benefits of employment. Businesses effectively have to provide quality health insurance coverage to compete in today’s market.

However, with the changing environment in the health insurance market since the Affordable Care Act (ACA) implementation, many find it challenging to navigate the current options.

Offering your clients help with their health insurance is an effective way to attract new clients and retain your current client base. Working with a health insurance brokerage agency with knowledge of the current market and access to multiple carriers can give you an advantage in the sales process.

What are the different types of health insurance?

Health insurance policies are distinguished by whether the policyholder is an employer or an individual. Employer-sponsored group health insurance plans are extremely common, and nearly half of all Americans are covered by group health insurance. Although group health plans are the best option for most people, you still want to weigh all the options, including individual plans and Medicare.

Group Health Insurance

Group health insurance is a type of private health insurance product offered by an employer to employees. In other words, a business or other employer purchases a health insurance policy and offers coverage under the policy to employees. The employer is the policyholder, and they make all the decisions about the specifics of the plan. Learn more

Individual Health Insurance

Individual health insurance is a type of insurance product that an individual purchases for themselves and their family. With changes in the health insurance market brought by the Affordable Care Act, individual health insurance is growing in popularity.

Medicare

Medicare is a type of health insurance offered by the federal government primarily to people age 65 and older. Medicare plans have a variety of options, including Medicare supplement, or Medigap, and Medicare advantage plans. Whether you are exploring health insurance policies for an individual or an employer, you should be familiar with the most common types of plans, PPO and HMO:

Preferred Provider Organization (PPO)

Preferred Provider Organization plans offer the most flexibility in where the insured can receive treatment. PPO plans provide coverage nationwide and allow you to visit specialists without needing a referral. Some healthcare facilities accept only PPO plans.

Health Maintenance Organization (HMO)

Health Maintenance Organization plans tend to be more affordable than PPO plans, and more restricting. With HMO plans, the insured individual must choose a designated physician and get referrals before visiting specialists. Many states restrict HMO plans to coverage in-state, which can cause issues during travel.

How do I find the best health insurance policy for my client?

The purpose of health insurance is different for every client. You need to look at their specific situation and consider their goals, finances, health, and lifestyle to find the right policy for any given client.

When working with a business or other employer, consider the number of employees, their budget, and the other benefits they offer. Your client may need help conducting a census, which looks at the number of employees, how much they work and earn, and other factors. Avoid price shopping for the cheapest possible plan, as employees may not enroll in a bad plan, which might jeopardize your clients’ eligibility.

An insurance brokerage agency can help you and your client work through all these details and more. While it may seem logical to go directly to an insurance carrier like Blue Cross Blue Shield, the process can be tedious and complex. For example, it is not uncommon to get rerouted to 15 different departments before finding the help you need. Once you purchase the policy, there may be unexpected maintenance items required when hiring new employees.

Moreover, working with a broker will not cost you anything. Insurance carriers compensate brokerages for providing auxiliary services to clients. So let a broker shop the market for you and select from a wide range of products and insurance carriers that meet your customers’ needs. Working with a health insurance brokerage can be the difference between purchasing a policy tailor-made for your client or an inferior product that will not provide the needed coverage.

How do I find the best health insurance broker?

When shopping for health policies, you will want to seek out insurance brokerages that not only understand the market but are there to provide back-end support throughout the life of your policy. Asking for referrals from your network is one of the best ways to find brokers. You should also consider connecting with the Texas Association of Health Underwriters, a trusted nonprofit association for licensed health insurance agents and benefits professionals.

You can also do your research by prospecting several insurance brokerages in your area. We recommend looking for these qualities in a broker:

• Responsiveness and attentiveness. Are they knowledgeable of the products and solutions available to serve you and your clients’ needs?
• Back-office support. What happens after an application is submitted?
• A good team instead of just a good salesperson: make sure that the service is as good as the pitch. Service can make or break a relationship.
• Do the owners invest back into the agency or focus on paying themselves?

You can also learn a lot about the brokerage by calling them up and asking pertinent questions, such as:

• How long have you sold health insurance?
• Have you had any complaints with the state?
• Who are your primary carriers? 
• What are the carrier ratings?
• What types of products are the affiliate carriers selling?

Do your homework and determine if the brokerage gravitates towards products with the most commission. Most importantly, visit the agency. Do an onsite visit and speak with the brokers in person.

EMG can help.

As a brokerage general agency, EMG Insurance Brokerage handles everything from submission to the commission. Our relationships with over 30 carriers allow us to help choose the best carrier for your client based on the purpose of coverage, underwriting obstacles, and type of product. We will walk you through the process and have the ability to tailor solutions to the unique needs of each client, whether they are shopping for individual or group health insurance.

We have a dedicated group health department ready to help you throughout the life of your policy. Whether your client is purchasing a policy for the first time or needs help managing enrollments, we are here to make the process seamless. We will take your client’s census annually, review their current policies, and shop the market to come back with a competitively priced benefit package tailored to their needs. We provide group insurance to over 900 businesses every year and continue to grow and develop our process.

Our agents pride themselves on their ability to get your questions answered in a timely fashion and are already up-to-date on what is currently happening in the health insurance marketplace. You will have access to a dedicated case manager that will follow your case from submission to final approval and placement. This highly personalized approach gives us the ability to tailor solutions to each client.

Connect with us by phone, online, or in-person, or schedule a consultation with your sales director today on how to grow your business.

Frequently asked questions about health insurance.

Is it possible to combine several types of health policies?

No. You are only able to purchase one major medical health insurance plan at a time. However, you may purchase a policy that helps offset the deductible. You may also purchase policies providing coverage where your major health insurance plan may fall short.

What insurance covers the items that health insurance does not?

Gap insurance helps to cover out-of-pocket costs applicable towards your deductible. Critical illness insurance covers serious illnesses and long-term medical conditions by paying a lump-sum benefit amount. 

What is the difference between a health insurance agent and a broker?

Both independent health insurance agents and brokers represent multiple companies. The difference is that while health insurance agents work on behalf of those companies, a health insurance brokerage works on behalf of the consumer.

What are the four categories of health insurance available through EMG?

Group Health Insurance – BCBSTX: 2 to 50 Lives, Self-Funded National General, All Ancillary Lines of Coverage

Medicare – Medicare Advantage Plans, Medicare Supplement Plans

Individual Health Insurance – ACA Under 65 Major Medical, Short-Term Major Medical

Travel Health Insurance

What are the featured carriers that EMG works with?