California Health Insurance – Independent Health & Life Agent Verses Insurance Company In-house Agent

You’ve just filled out an online form requesting a free health insurance quote and moments later you’re being inundated with phone calls from insurance agents hoping to get your business. Try not to get overwhelmed or annoyed by these “nuisance salespeople” because they aren’t really telemarketers. Most of them are well-trained, state-licensed professionals who can really help you make a good decision about which health plan is best and most affordable for your individual or group coverage needs.

You may be under the misconception that if you buy your health plan directly from the insurance company and cut out the “middle man,” you’ll save money. This is absolutely not the case. In fact, insurance companies rely on agents for most of their business and that’s why they pay them commissions for bringing in clients. It doesn’t cost a consumer a penny more to use a California licensed health insurance agent to obtain their insurance coverage.

There are many differences between health insurance in California and other states, including how you apply.

For example, while Blue Cross and Blue Shield are one company in other states, here in California, each is separate and applies individually as Anthem Blue Cross of California and Blue Shield of California.

The California health insurance law AB 1672 is an improvement over the federal HIPAA law that covers all states, as it includes the following with respect to California group coverage:

1. People with pre-existing medical conditions can switch to a new group health plan without an exclusion period.

2. Allows small businesses and professional organizations access to health plans as long as they have between 2 and 50 full-time employees.

3. Prevents insurance rates from going up after a claim is filed.

4. Employees with health problems can change jobs or health plans without receiving a higher rating for having pre-existing conditions.

That said, the best health insurance agent for your individual and business needs is an “Independent Agent.” Why? Because they represent multiple insurance companies, not just one. An independent agent can help you select the most appropriate cost-effective plan that offers the most benefits for your money as available from the major carriers, rather than just one carrier’s line of health plans that may not meet your needs. individuals. Many people are too complacent and settle for what their current insurance company has to offer. They could use a good independent agent to sort through the many plans available from multiple insurance companies to find and provide the best choice of options.

Another misunderstanding you may have is that insurance agents set the premium rates for the health insurance plans they sell. Thinking that if you compare prices, you can get a better price for the same plan. Premium rates are based on your age, zip code, or county in which you reside and are completely controlled by the insurance companies. Each agent uses the exact same rate guides established by the insurance companies. Her health condition may affect her premium, which may increase after the insurance company’s underwriting department has reviewed her medical records. Again, the insurance company, not the agent, determines that result.

Now, let’s talk about the benefits of having a good insurance agent representing you. Most consumers do not know or understand the benefits of a health plan being offered and need the expertise of an agent to fully explain the benefits to them. For example, do you know the difference between an “out-of-pocket maximum” and an “annual deductible”?

An out-of-pocket maximum is the most you’ll have to pay in a given year for deductible and coinsurance for covered benefits before your insurance begins paying 100% of most expenses until the end of the year.

An annual deductible is usually the amount you pay each year before your health plan begins to pay for covered services. In general, the higher the deductible, the lower the premium. Certain services, like prescription drugs, have separate deductibles. Plans may vary, and sometimes benefits will kick in before you have to meet your deductible.

A knowledgeable health insurance agent can guide you through the maze and help you choose the right plan to meet your needs and budget while getting the most bang for your buck. An agent will also clarify how generic prescription benefits may differ from brand-name prescription benefits in a particular plan.

Once you’ve set up a health plan, a good, caring agent will remind you to pay your premium on time so the insurance company doesn’t cancel it. Your agent can also be a great resource for assistance if you have a problem with a health insurance claim. Instead of waiting on hold at the insurance company’s 800 number for thirty to forty-five minutes, call your agent and explain your problem, and if you’ve chosen the right agent, you’ll get help and can save yourself a lot of time and frustration. maybe even some money by having an expert in your corner where your best interests come first.

So the next time you or someone you know fills out one of those online forms for a health insurance quote and gets multiple phone calls from health insurance agents wanting your business, be thankful that a professional wants to help you for free. to choose. the right plan and you will have an important friend for life.