Individual Health Insurance Agents

An individual health insurance agent is a licensed business or individual that represents one or more insurance companies in the promotion and sales of individual health insurance. Most individual health agents are independent contractors and compensated by the insurance companies on a commission basis. As a contracted representative of the insurance company, an individual health agent has the responsibility of acting as liaison between the consumer and the insurance company. However, the insurance company may not be legally bound by the actions or promises of the individual health insurance agent if they acted outside of their contractual rights with that insurance company. The insurance company will not be responsible for any misrepresentations they made in regards to covered benefits or rate guarantees.

Types of Individual Health Insurance Agents

There are two basic types of individual health insurance agents: captive agents and independent agents:

Captive Agents

A captive agent is an agent that is contracted to work with a specific Insurance (or specific individual) of insurance companies. This means that this agent will only be able to offer and sell individual health insurance from one company. Some captive agents may even be under the employment of that insurance company and have an exclusive agreement that prohibits them from selling individual health insurance from competitive insurance carriers. Most insurance companies do not demand exclusivity, but there are a few. They are usually easy to spot because these exclusive agents will be promoting only one insurance company that will not be quoted by agents that represent multiple companies.

Independent Agents

An independent agent is an agent that does not have an exclusive agreement with one specific insurance company. Although they may elect to only sell the individual health insurance plans offered through one company, they are not contractually obligated to do so. Most independent agents will offer individual health plans from more than one insurance company. Individual health insurance agents that represent multiple insurance carriers are more commonly referred to as “brokers” because they assist you in comparing rates from multiple companies. Usually, independent agents have a better understanding of the pros and cons of almost all the policies available with different companies. They can provide comparison charts of the policies available with different insurers. This makes suggesting options that better suit your requirements an asset in your favor.

Benefits of Using a Individual Health Insurance Agent

If you choose to not use the services of a health insurance agent or broker in finding an individual health plan, your only alternative is to contact the insurance companies directly. If you wish to compare plan options from multiple companies, this can be very time consuming. An individual health insurance broker will be able to provide you with quotes from multiple insurance carriers within a short period of time. You will find many agent websites that even provide instant online quotes for multiple companies with the option to print brochures and even submit an application online.

There are no additional fees or premiums associated with working with an individual health insurance agent. The rates that they will quote you will be identical to the rates that you would receive directly from the insurance companies. The agent is compensated by the insurance carrier by receiving a percentage of the monthly premium as commission.

In addition to providing you with quotes from multiple insurance companies, an individual health insurance agent will also provide you with all necessary enrollment applications, plan details and brochures. They provide assistance in helping you complete the applications and review them for completeness before submitting to the insurance companies. This is very important because an incomplete application my greatly delay your approval time and may even result in your application being declined. Before submitting your application to the insurance companies, they will make certain that your application will pass the underwriting and acceptance guidelines of the insurance company. Not all insurance companies have the same acceptance guidelines. If the agent sees a concern, such as a pre-existing medical condition, when reviewing your application, he will instruct you to consider submitting the application to a different insurance company that has a history of being more acceptant of that particular concern.

The assistance you will receive from an individual health insurance agent does not stop once you are enrolled in a new individual health plan. Your agent will continue to assist you by informing you in advance of planned rate increase from your insurance company. If the rate increase is not acceptable to you, your insurance agent can assist you in reviewing other options currently available on the individual health insurance market in your state.

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