The ins and outs of working with an agent, broker or consultant

Ask an expert: what to know about working with an agent, broker or consultant

Understanding health insurance can be a daunting task. When considering plans for your business and employees, too much is on the line to misunderstand what you’re signing up for.

According to a study by Health Literacy Research and Practice, more than 50% of U.S. adults had:

Little knowledge of basic health insurance terms
Difficulty using health insurance to access health care services

If you or your employees don’t understand your plan, you could lose out on valuable services and benefits that keep you healthy.

The best way to understand your health insurance needs and how to use your benefits is to work with a trusted professional. An agent, broker or consultant can act as your guide throughout the process, helping you understand:

The definitions of terms you need to know in a way that makes sense and doesn’t cause confusion
What types of plans are available
Which plans are best for your business and employees
How to save money without sacrificing quality
How to fully utilize your benefits

Learn about three types of health insurance professionals and how they can help.

What’s the difference between an agent, a broker and a consultant?

An agent typically works with one health insurance carrier, while a broker often represents many insurance carriers. The role of an agent and broker are closely intertwined – as they both work to provide recommendations about which plan may be best for your business.

Agents are typically paid directly by their insurance carrier. Brokers are often paid on commission after you’ve enrolled in a plan. Neither of these options cost you money as the insured client.

A consultant also represents multiple companies but may provide additional services for a fee, such as compliance reporting, assistance with supplementary benefits and plan administration. Additionally, a consultant typically works with large group employers and is actively involved in your company’s plan year-round.

What are the benefits of working with an agent or a broker?

Agents and brokers are licensed in the states where they practice and are extensively trained and educated on plans and provider networks. Best of all, they’re available to you at no cost.

To recommend the best options for your business, your agent or broker will vet different plans, provide you with quotes to review and explain the ins and outs of each option. One of their most important roles is to help eliminate confusion by helping you understand the finer details of each plan.

Remember that your agent or broker is your advocate, and their goal is to recommend the best options for your business. They’ll consider the needs of your business and what additional services may be the most beneficial to you, such as free COBRA administration. By doing some of the legwork for you, an agent or broker can save you time and money.

Do I pay a fee to use an agent or broker’s services?

No, purchasing health insurance through an agent or broker does not cost you anything. An agent or broker’s pay or commission is already accounted for or built into your rates, so you’ll pay the same monthly premium whether you purchase health insurance on your own or through a licensed insurance agent or broker.

How does a typical contract work?

Once you have signed on with an insurance carrier, your contract typically lasts one calendar year. Your contract includes an agreement to the rate and administration requirements.

Before it is time for renewal – often in the fall – you can evaluate if your plan’s coverage and services meet your needs. Your agent or broker will also give you updated information for the coming year and can provide you with quotes if you’d like to consider switching plans or insurance carriers.

Where can I find a health insurance agent or broker?

Sanford Health Plan can connect you with a local insurance agent in your community. These agents are here to help you fully understand all aspects of insurance and how it can benefit your business. Having a qualified agent in your corner can ensure you are able to make informed decisions on selecting a plan – and get the most out of your benefits.

You can also find an agent or broker on the Marketplace at healthcare.gov or use Help On Demand, a tool that connects you to agents or brokers for immediate assistance.

Find an insurance professional to help you every step of the way. Call (888) 535-4831 to connect with an agent today. If you're ready to request a quote, visit sanfordhealthplan.com/get-a-quote. Our team can connect you with an agent to help you sort out your options.