Un corredor de seguros de salud es un profesional que puede ayudarle a conseguir la mejor póliza para sus necesidades. Pero, ¿en qué se diferencian de un agente de seguros de salud? ¿Qué debería saber antes de utilizar cualquiera de sus servicios? ¿Consigue una mejor oferta utilizando uno que el otro?
Cuando llega el momento de buscar una nueva compañía de seguros o una póliza para empleados, conviene entender la diferencia entre un agente y un corredor. Antes de firmar en la línea de puntos para su próxima póliza, revise lo que cada uno tiene para ofrecer y algunos puntos más finos que quizás desconozca.
¿Qué hace un corredor de seguros de salud?
A health insurance broker’s primary job involves working one-on-one with clients to locate a health insurance policy that’s right for them. These brokers are authorized to guide clients through the various policies available to them. They explain the nuances of each plan so clients can make a well-informed decision. They also assist clients in enrolling in a Plan de salud calificado (QHP)) a través del mercado.
Brokers are licensed and must have passed a series of examinations and courses to attain that license. After they’ve received their legal license, brokers may be required to take additional classes by the state. Once they’ve passed these examinations, they are required to stay up to date with the latest policy and law changes. Currently, health care reform has required brokers continuously educate themselves to ensure they can provide their clients with relevant information. Additionally, states constantly change their health care policy, making it an even greater challenge to be a broker.
Además de conseguir y negociar la cobertura de salud para los clientes, los corredores también participan en las actividades diarias relacionadas con los seguros. Resuelven disputas sobre reclamaciones, ayudan con las inscripciones, gestionan el estado de las pólizas de cuidado infantil y familiar y resuelven problemas de facturación. Son más que un simple intermediario entre el individuo y la compañía de seguros.
Most brokers are independent of insurance companies. They work as “free” brokers and are given the authorization to offer clients a host of insurance plans. A health insurance broker earns more by finding clients affordable plans with high benefits, which works in the favor of his clients.
Las empresas también pueden pagar una tarifa a los corredores para que aíslen el mejor plan en el mercado local para su negocio.
La Ley de Atención Médica Asequible (ACA) ha aumentado la demanda de intermediarios, ya que las complejidades del proyecto de ley son difíciles de seguir. Las personas y las pequeñas empresas necesitan especialmente intermediarios que identifiquen los mejores planes disponibles.
En resumen, los corredores de seguros de salud hacen lo siguiente para sus clientes:
- Busque en los mercados de atención médica locales para encontrar las mejores opciones de planes
- Ayudar a los clientes con reclamaciones
- Negociar tarifas
- Ayudar con problemas de facturación
- Esquema de diseños y opciones de planos
¿Qué hace un agente de seguros de salud?
A health insurance agent is a bit different. While their primary job description is the same as a health insurance broker (identifying the right plan for clients), who they answer to is different. Most brokers are able to offer a wide variety of health insurance policies to their clients because they don’t work for just one. Instead, they receive a commission on the sale of policies, but this does not increase the costs for their clients.
Los agentes, por otro lado, pueden representar a una sola compañía de seguros, en lugar de a varias. Son pagados por esa compañía en un sentido más general. El número de planes que pueden ofrecer está limitado a esa compañía. Obviamente, esto puede hacer que sus clientes paguen más por las mismas pólizas o pólizas similares que un corredor podría sugerir.
Interestingly, however, a health insurance agent may be employed by a health insurance broker. These agents work with brokers to isolate the best plan from a specific company. The word “agent” and “broker” may also be used interchangeably, but most brokers will advertise that they are a broker since most in the market associate that title with greater options and lower priced plans.
Health insurance agents, like brokers, can also help their clients understand the benefits offered by non-government exchange plan options. The marketplace is designed to bring about lower priced premiums, but recently that hasn’t been the case. To get a more affordable plan, most individuals and employers need a qualified and highly educated agent in their corner working to explain their plan options. However, with most agents, you won’t be able to purchase the plan through them since they are restricted by the company they work for. Nonetheless, the information they provide is invaluable.
Another offshoot of health insurance agent is a “captive” health insurance agent.
¿Qué son los agentes de seguros cautivos?
Captive agents, also known as “direct” agents, sell policies exclusively for a single insurance company. You can easily spot these captive agents via their marketing. Notice a specific insurance logo in their emails or invoices? If so, they are likely a captive agent.
An independent agent is usually called a “broker” as they shop the marketplace for the best policy and then once they identify a plan that works for you, they become your ‘agent’. Because they aren’t bound by the insurance company’s options, they won’t sell you a policy that might not be right for you. Captive agents, however, are bound by the company and will do their best to sell you plans that may or may not be right for your needs.
How You’re Affected
Whether you’re hiring a health insurance broker to find a good group employee plan or an individual family health care plan, a broker is a crucial tool in lowering insurance costs. Additionally, the right broker can secure a plan that has all the benefits you need and more. They save you time and money along the way.
A health insurance agent can also save you money, but if they are a captive agent they might corner you into a plan you don’t want because they don’t have the freedom to search the entire marketplace. If you’re looking for the best plan option, then the best route to take is to hire a health insurance broker who can then become an independent agent once they find the right plan.
Also, working with multiple agents won’t save you money. An independent broker can provide the cost savings you’re looking for without the headache of working with multiple agents.
Las empresas necesitan especialmente un intermediario. Negociar planes patrocinados por el empleador es difícil y externalizar esta tarea a un profesional ahorra tiempo y dinero.
Sea cual sea el camino que elija, recuerde que entrar al mercado sin un corredor o agente puede costarle mucho dinero. Los ahorros que puede conseguir con un profesional a su lado son incomparables.
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