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- The obligations and limitations of health insurance policies
- The differences between the policies offered by various companies
- Understanding the Affordable Care Act (Obamacare) and any changes that may be made by Congress
- Realizing that all health insurance policies must meet minimal ACA standards
- Staying up-to-date on various state laws in addition to federal regulations
To be a successful health insurance agent, it is mandatory that as an agent or broker, be a person that understands the insurance market, is aware of the available options and be able to relate this information to the customers.
Purchasing health care insurance can be a very difficult task. Purchasing insurance is not like going to the store and picking out a policy. Group coverage offered by a company or organization is different and has less flexibility in that everyone in the group gets the same coverage.
The individuals and families securing health care coverage can get their insurance through coverage provided by their employer or some type of business, trade or fraternal organization will be covered by the provisions of the policies. However, in many, if not most cases, if a person leaves the employer or another group, the coverage will be terminated.
However, those individuals can purchase insurance on the open market as a result of the Affordable Care Act or as it is known as Obamacare. While the ACA is encountering some political and economic issues, it does ensure that a person cannot be turned down for prior health conditions.
The ACA also provides sources for securing insurance through the ACA Marketplace. Individuals can also secure insurance from other sources, as long as the basic guidelines are met.
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Providing the Right Help
Therefore, persons purchasing their own health insurance may need to have some help, which can be provided by a Health Insurance Agent. While the ACA provides for direct coverage, it is sometimes overly expensive or unavailable through the ACA HealthCare Marketplace.
Health insurance policies differed in some manner among the different companies operating within the area.
ZaneBenefits is one company that concentrates on small business employee benefits. In this category of insurance providers, there are some basic rules for agents to understand and use.
Rules Which Will Impact future Sales
- Do not try to rush the sale. Be prepared to spend time with the client and explain all details.
- Make the best use of your time. Focus your time on the leads. A lead can come from a cold phone call to a previous successful sale leading to a friend or relative that has been satisfied with your efforts.
- Be courteous to the customer. It is possible that he is very knowledgeable about insurance and is talking to a number of agents. If the answer you receive is no, you can ask why, but recognize the customer’s wishes. Depending on the policy the customer is purchasing, he may end up being your client in the following year.
There are other rules offered by a number of sources. Therefore, as a person seeking to be an agent or broker, it is your responsibility to keep up with all the changes in health care laws and learning that something covered last year is no longer offered or something new is available.
However, regardless of where the insurance is purchased the security of knowing a person cannot be turned down for prior health conditions is assured, and accordingly, gives the insurance agent or broker more flexibility in meeting the needs of their customers.
A health insurance agent is responsible for helping the client determine the precise coverage that is being sought, the various parts of the Affordable Care Act and other issues that are a part of the sale of health insurance.
Thus, the health insurance agent has to be knowledgeable in all the nuances involving health insurance that may be purchased by individuals, a family or some type of organization.
No one wakes up in the morning and says, “Hey, I am an insurance agent.” A considerable amount of education and training is involved so that a person can become a licensed insurance agent.
Understanding What a Health Insurance Agent or Broker Does
Health insurance agents generally have a college-level degree, but it is not an absolute necessity. Those persons that did not attend or finish college can perhaps become a health care agent.
A health insurance agent or broker is the person who makes the deal with the customers seeking coverage. To do this, the agent must have considerable knowledge about the policies he is offering and be able to explain the levels of coverage, restrictions, coordinating with other health policies if applicable and making sure the customer completely understands the coverage or product he is about to buy.
Agents work with individuals and companies or organizations that provide insurance. A number of companies can be found online and limited to a specific area. A good step is to review these sites, but take time in making a choice. The Wall Street Journal has published a story on how to select and insurance agent.
When purchasing health insurance on an individual or family basis, it is necessary to know that you are dealing with a licensed insurance agent. All states have various requirements for the different health care related issues, such as doctor and hospital services, emergency room, disability, and long-term care.
Licensing Regulations Vary Among the States
There are many types of insurance available on the open market such as property, auto, disability, long-term care and other specialties.When seeking a health insurance agent, it’s important to make sure that they have the necessary certifications to sell health insurance and perhaps additional training in disability coverage and long-term care according to study.com.
Agents can be employees of specific insurance companies. Accordingly, they will be offering and promoting the coverage that a company is offering. There is nothing wrong with this approach, and the individual still has the right to check with several agents. There is also the possibility that by dealing with one agent representing one company, there may be some monetary discounts on the various types of coverage offered.
However, an independent agent can represent several different lines of insurance and possibly offer equal or near-equal coverage at a competitive price.
An independent agent may also be in a position to help acquire other forms of coverage such as dental, supplemental coverage and other lines of coverage, depending on the needs of the individual or family being covered.
An example of the independent agency is the Independent Insurance Agents & Brokers of America. Because these individuals represent more than one company, they can offer a greater variety of coverage options, including health care but extend out to other areas such as auto, home, life, retirement, etc.
Agents and insurance brokers technically do the same thing: sell insurance policies. The primary difference is that the broker may represent a variety of companies that offers several lines of coverage, while an agent may be focusing on one type of coverage. Unlike agents, brokers have to meet certain standards or lose their license. Brokers do sometimes charge an administrative fee for their services.
Brokers can also be helpful in securing Medicare insurance for people younger than 65 but having unique situations that go beyond the scope of regular insurance.
By understanding that there are different sources for securing coverage, it becomes apparent that there are many options available to the potential client. It is not necessary for the customer to take the agent’s first offer. The independent agent and broker option can be pursued before a final decision is made.
Medicare Coverage Provided by the Federal Government and States
Medicare is a form of health insurance that offers some options. Normally limited to persons 65 years or older, Medicare can be made available to individuals younger than the age limit and for persons with varying disabilities.
Persons receiving Medicare coverage can receive supplemental coverage from several companies that cooperate with Medicare. Thus the agent or broker has an important role to play. The agent must secure the supplemental coverage that best meets the patient’s needs and be within an affordable price range.
Accordingly, brokers and agents can assist current and former clients with securing basic Medicare insurance.
There are many things a broker or agent cannot do when offering Medicare insurance to eligible people. There are things the agent can do in an effort to assure the client that he is getting the best coverage available.
The Agent’s Ultimate Responsibility to the Client
Insurance agents and brokers provide a very important service that people depend upon to provide the best coverage possible. Therefore, after completing the basic requirements for becoming an agent in your state, your next task is to use that training in a manner that best serves the potential client.
It would be foolish to believe that every potential client you meet is going to purchase the policies you are offering. Always stay professional and when a prospect says no, be sure to thank them for the time they spent with you and tell them if they ever want to change companies to please let you know.
Each company has its own code of ethics. While the wording may be different and greater emphasis is give to the fact a person is representing a particular company, the guidelines are about the same for everyone.
- The Agent represents a high level of qualification of the profession.
- The Agent follows the precepts of honesty, competence, and financial care.
- The Agent refrains from acts that are not in accordance with fair competition, including but not limited to refraining from acts in violation of unfair competition laws, such as the Sherman Act and the Clayton Act, antiBoycott laws and regulations, the Foreign Corrupt Practices Act, and the laws and regulations administered by the Office of Foreign Assets Control.
- Relationships with the Agent should be characterized by trust and partnership. The Agent should respect the personal dignity, privacy, and personal rights of each individual and act openly.
- The baseline for any action is compliance with contractual obligations and the law. Agents will carefully and thoroughly fulfill their contractual duties and responsibilities while complying with all applicable laws and regulations.
- Agents will extend this Code of Conduct upon persons acting on its behalf, including its employees. Thus if an employee is not an agent, he must meet the same standards as the agent.
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