How to Choose a Health Insurance Broker

A health insurance broker is a licensed professional who helps you compare and buy coverage. The good ones save you hours of reading plan documents and catch mistakes that cost real money, like a plan that leaves out your doctor or a subsidy estimate that's too high. Here's how to tell a good broker from a sales pitch.

Brokers, agents and captive agents

"Broker" and "agent" get used interchangeably. What matters is how many insurers the person can sell:

Captive agents represent one insurance company and can only quote its plans.
Independent agents and brokers are appointed with several insurers and can compare them side by side.
Marketplace-certified agents have completed the training needed to enroll you in a subsidized plan through HealthCare.gov or your state's exchange.

For most individuals and families, an independent agent who is certified with the marketplace is the right fit.

Want this done for you?

Licensed agents compare plans from several carriers, check your doctors and estimate your subsidy. Free to you.

Call 866-645-8540

What it costs you

For individual and family health plans, nothing extra. Insurers pay brokers a commission that is already built into the premium, and the premium is the same whether you enroll on your own or with help. If anyone asks you for a fee to enroll you in a marketplace plan, ask why before you agree.

Questions to ask before you commit

Which insurers can you quote in my county?
Are you certified to enroll people in subsidized marketplace plans this year?
How do you check whether my doctors and prescriptions are covered?
Will you help me at renewal, and if I have a billing or claims problem?
Can you give me your National Producer Number so I can verify your license?

Check the license

Every state insurance regulator lets you confirm that an agent is licensed and in good standing. Ask for the agent's National Producer Number (NPN) and look it up. A licensed health agent will usually hold an "Accident and Health" line of authority or your state's equivalent.

Red flags

Pressure to decide on the same call before you've seen the plan's network or drug list.
A price that sounds far lower than anything else you've seen. Short-term and fixed-indemnity plans can look cheap because they don't cover what an ACA plan covers.
Changing your plan or income information without asking you. You should always see and approve the application.

The bottom line

A good broker compares several carriers, checks your doctors, explains the trade-offs in plain language and sticks around after you enroll. If you'd like that comparison done for you, licensed agents are available by phone at no cost.