What Does a Health Insurance Broker Do?

A health insurance broker's job starts before you pick a plan and continues long after. Here is what you can expect from a good one.

Before you enroll

Gathers the basics: who needs coverage, ZIP code, ages, expected household income, doctors and prescriptions.
Estimates your premium tax credit if you're buying through the marketplace.
Compares plans from the insurers they're appointed with, including the monthly premium, deductible, out-of-pocket maximum and network.
Checks your doctors and drugs against each plan's network and formulary.

Want this done for you?

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

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At enrollment

Submits your application through the marketplace or directly with the insurer.
Makes sure the right subsidy is applied and confirms your effective date.
Reminds you to pay the first premium, which is what actually turns coverage on.

After you enroll

Helps with ID cards, billing errors and claim questions.
Updates your income during the year if it changes, so you don't owe money back at tax time.
Reviews your options at renewal each fall.

What a broker can't do

Brokers can't change what a plan covers or guarantee a price before an application is approved. For group coverage, rules also depend on how many employees you have.