Some services should never be decided by choosing the first one that comes up on an online search. You would do better simply asking for a referral from anyone you know who has purchased health insurance through an agent.
And, in fact, that’s good advice. But there is more you should know before you choose a California health insurance agent.
What is a California Health Insurance Agent?
Unless you’re already familiar with the health insurance industry and California insurance laws in particular, this may not be an easy question to answer.
Aside from the more obvious aspect – an agent that sells health insurance in California – there’s a bit more to the role and the profession. These individuals are licensed to sell health insurance in California only. In fact, there are a number of types of agents or brokers, usually categorized by the method of product distribution they employ.
The California Department of Insurance provides the following descriptions of the basic distribution methods:
Captive Agent
A broker-agent acting as a captive agent represents a single insurer, or single fleet of insurers, and is obligated to submit business only to that company or, at the very minimum, give that company first refusal rights on a sale.
Insurance Broker
A broker-agent acting in the capacity of an insurance broker is an independent insurance sales person who searches the marketplace in the interests of clients, not insurance companies, and may place coverage with any admitted insurance company.
Independent Agent
A broker-agent acting as an independent agent is a contractor who represents different insurance companies and who searches the market for the best coverage based on a client’s insurance needs. However, unlike an Insurance broker, independent agents must be appointed by each insurance company they represent before placing coverage with that company.”
While it is possible to purchase your own California health insurance plan on your own, this is not always an easy or simple task. In fact, it is almost always better to seek help from a licensed California health insurance agent or broker.
An insurance agent will likely have to deal with many of the same delays and technicalities that you would face as an individual consumer, relying on an agent can make the decision and purchase process easier in several ways.
For example, an experienced agent can help you compare plan prices and coverage details, and explain complex features or unfamiliar terms. In addition, an agent can determine whether you qualify for subsidies for insurance premiums and recommend plans that may be best for you or you and your family.
A qualified broker, like JC Lewis, will have years of experience and expertise and can walk you through the application process and help you understand your health coverage options in a way you might not be able to get on your own.
How Are California Health Insurance Agents Paid?
When shopping for individual or family California health insurance plans it is important to understand that the services given by agents to applicants of health insurance plans are all free.
California state law prohibits California health insurance agents and brokers from charging a fee for their services to consumers, which means that the cost of your plan will be the same whether you choose to use an agent or not.
This does beg the question, how do California health insurance agents get paid then?
Agents and brokers are paid through commissions from the insurance companies and are paid either a flat fee or a percentage of the monthly premium. Depending on the company and the agreement with the agent or broker, this percentage is typically between one and five percent.
This compensation to the insurance agent is paid for bringing the customer to the insurance company and also for agreeing to service the customer in the future. Regardless of how the agent or broker is paid, the customer is never charged by them.
According to information provided by HealthForCalifornia.com,
“People who are seeking insurance for themselves or for their families should understand how health insurance agents are paid so that they choose an agent wisely. Agents who have bonus incentives to sell more of one particular insurance company may not meet your needs the best.
Individuals who choose independent agents or brokers who sell a variety of insurance companies’ plans will have the most options and are more likely to find a more suitable plan for their needs. Individuals who choose a captive agent, one who sells only one insurance company’s plans, limit their options to only one insurance carrier.”
Your Best Choice for a California Health Insurance Agent
JC Lewis Insurance, based in beautiful Santa Rosa in Sonoma County, offers California health insurance plans only from leading health insurance carriers licensed to do business in California.
In addition to being expert brokers, we are licensed and certified by each insurance carrier to offer coverage to individuals, families, small group employers, and to seniors with Medicare supplemental and prescription drug plans.
If your employer doesn’t provide health benefits, an individual or family plan may be the best option for you and/or your family. California’s health insurance plans are now categorized as “on-exchange” versus “off-exchange.”
Buying a plan on-exchange simply means buying a plan directly through the state government exchange, or Covered California. Purchasing a plan off-exchange refers to enrolling in a plan directly through an insurance carrier. Call us today for more information or request a quote online.
Factors to Consider Before Choosing a Health Insurance Agent
Understanding Agent Licensing Requirements
Not all agents are created equal when it comes to expertise and qualifications. When selecting a health insurance agent in California, ensure they hold a valid license issued by the California Department of Insurance. Licensed agents are required to complete ongoing education to stay updated on changing laws and regulations, ensuring they provide you with accurate and relevant advice. Verify their credentials to avoid unqualified agents who may lead you to suboptimal coverage.
Captive vs. Independent Agents: Key Differences
While the article discusses different agent types, it’s vital to dive deeper into the pros and cons. Captive agents may have exclusive access to unique plans from their carrier, which can sometimes offer specialized benefits. However, independent agents often have the advantage of broader market access, enabling them to find competitive rates across multiple providers. Consider your priorities—do you value exclusive plan features, or is price flexibility your main goal?
Leveraging Agent Expertise for Tax Credits and Subsidies
A knowledgeable agent can do more than find you a plan—they can help you unlock potential savings. For instance, agents familiar with California’s Covered California exchange can identify if you’re eligible for tax credits or premium subsidies under the Affordable Care Act. This assistance can significantly lower out-of-pocket costs, making health insurance more affordable for individuals and families alike.
By considering these additional factors, you can ensure that your chosen California health insurance agent meets your unique needs while helping you secure the best coverage at the most competitive price.
