Insuring Your Future: Is Your Insurance Agent Ready? (For Obamacare)

The advent of ObamaCare will result in many changes, including the job description for insurance agents. A year ago I was told by a state legislator that “thanks to the new health exchange buying insurance will be as easy as booking a trip.” Simply go on line and find a plan, sign up and send in your money. It certainly sounded easy enough, but it couldn’t be further from the truth.{{more}} What my friend the legislator forgot is that employers and individuals depend on their agent to wade through the various plans and interpret them and rather than being less confusing – it is much more.

Prior to the Affordable Care Act, an agent would search the major carriers for plans that had the best fit for clients based on number of employees, amount of employer contribution and cost. Employers could choose to keep coverage and pay higher premiums or switch to a different plan. If the client were an individual we would do the same, also taking into consideration any health issues that they may have. While the medical history of an individual has been taken out of the equation, many other factors have been added, creating an even more complex web of options and points to consider.

Now we have new rules, new choices, new subsidies, new penalties and new premiums. The “Health Exchange,” called Access Health CT, has been added to the mix which is simply a central marketplace with insurance plans offered by the major insurance companies. They have created platinum, bronze, gold and silver labels for various levels of coverage. Now, if you aren’t completely convinced, read on . . . .

Employers will need to make strategic business decisions based not only on plan benefits, but employee income levels to see if the Exchange product is a good fit versus staying with a private product. They can allow each employee to purchase his or her own insurance and contribute to the premium on an individual basis through a defined contribution plan. Or they can choose a combination of private and public plans.

If an insurance plan does not meet minimum coverage standards, and the employee qualifies for a subsidy through an exchange plan, the employer could be penalized. Still want to try this alone?

Health insurance agents today need to be well versed in both the public and private marketplaces for purchasing insurance. In addition to being good advisors they also must be good analysts. My clients depend on me to educate them on their best benefit options, which means I need to gather the right information (ask more questions), be well informed on the private vs public purchase options (lots of training) and then evaluate all elements of choice such as networks, maximum out of pocket and family pricing (lots of research). While many in our profession feared that the new laws could mean the worst of times, it is turning out to be the best of times – as well as the most challenging. I believe that we are the key to the ultimate success of the Affordable Care Act as the informed professional – our clients will depend on us now more than ever.

Trish Pearson is a licensed independent insurance agent and certified Long Term Care Specialist. Contact her at 203-640-5969 0r