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by Tony Novak, CPA, MBA, MT, NAHU certified consumer driven health care consultant, originally published 1/20/2012, last revised 2/26/2013
Prior to implementation of health reform measures, finding information about health insurance options for your business or yourself was relatively straightforward. A telephone call to your local agent or broker typically resulted in a suitable response. Today the story is much different. Health insurance information is distributed through stratified specialists, each with a unique focus.
The price of health insurance is the same regardless of the source of information or the choice of enrollment method. However, the choice of health plans that will be available varies based on the source. This article lists the five primary sources of information about health insurance, a brief synopsis on the best use of each type and how to access each through the Freedom Benefits network of services.
The U.S. Department of Health and Human Services has made much information available to individuals and small business owners through their Web site. Our recent test indicated that the national clearinghouse listed about the same number of commercial health insurance choices as other online exchanges but that is only about half of the total number of insurers.
Advantages: No fee; commission is paid by insurance company, best source of information about public health plans and child-only health insurance. This is equivalent to a federal health insurance exchange except that the insurance is offered by private/commercial health insurance companies.
Disadvantages: Only a portion of the available insurance choices are currently listed; does not include limited benefit or short term plans, online application can be difficult, does not offer non-insurance options or complete business benefit plans
Best suited for: individuals who are not able to afford commercial insurance, individuals with serious pre-existing medical conditions, businesses that cannot afford professional help.
How we can help you get started: visit www.HealthCare.gov. Freedom Benefits support for this site is only available through OnlineNavigator.org as described below.
Insurance agents or brokers typically have access to a handful of the most popular health insurance plans in their state. They tend to be very familiar with these choices. Unfortunately, due to reduced compensation for health plans, few professional will handle a health insurance policy unless they also handle other insurance for your business or family. For this reason it makes sense to use an agent or broker
Advantages: No fee; commission is paid by insurance company, individual personal telephone service
Disadvantages: Only a portion of the available insurance choices are available, non-commissioned choices are not available, weak integration with cafeteria benefit plans, most tend to be licensed in specific states but not nationwide. Some "call centers" create psychological pressures and spread misinformation in order to increase telephone-based sales.
Best suited for: individuals or businesses who want traditional insurance, consumers who do not wish to use a computer to enroll
How we can help you get started: follow the "Contact Me" link at the top left section of this page to have an agent licensed in your location call within minutes.
The downside is that none of the available insurance exchanges list all of the available health insurance options and it is still necessary to gain multiple sources. There are many commercial insurance exchange Web sites, the FreedomBenefits.net Web site covers the developments on the state-run and commercial health insurance exchanges on a state-by-state basis.
Advantages: No charge, commission is paid by insurance company, a good selection of Health Savings Account options, some are licensed throughout the entire nation, e-mail based enrollment support
Disadvantages: Only a portion of the available insurance choices are currently listed. Most states do not have a government operated exchange (as of the date of this article revision).
Best suited for: individuals who are comfortable with online enrollment
How to get started: visit www.FreedomBenefits.net and select your state for links to your state insurance exchanges, if available.
The affordable Care Act introduces a new type of health plan adviser called a “Navigator”. A navigator works primarily with government-produced resources on a wide range of health plans including both public and commercial health plans. Navigators are not paid by insurance companies but presumably will eventually work for the health insurance exchange or another government agency. These navigators will not be available until 2014 at the earliest. For now, navigator services are available on a limited basis and are typically paid by an employer. OnlineNavigator.org is developing a direct to consumer service that offers personal assistance with the resources of the U.S. Department of Health and Human Services at a flat fee. Pricing has not been set. The service will be introduced in early 2012.
Advantages: Access to the full range of insurance products, personal service, no sales pressure
Disadvantages: Up-front fee of $40 to $150 for private commercial navigators, currently only available to individuals. Government-paid navigators are not yet available (expected October 2013).
Best suited for: individuals who want personal professional help, are not able to locate a plan through other sources, individuals with significant pre-existing medical conditions, employees of businesses that adopt a cafeteria benefit plan
How we can help you get started: visit www.OnlineNavigator.org to check on the status of navigators in your state. (Neither Freedom Benefits nor OnlineNavigator.org are licensed with any government health insurance exchange as a navigator).
Virtually all mid-sized and large companies use a benefits consultant to help sort through the overload of
benefit plan information. The obstacle for smaller firms is availability and cost. Currently few firms offer services at a price point that is attractive to firms with less than 20 employees. Freedom Benefits and others are working to close this gap.
Advantages: Access to a wide range of insurance choices, insurance can be integrated with other benefits, availability of cafeteria benefit plans, Health Reimbursement Arrangements, greatest probability of reducing costs through wage tax savings
Disadvantages: Up-front fee starts at $1,000, only available to businesses
Best suited for: Small businesses
How we can help you get started: visit www.FreedomBenefits.org for more information on small business employee benefit services.
This web site is independently owned and managed by Tony Novak operating under the trademarks "Freedom Benefits", "OnlineAdviser" and "OnlineNavigator". Opinions expressed are the sole responsibility of the author and do not represent the opinion of any other person, company or entity mentioned. Tony Novak is not an agent, broker, producer or navigator for any federal or state health insurance exchange but may provide uncompensated advice, reviews and referrals to these official resources. Novak is compensated as an accountant, adviser, affiliate consultant, marketer, reviewer, endorser, producer, lead generator or referrer to some of the other commercial companies listed on this site. Information is from sources believed to be reliable but cannot be guaranteed.