5 reasons to see a broker for your health insurance

Using their professional knowledge, good insurance brokers can give you valuable views of what goes on backstage – the good and the bad that insurance companies won’t tell you, and key information that you won’t find on the internet.

Here are the top 5 reasons why using an insurance broker will likely to land you a better deal than shopping alone, and tips on how to ask the right questions like a pro.

1. Insider info on reimbursement methods, tools and delays

As an insured person, the thing that concerns you most should be reimbursement. Many health insurers will promise expedited reimbursement, but some will fail to uphold that promise.

Sometimes, this is related not to the health insurer itself, but linked to the type of insurance product that you’re buying: collective and individual contracts do not share the same claims fund for example, and will have an impact on the reimbursement delays. Other times, this is related to the capacity of the insurance company’s administrative team. In rare cases, the insurance company may have exhausted its claims funds and no longer has the means to cover your medical fees.

So how would you know if you would be properly reimbursed?

The middle man would know. One of the first questions that you should be asking your insurance broker is how reimbursements will be made, and what the usual delay is.

2. Insurance card recognition

While most insurance companies will boast an inexhaustibly long list of hospitals and doctors under its belt, many of these collaborations only exist on paper. Brokers are known to receive complaints from patients who are forced to front an exorbitant amount of cash before they are released from care, because their insurance card was rejected by the medical provider – sometimes due to the insurer’s bad reputation for cash settlement.

To avoid being caught in a nasty surprise, you can ask your broker about the reputation of a potential health insurer. Here are some useful questions that you can ask:

  • Where does the insurance company use a Third Party Administrator?*

  • Are there regions where the company’s insurance card is not easily recognized?

  • How is direct settlement arranged with this insurance company?

*A Third Party Administrator (TPA) is an agency that manages claims and provides its own medical network to the health insurer to facilitate fund transfers into hospitals.

3. Know the insurer’s premiums stability

Recently, websites that compare affordable insurance premiums have become increasingly popular. The prospect of saving thousands of dollars is an extremely attractive concept to users. But as with all things, when you find an insurance premium that is too cheap to be true, it probably is.

Sometimes an insurance company will lower its premiums significantly to boost its portfolio, says Taoufik Saber, founder of Youna IHS.

When an insurance company deliberately lowers its premiums to attract more contracts, Mr. Saber points out, the insured members will find themselves facing an exaggerated premiums increase over the next year, and will be nearly impossible to negotiate.

“I have seen a 30% increase on a collective contract,” he says, taking the example of an international insurer that he’s worked with for a group of 5,000 insured members, who simply opted for the lowest premiums on the market without further questioning.

A price comparison website is extremely useful in finding the cheapest deal out there, but only a broker will be able to tell you about the stability of the insurer’s premiums. A stabilized premium over the years shows an effective cost containment strategy from the health insurer. It would mean that the insurer will be able to deliver a trustworthy service, respect the promised reimbursement delays and allow you to be easily admitted to a hospital when you need it most.

So whether you are an individual or a human resources officer looking for a collective health insurance plan, always ask your insurance broker about the premiums history of health insurers before you make a choice.

4. Same price for the extra service and insider information

When buying a health insurance plan, you should pay exactly the same insurance premiums anywhere, whether it is signed through a broker or directly from the insurance company.

So what’s in it for the brokers?

The commissions that pay for the broker’s time with you are borne by the health insurer, with whom the broker has signed agreements.

The difference between selling their insurance contracts through a broker or directly to you is that the insurance company saves on commission fee if you didn’t sign it through a broker; whereas for the same price, a broker will be glad to share all the information that your insurance company is reluctant to tell you.

5. Brokers are interested in your satisfaction

Insurance brokers will give impartial and objective opinions about health insurers, because they should hold exactly the same commission agreements with every insurance company. No matter which company you choose to go with, the broker earns the same commission.

This means that insurance brokers are genuinely interested in making you happy with your purchase, and negotiate in your interest with the health insurer, should something go awry.

So bottom line is…

Next time you are shopping for a truly affordable insurance premiums, don’t be shy to knock on an insurance broker’s door. Their job is to give you the detailed background story and make sure that you’re satisfied with your coverage.
— Kailing Huang