How to choose the right healthcare plan

By Eugene Starks

Last month, HealthCare.gov's open enrollment period concluded. But consumers may still be able to sign up for coverage. People who have lost employer-sponsored insurance, moved, or experienced other significant life changes may be eligible for a special enrollment period.

Choosing the right health plan can be difficult in the best of times. The coronavirus pandemic has made shopping for health coverage even more challenging.

Health insurance agents and brokers can ease the process of finding the right health plan. Consumers should consider consulting with an agent or broker to ensure they select a plan that provides the coverage they need at the most affordable price.

In 2020, many people shopped for coverage on the exchanges for the first time. More than 20 million people lost their jobs -- and often, their employer-sponsored coverage -- early in the pandemic.

Open enrollment was busier than expected, exceeding previous years. In the first week, nearly 820,000 Americans signed up for coverage -- over 170,000 of which were new consumers. The rate of new daily signups outpaced the previous year's by almost 15 percent.

Signups via special enrollment have skyrocketed because of the COVID-19 pandemic. Between the end of open enrollment in 2019 and May 2020, the number of people who utilized a special enrollment period because they lost their existing coverage increased 52 percent, compared to the same period the previous year. 

A new report from the Centers for Medicare and Medicaid Services offers case studies of who some of those enrollees are.

They're people like Rahul, a 31-year-old flight attendant who lost his employer-sponsored coverage when he lost his job because of the pandemic-fueled decline in air travel. He knows he needs basic coverage until he can find a new job with health insurance -- but may not know where to start.

Or take Ava, the 26-year-old freelance writer who is no longer able to stay on her parent's plan. Because she's never bought her own insurance, she's unsure what the difference is between a deductible and a premium.

Rahul and Ava aren't alone. According to an October 2020 survey, 72 percent of Americans find purchasing or using health insurance confusing.

Agents and brokers are specifically trained to help people make decisions about health insurance. They're licensed by the states in which they practice and required to undergo continuing education.

They also work for their clients, not insurance companies. They advocate on behalf of those clients when billing or claims disputes arise.

Agents and brokers helped about 4 million people sign up for exchange coverage that took effect last year -- about 50 percent of the total.

Further, agents and brokers are more effective at getting people covered than federally funded navigators. According to the CMS report, the average agent or broker enrolled 48 percent more people than the average navigator. And agents and brokers did so at lower cost -- about 9 percent less.

It's no wonder nearly 84 percent of marketplace enrollees who have used an agent or broker found them helpful. Indeed, as the CMS report concludes, "Health insurance agents and brokers put a local, friendly face on the often-stressful process of buying coverage, while also offering deep market and product expertise tough to find elsewhere."

The pandemic has made securing health insurance coverage more important than ever before. Agents and brokers can be crucial aides in that pursuit.

Eugene Starks is a Jackson, Miss.-based insurance agent and President-Elect of the National Association of Health Underwriters.