Part of your responsibility in serving the needs of your clients is helping them understand their options. You want to ensure they are realistic when evaluating their plan choices. And, of course, you want to help them successfully navigate claims issues.
Many employers and employees don’t fully understand their health insurance. KFF found in 2025 that half of insured adults said they had some difficulty understanding their coverage.
- The most misunderstood aspects of health insurance relate to deductibles and out-of-pocket maximums. Many do not understand the distinction between the two.
- In-network vs. out-of-network is another challenge for many.
- Copayments and coinsurance are problematic.
- Preventive care vs. diagnostic care is often misunderstood, too.
How Brokers Can Help Clients Understand Their Health Insurance
Whether it’s employer clients or enrolling employees asking questions, you need to be prepared with responses. Or if you don’t know the answer, you need to be able to commit to finding the answer and responding within an agreed-to period of time.
Developing a Communication Kit can provide valuable guidance to frequently asked questions. Many of Word & Brown’s carrier, health plan, and administrator partners offer collateral to help you. You can find these materials in our online Insurance Forms Library. Items also available are FAQs, administrative guides, underwriting guidelines, and employer guides. Of course, you will find apps and forms in the Library, too.
Links to assembled enrollment kits and SBCs are accessible through our Carrier Portfolio. Provider and Rx Search info, too. Carrier commissions, contact emails, and phone numbers available, too. The California Carrier Portfolio includes information on more than 40 of our partners. For Nevada, we feature links to 30 carriers’ information.
And, of course, HeyHealthInsurance.com offers definitions for dozens of terms for anyone not sure of “what’s what” when it comes to health care and insurance.
Regulating agencies in California and Nevada also offer information to assist residents. The California Department of Insurance site includes Health Insurance Basics and other guidance. Informational guides are available, too.
The Nevada Division of Insurance guide, How to Buy Health Insurance, is targeted to individuals and families. The state also offers access to the NAIC pdf, A Consumer’s Guide to Buying Your Own Health Insurance.
How Word & Brown Helps When You Need It
If you get questions about topics you are unsure how to answer, reach out to your W&B representative. We have been working with brokers for more than 40 years, and we’re known for our Service of Unequalled Excellence. We have the insurance industry knowledge and contacts to help you deliver answers to employers and their employees.
If you’re not working with us yet, register online to get started or call 800-869-6989.
