I'm self-employed. Is it better for me to buy health insurance through a broker, or through the exchange?
You can have the best of both worlds – a broker can help you enroll through the exchange, giving you personalized help and recommendations, but also allowing you to get any Obamacare subsidies for which you’re eligible.
As of November 2023, for enrollment in 2024 coverage, there are 32 states where HHS is running the exchange enrollment process. If you’re in one of those states, you can use the “find local help” link on HealthCare.gov. The default results will include enrollment assisters (navigators and certified application counselors) as well as agents and brokers, although you can narrow the search by eliminating either category.
(All of these types of assisters can help you understand terminology, compare available plans, and complete the enrollment process. But only agents and brokers can make policy recommendations, as they are licensed by the state in addition to being certified by the exchange.)
If you’re in a state that is running its own exchange, you’ll find a similar link on your state’s exchange page, where you can see a list of brokers who are licensed by the state and certified by the exchange, as well as navigators or enrollment counselors.
It does not cost you anything to use a broker,* and most brokers who are certified by the exchange are also able to help you compare ACA-compliant off-exchange plans with the options available through the exchange. If your income is too high for subsidies, a broker who can help you shop on and off-exchange will be an excellent resource.
This is especially true now that the cost of cost-sharing reductions is being added to premiums in most states, by typically only to silver plan premiums, and often only on-exchange – ask your broker about this if you don’t qualify for premium subsidies. If you do qualify for subsidies, a broker can compare the exchange plans in your area and help you determine which one will be the best for your needs
After you purchase a plan, the broker will continue to be your go-to resource when you have questions about your policy, network, or claims – and in almost all cases, there’s never a charge for these services.
* Some states, including Louisiana, Texas, and Colorado, have laws or regulations that allow brokers to charge fees, in some cases only if they aren’t getting commissions from insurers (some insurers have opted not to pay commissions in the individual market, although this is much less common than it was a few years ago). But it’s still very rare for individual market brokers to charge fees, and if they do, the fees must be fully disclosed to the client. When brokers are paid commissions, the payment comes from the insurance company, and the enrollee pays the same price for coverage regardless of whether they receive help from a broker or not.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.