Health Insurance 101
The Health Insurance Santa Claus Explains All:
Your service is completely free. Health insurance brokers like us are paid commission by the insurance companies, not by you. The price of your health insurance plan is the same whether you buy directly from the carrier or through a broker. The difference is that you get expert comparison shopping, personalized recommendations, and ongoing support—all at no extra cost.
A health insurance broker works with multiple insurance companies and shops on your behalf to find the best plan for your needs. An insurance agent typically represents just one insurance company and sells only that company's products. As independent brokers, Thomas and Angela represent over 150 carriers, which means we have far more options to find you the right coverage.
Self-employed individuals generally shop for their own coverage rather than receiving employer-sponsored insurance. The cost depends on factors such as age, location, household size, income, and plan selection. Depending on household income and circumstances, you may qualify for financial assistance that lowers your Marketplace premium.
Absolutely. Losing job-based health insurance, getting married, having a baby, turning 65, or starting a business all qualify as life events that give you special enrollment periods outside of Open Enrollment. We help you understand your options and enroll in new coverage right away, so you're never without protection.
Yes. We're local Medicare experts who represent every Medicare Advantage and Supplement plan available in your state. Whether you're new to Medicare or want to make changes at your Annual Enrollment Period, we compare plans, explain your options, and handle the enrollment process so you can avoid calling multiple carriers.
The cost of health insurance depends on several factors, including your age, location, household size, income, tobacco use, and the type of plan you choose. If you qualify for financial assistance through the Marketplace, your monthly premium may be significantly reduced. A licensed insurance professional can help you compare available plans and determine which options fit your budget.
Yes. We design custom group health insurance plans for businesses of any size—from solo owners to teams of 50+. We help you choose coverage that attracts great employees, fits your budget, and works with our online tools to simplify benefits administration. We also handle ongoing support for plan changes and renewals.
We're here for you year-round. Whether you have questions about claims, want to change plans, need to add or remove coverage, or are ready to explore better options at renewal, just reach out. Good brokers don't disappear after enrollment—we stay your partner.
HMO and PPO plans differ primarily in how you access doctors and specialists. HMO plans generally use a defined provider network and may require you to select a primary care provider or obtain referrals for certain specialists. PPO plans typically offer more flexibility to see providers outside the network, although out-of-network care generally costs more. The exact rules vary by plan.
Start by considering your expected medical needs, doctors and hospitals you want to use, prescription medications, monthly budget, deductible, copays, coinsurance, and out-of-pocket maximum. You should also verify that your preferred providers and medications are covered by the plan. The best plan is usually the one that provides the right balance of coverage, cost, and access for your situation.
Before enrolling, consider asking:
- What is the monthly premium?
- What is the deductible?
- What are the copays and coinsurance?
- What is the annual out-of-pocket maximum?
- Are my doctors and hospitals in-network?
- Are my prescriptions covered?
- What services are excluded?
- Does the plan require referrals?
- Do I qualify for financial assistance?
- When does my coverage begin?
Consider more than the company's name. Look at the plans available in your area, provider network, prescription coverage, premiums, deductibles, out-of-pocket maximums, customer service, and the overall benefits offered by each plan. A carrier that works well for one person may not be the best fit for another.
Compare plans using the same categories: monthly premium, deductible, copays, coinsurance, out-of-pocket maximum, provider network, prescription coverage, and covered services. Also consider how much you expect to use your coverage. Looking at the total potential cost—not just the monthly premium—can make comparisons much easier.
