Affordable Care Act

As Obamacare Deadline Looms, Texas Insurance Brokers Tout Their Expertise

Insurance agents and brokers are marketing themselves aggressively to the uninsured

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Updated at 11:58 a.m. on Jan. 22, 2015. 

Bart Franco
Bart Franco, 65, prays in a nondenominational church he created in his backyard garage, north of downtown Houston. After difficulties shopping on his own last year, Franco used a licensed broker to buy health insurance for his family in 2015.

This year the deadline to sign up for health insurance through the Affordable Care Act is February 15. This second season of enrollment is shorter than last year’s, when customers had six months to shop and compare insurance plans.

Insurance brokers are taken a more proactive stance during this second round by marketing themselves to uninsured people who need free help picking the right coverage plan. It’s a big change, because brokers have had an uneasy relationship with the health law from the beginning.

Bart Franco, 65, is a Houstonian who didn’t use a broker during his first attempts at purchasing coverage.

He’s retired, and also has Medicare. But he needed insurance for his wife and son.

When he tried to enroll them in an Affordable Care Act plan last year, he got nowhere.

“First, I called the 1-800 number and I was on hold for 40 minutes and just hung up, gave up. I’m not going to put up with that,” he recalled.

Franco missed the 2014 deadline to get a plan on the federal marketplace exchange. He later called Blue Cross Blue Shield directly, and succeeded in purchasing a short-term catastrophic plan for his family. But he felt the process was rushed.

“They just give you an insurance and (say that) it costs this much, and you only pay $146 (a month) that sounds good, doesn’t it? Okay, fine. And you’re hooked, and you don’t even know what you have.”

Franco didn’t like the plan’s high deductible, which was more than he made in a year.

So this year, when enrollment began again for 2015 plans, he used a licensed insurance broker that had advertised in the local paper.

“She connected us on the computer, she showed us everything, showed us a deduction, why we didn’t want this and why we didn’t want that. So she explained everything,” Franco said.  

Franco’s experience last year was common, said his broker, Jo Middleton. People struggled to pick plans on their own, using the website. Many learned later they couldn’t afford the deductible. Others discovered that a favorite doctor or hospital wasn’t accepting a particular plan.

Middleton is also president of the Houston Association of Health Underwriters.

“Buying an insurance policy is not like going online and buying a vacation,” Middleton said. “It’s much more complicated, there are a lot more nuances.”

Jo Middleton
Jo Middleton is co-owner of TradeMark Insurance Agency and president of the Houston Association of Health Underwriters.

Shoppers can connect with navigators or counselors for assistance, but Middleton said those government-paid workers have just a fraction of the training and expertise that insurance brokers have.

“They can read — just like everybody else can — what’s on the screen. And they can tell you ‘Well, this plan has a co-pay or that plan doesn’t have a co-pay.’ But they don’t know the nitty-gritty about what goes on within the plan,” Middleton said.

“They couldn’t tell you that Walgreens is perhaps not a pharmacy that’s contracted with that specific carrier. They can’t tell you that MD Anderson isn’t contracted with that specific carrier. Those are the things that an agent or broker brings to the table.”

Last year, Houston brokers worked on their own to help consumers. But now they’re uniting to assert their expertise and market themselves. Middleton has organized two enrollment events featuring brokers from the Houston Association of Health Underwriters.

Brokers across Texas are trying multiple strategies: holding events with hospitals and community groups, putting up fliers and even buying TV ads.

Middleton said brokers have to become more visible, because the Affordable Care Act was written in a way that sidelined brokers and what they could offer.

“There has been a deep-rooted thought process that agents and brokers are superfluous. That we are not necessary, that we are an added expense,” she said.

Brokers do get paid a commission every time they sell an individual policy. That’s in contrast to navigators or certified application counselors, who are typically short-term workers who earn a salary from nonprofits or federal grants.

The assistance is free for the customer, either way. But Middleton dislikes that much of the marketing from the Department of Health and Human Services focuses on the navigators, the toll-free 800 number, and the federal website.

“I think the message about having a licensed professional to help you has somehow gotten lost in the mists out there, and you don’t ever hear about that.”

Enrollment Events for Saturday, Jan. 24

Project INSURE Houston (Houston Association of Health Underwriters): Licensed brokers will be enrolling people 10 a.m. – 4 p.m. at Community Health Choice, 2636 South Loop West, Suite 900.

Healthcare Enrollment Forum (Congressman Gene Green): 9 a.m.– 1 p.m. at M.O. Campbell Educational Center: 1865 Aldine Bender Road

Rock Enroll Houston (enrollment event for young adults featuring DJs and bands) 11 a.m. – 4 p.m. at Discovery Green, 1500 McKinney Street.

That’s not the only problem brokers and agents have with the law.

The law puts a cap on insurance companies’ profits, and some companies have dealt with that by cutting the agents’ commissions.

Marcy Buckner is with the National Association of Health Underwriters in D.C.

“This has just kind of devastated the agent community, and has been in place for several years,” Buckner said.

The Association is backing a bill in the new Congress that would help insurance agents and brokers with those reduced commissions.

The bill would also tweak the Affordable Care Act in other ways that could help brokers cope with the massive changes forced on them by the law, Buckner said.

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