One thing we learned from the 2019 open enrollment period is that the government’s outreach efforts are coming up short. Marketplace enrollment was down this year, and that corresponds with a huge 90 percent reduction in the marketing budget for Healthcare.gov.

For agents, that’s actually a good thing. If it were as simple as taking orders, the government and the insurance companies wouldn’t need us. In our current system, though, many people will go without coverage unless an agent shows them their options and explains the importance of having health insurance.

The problem, of course, is finding people who are willing to listen. Individual health plans have been guaranteed issue since 2014, and premium tax credits have been available to those who qualify for the past five years. Perhaps we’re at a point where nearly everyone who wants health insurance has already signed up.

So, as an agent who specializes in individual health plans, how can you locate prospects who need health insurance and actually want to learn about their options, especially outside the open enrollment period? One suggestion is to market to employers.

Group Agents Sell Group Products

This may sound like an obvious statement, but a lot of brokers who market to group clients sell group health insurance and ancillary products. They don’t sell individual coverage or Medicare-related products, and this presents an opportunity for agents who do.

To the extent that individual or Medicare solutions are needed in a group setting, you can be the one to provide those solutions.

Be a Problem Solver

Employers offer health insurance to attract and retain quality employees, but the group health plan may not work for everyone. In a group setting, there are a lot of people who need other solutions. You could approach employers and tell them that you’re a problem solver, that you work with companies to find solutions for those individuals who often fall through the cracks. When you do, you can explain that you’re not there to make a bid on their group plan—if they’re happy with their agent, that’s fine. But you can also explain that many group health agents specialize in employer-based solutions and that the service you provide can complement what their current agent is offering by helping the “outliers” for whom the group health plan is not the best solution.

Here are three areas where you have an opportunity to be of assistance to employers and pick up some new clients in the process:

Help those transitioning to COBRA: Typically, when an employee terms their employment, the employer provides them with a COBRA Election Notice (or similar notice for those who qualify for State Continuation) which explains their right to continue the group health plan and pay 100 percent of the premium for a period-of-time. Prior to starting the health plan, these same employees should have received a HIPAA Special Enrollment Notice explaining their right to join a spouse’s health plan if they ever lose their group health coverage as well as a Notice of Coverage Options explaining their right to special enroll in the individual market. With all of these notices, it’s no wonder that people are confused about their options.

You could offer to reach out to employees whenever they lose their group health coverage, either because of termination of employment or a reduction in work hours, and walk through their options with them. For some people, COBRA may be the best option. For others, individual coverage might be a better solution, especially if the reduction in income will help them qualify for a premium tax credit. Still others will do better with a short-term health plan to cover the gap until they start another job that offers health insurance.

Why would an employer want to help their former employees find health insurance? The answer is that not all will. But if the employee was valuable to the company and left on good terms, some business owners would be happy to help make sure they’re covered. Also, some employers find COBRA administration to be a hassle, so it actually helps them if their former employees find other solutions.

Help the Kids: Another service you can provide is assistance with health coverage for the children of the company’s employees. Some of these children might qualify for the Children’s Health Insurance Program (CHIP), an option for children in low-income families. CHIP is a more affordable option and provides great coverage, but a lot of employees are unaware that their children might qualify. While you won’t be compensated for helping children enroll in CHIP, it’s a great way to use your expertise to do some good, and it will build goodwill with the employer.

You can also help young adults get individual health coverage when they turn age 26 and age off their group plan. While many of these young adults might not initially understand the importance of having health insurance, their parents who have been paying for their health insurance for years certainly do, so you might want to involve them in the process. They will appreciate your assistance.

Help those eligible for Medicare: Last but not least, you can help employers by educating their Medicare-eligible employees about their options. Many people working past age 65 remain on the group health plan simply because the employer pays a portion of the premium, not realizing that they might actually get better coverage at a lower cost by dropping off the group plan and signing up for Medicare plus a supplement or enrolling in a Medicare Advantage plan. Simply educating these employees so they can make an informed decision would be a huge benefit to the employer, who will save some money if some of their employees choose to move to Medicare.

If the company has fewer than 20 employees, the employer might actually be able to reimburse employees for the cost of Medicare Part B and a Medicare supplement by setting up a Medicare Premium Reimbursement Arrangement. This can have a big impact on the company’s health insurance premiums as a single older employee on a small group plan can increase the average age significantly.

Closing Thoughts

With the individual mandate penalty disappearing in 2019, it’s going to become more and more difficult for brokers to find individuals who want and can afford to purchase health insurance. In order to maintain a healthy stream of leads, brokers need to get creative in their prospecting efforts, and approaching employers whose employees understand the need for health insurance is a great way to do that. In the process, you’ll likely sell some ancillary products and pick up some AORs for the group plan. If you decide to give this strategy a try, please let us know how it works out—and let us know how we can help you be successful.