When Your Client Loses Their Job And Their Health Insurance

By Ray Farmer

Health coverage is always important, but it is crucial during a global health crisis. Millions of Americans are facing the loss of health insurance as the global health crisis shuts down businesses and jobless numbers reach peaks not seen since the Great Depression.

According to the U.S. Department of Labor, at least 30 million people are currently unemployed. Since the majority of people obtain health insurance through their employers, millions of people are now looking for new sources of coverage.

During times of crisis, many consumers turn to agents and advisors as trusted sources for advice and guidance. When it comes to health insurance, comparing coverage options and understanding what is and isn’t covered can be complicated. New regulations have impacted submission deadlines and there is differentiation at the state level.

For example, some states have instituted a Special Enrollment Period allowing anyone to apply for Affordable Care Act coverage, while others limit a SEP to those who are recently unemployed.

With the pandemic continuing to spread, it seems likely that more people will be furloughed or laid off and in need of new health coverage. As agents and advisors, here are three ways to help your clients navigate their options during this trying time.

Don’t Assume Clients Know The Basics

Although you are well-versed in the nuances of health plans and coverage, most ordinary Americans are not as informed. Many are still confused by basic terms such as deductible and copay. Important information such as enrollment deadlines and the elements of COBRA might also be new to your clients.

Take time to review the specifics for each option and break them down into easy-to-understand explanations. Make sure your clients understand what documentation is required for enrollment. If they are considering a short-term plan to bridge the gap between jobs, review the fact that it may not cover pre-existing conditions, or COVID-19 testing and treatment.

Also check that they understand that a short-term carrier can terminate coverage at any time and that this is not considered to be a qualifying event to enroll in ACA coverage.

Stay Up To Date With Legislative Developments

Changes are happening quickly. Agents and advisors need to understand federal and state legislation that can impact a client’s enrollment process and coverage options. For example, clients may have questions about how stimulus checks and unemployment benefits should be factored into income when applying for Medicare or ACA coverage.

Until the pandemic ends, it is likely that more rules and legislation will be passed to try to ease the burden that this pandemic has caused to many people. Congress is currently trying to work out another stimulus bill that is expected to have direct payment to citizens and more unemployment benefits.

Also, pay attention to how legislation is impacting service coverage. Many plans have made adjustments to what they will or will not cover as a result of the pandemic. For example, Medicare used to only cover telemedicine if the patient was in a remote location or for short, very specific visits, but now all enrollees can use this option. Making sure clients know what services are covered will help them choose the plan that is right for them.

Keep An Eye On The Long-Term

Finally, don’t make the mistake of thinking about this coverage only as an interim solution until your client finds their next job. Instead, recognize the opportunity to really understand your client’s needs so that you can assist further when the time comes.

Your client may have closed a small business but will be looking to start another one when the market changes. Or your client may find a new job that does not have adequate benefits and may need to continue buying health coverage in the future. Building a strong relationship now could provide important opportunities in the future.

Foster these relationships by going beyond their initial questions about health care options. Talk with clients about any coverage concerns they might have. Once they have coverage, provide additional services and resources to help them navigate their plans.

A pandemic is not the time to be without health insurance. Health insurance advisors and agents are being called on to help millions of people find plans that work for their current situations. If agents and advisors take the time to stay informed, address their client’s concerns and ensure they adequately explain the pros and cons of different options, these initial relationships can turn into long-term business opportunities down the road.

Ray Farmer is the president of the National Association of Insurance Commissioners and director of South Carolina Department of Insurance. He has more than 50 years of insurance industry experience. Ray may be contacted at [email protected].