A Typical Conversation Post-Open Enrollment
The conversation remains the same. A potential client will call in, and one of the agents at American Exchanges answers the phone. The prospective client initiates the conversation:
Prospective Client: “Um, I’m calling about health insurance.”
The agent, with his breadth of knowledge of the health insurance business, does not hesitate, and he replies:
Agent: “Happy to help. May I please take down some information in order to assist you better?”
From there, the agent walks the client through the entire process explaining terms such as deductibles, out-of-pocket maximums, and monthly premiums. In addition, the agent discusses the benefits of the health plan including the doctors, the hospitals, and the prescriptions that the plan covers.
The conversation spans anywhere from ten minutes to an hour, and the conversation ends in one of two ways. The prospective client will decide to purchase a health plan, or he will decide that he needs more time to digest the information. Yes, the conversation remains the same, but the rules have changed.
January the 31st marked the end of Open Enrollment. The former is the name of the season where any consumer can purchase a health plan through the State Exchanges as well as the healthcare.gov portal. The season lasts from November to the end of January, and any person living in the United States has the opportunity to inquire about purchasing health insurance. The season is over now, so the conversation has a different twist.
Only those with qualifying life events are eligible to enroll in coverage.
Prospective Client: “Yea. I’m calling about health insurance. Obamacare health insurance.”
Agent: “Yes sir, we’d be happy to help you. Now, I want you to know that Open Enrollment is over, and you must have experienced certain circumstances in your life to enroll in coverage.”
From here, the agent will ask several questions concerning different qualifying life events that allow for a Special Enrollment Period. Has the prospect moved to a new state? Did the prospect have a baby in the past 60 days? Did the caller lose health insurance coverage for any reason? The agent can move forward with the sale of a health insurance policy once he hears a “yes” to any of these questions.
In conclusion, the agents at American Exchange are holding the same conversation daily. The whole purpose of the conversation is to match potential clients to the health insurance policy that best suits their needs and budget. We are, however, limited in our ability to help the consumer because enrollment in a health plan requires a qualifying life event. Nevertheless, it is a wise practice to call and inquire about your eligibility to enroll in health coverage outside of Open Enrollment. An agent at American Exchange can evaluate your life events to see if you qualify for a Special Enrollment Period.
Philip Strang is an enrollment specialist at American Exchange, and is a Marketplace Certified Agent/Broker. To contact him with any questions or comments you can email him at firstname.lastname@example.org or call at 1-888-995-1674