Description
Sell and service individual and group health insurance plans, including medical, dental, vision, Medicare, and supplemental coverage. Advise clients on plan options, networks, costs, and enrollment; assist with claims and renewals; and work as an independent broker or for an insurance company.
- • Meet with clients to explain plan benefits and networks, review coverage, and process changes such as adding dependents or updating PCP selections.
- • Calculate premiums, subsidies, and employer contributions, and set up billing and payment methods.
- • Customize health coverage to suit individual and employer needs, including medical, dental, vision, and supplemental plans.
- • Sell individual, family, Medicare, and employer group health policies.
- • Interview prospective clients to assess coverage needs, eligibility, budget, and existing insurance.
- • Seek out new clients and build a book of business through networking, referrals, community outreach, and digital channels.
- • Explain deductibles, copays, coinsurance, out-of-pocket limits, and provider networks to promote suitable plans.
- • Coordinate with carriers and underwriters and submit applications, enrollments, and required documentation.
- • Ensure eligibility and documentation are complete, including evidence of insurability, special enrollment proofs, and medical questionnaires when applicable.
- • Assist clients with claims, preauthorizations, and appeals, and liaise with carriers as needed.
- • Maintain client records, manage enrollments and renewals, and process policy changes.
- • Recommend carriers and plan designs that match client needs, formularies, and preferred providers.
- • Monitor claim issues to support fair resolution while following carrier policies and regulations.
- • Develop marketing strategies and campaigns for open enrollment and year-round sales.
- • Attend carrier trainings and industry seminars to stay current on products, ACA and Medicare rules, and enrollment platforms.
- • Verify provider network participation and formulary coverage for client doctors and medications.
- • Set up employer group billing and enrollment procedures and resolve account or system issues.
- • Coordinate integration of health benefits with employer payroll and benefits administration systems.
- • Explain premium billing, contribution, and reconciliation processes to employer clients.
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O*NET occupational data (work activities, skills, knowledge).
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Last reviewed: Jan 2026
