Major Medical

What is Major Medical Insurance?

Major medical insurance is a form of health care coverage that provides benefits for most types of medical expenses that may be incurred. Offering more complete coverage with fewer gaps, major medical insurance covers a much broader range of medical expenses – including those incurred both in and out of the hospital – with generally higher individual benefits and policy maximum limits.

Role of Agents and Brokers in the Federally Facilitated Marketplace (FFM)

Where permitted under state law and after fulfilling the FFM registration requirements, agents and brokers are able to assist consumers in completing eligibility applications, and in comparing and enrolling in QHPs through the FFM.

During plan year 2015 open enrollment, agents and brokers in the individual market are able to assist FFM consumers in two ways: (a) via the direct enrollment pathway (also known as issuer based enrollment), through which an agent or broker uses a QHP issuer’s or web-broker’s website to assist the consumer; and (b) via the Marketplace pathway, through which an agent or broker assists the consumer using the HealthCare.gov website. As explained in more detail below, both pathways transmit an agent’s or broker’s identifying information to the appropriate QHP issuer to facilitate the QHP issuer’s payment to the agent or broker for each enrollment transaction. Either pathway allows an agent or broker to assist qualified individuals with annual enrollment.

Like it or not, ACA plans are here to stay. The age group of 55+ to when someone ages into Medicare has both the highest premiums and most capital. If you want to create a pipeline for future Medicare sales and want to grow your business then we recommend servicing this market.