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​HOW TO INSURE INDIVIDUAL HEALTH INSURANCE
National Edition
  • Learn the Coverage.
  • Find the Prospect.
  • Build the Account.
Most people don't wake up one morning thinking:
“Today would be a good day to shop for health insurance.”
Something happens.
  • They leave a job.
  • Lose employer coverage.
  • Become self-employed.
  • Turn 26.
  • Get divorced.
  • Move.
  • Retire before becoming Medicare-eligible.
  • Start a business.
Their COBRA coverage is ending.
THE EVENT CREATES THE INSURANCE

CONVERSATION.
That's why successful individual health-insurance prospecting shouldn't begin with:
  • “Who wants health insurance?”
Start with:
  • “WHOSE COVERAGE IS CHANGING?”

DON'T PROSPECT FOR HEALTH INSURANCE
PROSPECT FOR COVERAGE TRANSITIONS.
  • This may be the most important business-development principle in this entire guide.
  • People usually look for individual health coverage because something in their lives changed.
  • The producer who learns to recognize those changes doesn't have to manufacture urgency.
THE LIFE EVENT ALREADY CREATED IT.

WHAT YOU'LL LEARN
This practical producer guide helps you work through topics such as:
  • Individual health-insurance discovery
  • Coverage transitions
  • Eligibility considerations
  • Enrollment timing
  • Marketplace and non-Marketplace considerations where applicable
  • Premiums
  • Deductibles
  • Copayments
  • Coinsurance
  • Out-of-pocket exposure
  • Provider networks
  • Prescription-drug considerations
  • Employer coverage transitions
  • COBRA considerations
  • Self-employment
  • Family changes
  • Moving and relocation
  • Early retirement
  • Documentation
  • Professional boundaries
  • Cross-selling
  • Prospecting
  • Referral development
  • Educational marketing
The objective isn't simply to compare premiums.
It's to help the client understand:
  • WHAT AM I BUYING—AND WHAT HAPPENS WHEN I NEED TO USE IT?
WHO IS THIS GUIDE FOR?
Especially useful for:
  • Accident & Sickness producers
  • Life & Health producers
  • P&C producers adding health insurance
  • Multi-line agencies
  • New producers
  • Agency owners
  • Producers serving self-employed clients
  • Producers serving small-business owners
  • Producers working with families
  • Agents developing health-insurance niches
  • Producers who need a better prospecting system

PRICE IS ONLY ONE PART OF THE DECISION
Clients naturally ask:
  • “How much is it?”
That's important.
But the lowest premium doesn't automatically mean the best fit.
The producer may also need to help the client understand issues such as:
  • Deductible
  • Copayments
  • Coinsurance
  • Maximum out-of-pocket exposure
  • Provider network
  • Prescription coverage
  • Plan structure
  • Eligibility
  • Effective date
  • Applicable enrollment rules
A plan isn't inexpensive if it doesn't work the way the client expected when care is needed.

START WITH THE CLIENT'S HEALTHCARE WORLD
Ask appropriate questions such as:
  • Who needs coverage?
  • When does current coverage end?
  • Why is it ending?
  • Are there doctors or facilities the client wants to continue using?
  • Are there prescriptions that need to be considered?
  • Is anyone currently receiving ongoing care?
  • What does the client understand about deductibles and out-of-pocket costs?
The producer shouldn't begin by pulling up the cheapest plan.
DISCOVER FIRST.

NETWORKS MATTER
  • A client may focus on premium and overlook the provider network.
  • That can create a painful surprise later.
  • Producers should help clients understand the importance of verifying provider participation using appropriate current resources.
Don't casually promise:
  • “Your doctor takes this plan.”
Verify according to available carrier and plan procedures, and encourage the client to verify when appropriate.
NEVER GUESS ABOUT THE NETWORK.

PRESCRIPTIONS MATTER TOO
A plan may handle prescriptions differently from another.
  • Formularies can change.
  • Tiers matter.
  • Pharmacy networks may matter.
  • Prior authorization may matter.
The producer shouldn't practice medicine or guarantee how a claim will be handled.
But the producer should recognize:
  • “THIS CLIENT USES MEDICATION. WE NEED TO CHECK THE PLAN DETAILS.”

ENROLLMENT TIMING MATTERS
  • Health coverage can involve specific enrollment opportunities and deadlines.
  • Those requirements can change.
  • The producer should use current authoritative guidance, carrier information and applicable rules rather than relying on memory or an old training manual.
This guide teaches the producer to recognize the timing issue.
  • VERIFY CURRENT REQUIREMENTS BEFORE ADVISING THE CLIENT.

COBRA IS A CONVERSATION—NOT AN ASSUMPTION
  • A client leaving employer coverage may have several potential paths depending upon the circumstances.
  • COBRA may be one.
  • Individual coverage may be another.
  • Other coverage options may exist.
The producer shouldn't automatically tell the client:
  • “COBRA is too expensive.”
or:
  • “Individual coverage is better.”
Compare the actual situation.

SELF-EMPLOYMENT CREATES A NATURAL REVIEW
A client leaves employment and starts a business.
  • What disappeared?
  • Possibly:
  • Employer health coverage.
  • Employer life insurance.
  • Employer disability coverage.
  • Other benefits.
One career change can create several insurance conversations.
DON'T LOOK AT THE HEALTH POLICY IN ISOLATION.

NOW LET'S FIND THE PROSPECT
This is where individual health insurance becomes particularly interesting.
Don't ask:
  • “Who needs health insurance?”
Ask:
  • “WHO IS GOING THROUGH A COVERAGE TRANSITION?”

PROSPECTING TRIGGER #1
LEAVING A JOB
  • Someone resigns.
  • Gets laid off.
  • Changes careers.
  • Starts a business.
  • Employer coverage may change or end.
That's a natural time to offer help.

PROSPECTING TRIGGER #2
TURNING 26
  • A young adult may no longer be eligible to remain on a parent's health plan under applicable rules.
  • Parents often know this transition is coming.
  • That makes it prospectable.
Your existing family clients may already contain the opportunity.

PROSPECTING TRIGGER #3
BECOMING SELF-EMPLOYED
  • Contractors.
  • Consultants.
  • Real estate professionals.
  • Independent insurance producers.
  • Freelancers.
  • Small-business owners.
People leaving traditional employment frequently need help understanding what happens to their benefits.

PROSPECTING TRIGGER #4
DIVORCE
  • Divorce can affect health coverage.
  • One spouse may have been covered through the other's employer plan.
The producer needs to handle these situations carefully and avoid giving legal advice.
But the insurance question is obvious:
“WHAT HAPPENS TO YOUR HEALTH COVERAGE?”

PROSPECTING TRIGGER #5
RELOCATION
  • Moving can affect available coverage, provider networks and other plan considerations.
And who often knows when a client moves?
THE P&C AGENT.
The insured calls to change:
  • Homeowners.
  • Renters.
  • Auto garaging.
  • Mailing address.
Don't hear only:
  • “Change the address.”
Hear:
  • “Something important in this client's life just changed.”

PROSPECTING TRIGGER #6
EARLY RETIREMENT
  • The client retires before Medicare eligibility.
  • Now there may be a gap between employer coverage and Medicare.
That's a natural individual health-insurance conversation.
And later, the same client may become a Medicare prospect.
ONE TRANSITION CAN CREATE A LONG-TERM CLIENT RELATIONSHIP.
​PROSPECTING TRIGGER #7
COBRA ENDING
COBRA doesn't last forever.
  • If you know when coverage ends, you know when another insurance conversation may be necessary.
  • Document important dates where appropriate.
  • Follow up before the transition.

YOUR EXISTING BOOK CAN TELL YOU WHO TO CALL
Look for clients who:
  • Changed employers
  • Started businesses
  • Became self-employed
  • Added or removed household members
  • Have children approaching age 26
  • Moved
  • Divorced
  • Retired early
  • Lost group coverage
  • Mentioned COBRA
  • Own very small businesses
Those aren't random names.
THEY'RE PEOPLE WITH A REASON TO TALK.
THE COMMERCIAL BOOK CAN HELP TOO
Suppose a small-business owner tells you:
  • “We're not big enough to offer group health insurance.”
Maybe.
Maybe not.
  • But perhaps the owner personally needs individual coverage.
  • Perhaps employees ask where they can obtain coverage.
  • Perhaps the business eventually becomes a Small Group Health prospect.
The producer should recognize the relationship between:
Individual Health.
  • Small Group Health.
  • Business ownership.
  • Employee benefits.

BUILD RELATIONSHIPS WITH PEOPLE WHO SEE TRANSITIONS FIRST
Potential centers of influence may include:
  • P&C agents
  • Real estate professionals
  • Mortgage professionals
  • Accountants
  • Payroll professionals
  • HR consultants
  • Business consultants
  • Career professionals
  • Small-business organizations
The approach shouldn't be:
  • “Send me health leads.”
Instead:
  • “When one of your clients loses employer coverage or becomes self-employed, I'm happy to help them understand their health-insurance options.”
That's useful.

EDUCATIONAL PROSPECTING
People have questions during coverage transitions.
Answer them.
  • I just lost my job. What happens to my health insurance?
  • I'm turning 26. What are my options?
  • I'm self-employed. How do I get health insurance?
  • Should I keep COBRA or look at individual coverage?
  • I'm retiring before 65. What do I do about health insurance?
  • I'm moving to another state. Does my health insurance change?
Those questions can become:
  • Google Business Profile posts
  • Facebook posts
  • YouTube videos
  • Website articles
  • Email campaigns
  • Short educational videos
  • Client newsletters
MARKET THE TRANSITION—NOT THE PRODUCT.

A 30-DAY INDIVIDUAL HEALTH PROSPECTING PLAN

WEEK 1 — BUILD A TRANSITION LIST
Identify appropriate clients and prospects experiencing or approaching:
  • Job changes.
  • Age 26.
  • Self-employment.
  • Retirement.
  • COBRA expiration.
  • Relocation.
  • Other coverage changes.

WEEK 2 — CONTACT THE FIRST GROUP
Don't say:
  • “Want a health quote?”
Try:
  • “I understand your employer coverage may be changing. Have you already figured out what you're doing next?”
That's a conversation.

WEEK 3 — ANSWER ONE TRANSITION QUESTION
Example:
  • “I'M LEAVING MY JOB. WHAT HAPPENS TO MY HEALTH INSURANCE?”
Publish a useful answer.
Then invite people who need help to contact the agency.

WEEK 4 — FOLLOW UP
Track:
  • Transition date
  • Current coverage
  • Needed effective date
  • Options reviewed
  • Applications
  • Additional insurance needs
  • Future review dates
Then repeat.

ONE HEALTH-INSURANCE CLIENT MAY NEED MUCH MORE
A self-employed prospect calls about health insurance.
During discovery you learn:
  • She recently left a corporate job.
  • She lost employer life insurance.
  • She lost employer disability coverage.
  • She owns a new consulting business.
  • She bought a home last year.
Now there may eventually be conversations involving:
  • Individual Health
  • Life Insurance
  • Disability Income
  • Business Insurance
  • Professional Liability
  • Homeowners
  • Umbrella
The health-insurance inquiry opened the door.
GOOD DISCOVERY BUILDS THE ACCOUNT.

REAL-WORLD PRODUCER THINKING
The guide includes practical situations involving:
  • Job changes
  • Self-employment
  • Turning 26
  • Divorce
  • COBRA
  • Provider networks
  • Prescriptions
  • Moving
  • Early retirement
  • Coverage timing
Work through them using:
  • HEAR →
  • ASK →
  • VERIFY →
  • DOCUMENT →
  • NEXT SAFE ACTION
Because the producer doesn't need to memorize every possible answer.
The producer needs to recognize when something must be verified.

PRACTICAL PRODUCER TOOLS
Use this guide for:
  • Coverage-transition conversations
  • Client discovery
  • Plan-comparison discussions
  • Provider-network awareness
  • Prescription considerations
  • Enrollment-timing awareness
  • Cross-selling
  • Existing-client reviews
  • Prospecting
  • Referral development
  • Educational marketing
  • Producer training
  • Scenario exercises

WHAT COULD ONE COVERAGE TRANSITION BE WORTH?
The guide costs: $25.
  • One client could repay it.
  • One family could repay it.
  • One self-employed client may become a commercial account.
  • One early retiree may later become a Medicare client.
  • One satisfied client may refer another person facing the same transition.
And you keep the guide.
$25 — BUY IT ONCE. USE IT FROM NOW ON.
CLICK HERE TO BUY — ONLY $25

NEED MORE COVERAGE TRANSITIONS TO FIND YOU?This is where educational marketing can become particularly powerful.
People often search for help after something changes.
They don't necessarily search:
  • “Best insurance salesperson near me.”
They search questions such as:
  • “What happens to my insurance when I leave my job?”
  • “Health insurance when self-employed.”
  • “Insurance after turning 26.”
That's an opportunity for your agency to be the one providing the answer.
FYI Express+ can help agencies create useful educational content and local visibility around those questions.
  • BE FOUND.
  • BE HELPFUL.
  • BE REMEMBERED.

ASK EDDIE ABOUT PROSPECTING & FYI LOCAL VISIBILITY

RELATED HOW TO INSURE GUIDES

SMALL GROUP HEALTH INSURANCE
  • When the individual prospect becomes an employer, another opportunity may develop.
VIEW GUIDE

DISABILITY INCOME
  • Health insurance helps address medical expenses. Disability income addresses another problem—the paycheck that may stop during illness or injury.
FREE SAMPLE
DOWNLOAD FREE GUIDE

MEDICARE-ELIGIBLE CLIENTS
  • Help clients navigate the next major healthcare transition as Medicare eligibility approaches.
VIEW GUIDE

BUSINESS OWNERS WITH LIFE INSURANCE
  • Self-employment and business ownership can create protection needs far beyond health insurance.
VIEW GUIDE

HOW TO INSURE INDIVIDUAL HEALTH INSURANCE
  • Recognize the Change.
  • Understand the Options.
  • Help the Client Move Forward.
ONLY $25
Buy It Once. Use It From Now On.
CLICK HERE TO BUY

FYI EXPRESS+
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Learn the Coverage. Find the Prospect. Build the Account.