In this new and rapidly evolving world of health care reform, does having a health insurance broker make a difference? Absolutely!
Competent, Responsive & Customer Focused
Now, more than ever, selecting the right insurance is a huge challenge. There are many new and highly complex legal questions, tax issues, timing factors and other complications that only the most competent broker can identify, comprehend and explain. In addition, sorting through the vast number of product options and finding the one that best fits your particular needs and budget requires a high degree of skill and expertise. This is why you want an experienced broker, one respected for intelligence, caring, listening ability, responsiveness and unmatched customer service. Debbie Carlton holds a BA from Stanford University and an MBA from Wharton. Prior to founding Carlton Insurance LLC in 2002, Debbie spent 20 years in the high-tech sector, including 12 years in market research, finance and customer service at Apple Computer. You will find she is uniquely qualified to assist you with your family and/or business’ health, life, disability, Medicare and long-term-care insurance needs.
Serving Individuals & Families
In January 2014, INDIVIDUAL health insurance products changed dramatically. The market and many carriers make both major and minor benefit changes each year and there are numerous changes to 2025 plans as well. Benefit changes between 2024 and 2025 are subtle and often difficult to identify but can have a major impact on your budget. For 2025 plans, some carriers made seemingly mild changes to prescription coverage and/or formulary. Others changed the network of providers associated with specific plans and some moved from a PPO to an EPO network model. Still others increased copays, modified coinsurance or out-of-pocket maximum limits, changed the HSA designation of a prior year’s plan, or applied a deductible to certain benefits. When comparing plan options by deductible and price in 2025, many options look the same across all insurance carriers with only a few dollars difference in monthly premiums. And yet, part-way through the year, you can be unpleasantly surprised by the lack of coverage provided by your new plan or the reality that your doctor is no longer in network. At that point in time, it is too late to change plans.
Furthermore, beyond benefit details, if you have questions about whether you'll qualify for a subsidy or even Medicaid, the consequences of over or under-estimating your annual income, options available if you're also a small business owner, and the pros and cons of having an HSA, where will you turn for answers? You'll need the most competent advisor and broker in the market, one with the educational background, work ethic, and reputation for customer service excellence.
Assisting Medicare Eligibles
MEDICARE products are numerous. Do you need a Medicare Advantage Plan or a Medicare Supplement? What are the critical differences and which option is best suited for your unique needs and budget? Which plans will your preferred doctors accept and bill? Do you need prescription coverage? If you choose not to have Rx coverage, what are the consequences and penalties? There are a number of reasons for Medicare eligibles to choose to go without a prescription plan. What is best for you as you make the final decision about your medical insurance coverage for the rest of your life? You'll need the most competent, reliable, ethical and sensitive advisor to assist you with this critical decision.
Serving The Small Group Market
SMALL GROUP products changed dramatically beginning January 1, 2014 and continue to change today. For 2025, a small business is defined as organizations with 1-50 employees based on the calculation of full time equivalents (FTEs). In 2025, some businesses whose employee population exceed 50 will not be required to offer health insurance depending on the number of FTEs. How is the FTE calculation made? Must you offer coverage at all? If you do offer coverage, do you need to offer it to all employees or only certain employees? Can employees still choose to purchase a plan in a state Exchange if you offer a small employer group plan? What are the pros and cons to both employer and employee of offering coverage to dependents? What are the potential tax savings and penalties? If your business is comprised of only two owners or has only one employee, is a small group health insurance plan the best option -- or an option at all?
The questions are numerous and many of the answers are complicated and confusing. Many agents and brokers won't take the time to answer these questions or may make up answers without checking the relevant state and federal laws and considering how each carrier operates within the law. It’s vital to have a broker who knows the questions to ask as well as the perseverance and expertise to find accurate answers. You want the most competent advisor and broker in the market, one with the educational background, work ethic, and reputation for customer service excellence.
What You Won’t Have To Pay
By law, brokers are not allowed to charge fees. Instead, they are compensated by the insurance carriers when you purchase a policy. This means the price you pay will be the same whether you use a broker or not.
If you live or work in Arizona, California, Colorado, Oregon, Texas or Washington, please contact me for information, quotes and guidance on your health, life, disability, and long-term-care insurance needs.
This web site may contain concepts that have legal, accounting and tax implications. It is not intended to provide legal, accounting or tax advice. You may wish to consult a competent attorney, tax advisor, or accountant.
