However you got here, there's a good chance you're overpaying for worse coverage.
Four separate markets, priced on different things, and nobody whose job is explaining the difference. Give me twenty minutes and I'll show you all four, including the ones I don't get paid for.
FREE · NO OBLIGATION · YOU TALK TO ME, NOT A CALL CENTER
01 · The part nobody explains
Four markets. Priced on completely different things.
Most bad decisions come from comparing a plan in one market against a plan in another. The cheaper number rarely wins.
Priced on health
Private, medically underwritten
You answer health questions. Clear them and you're priced on your own risk rather than the pool's, which is why a healthy 38-year-old can pay noticeably less here than on the exchange, for a broader network.
They also arrive as a package rather than one medical policy: accident and critical illness cover, telehealth, dental and vision alongside the major medical.
- Wins when
- You're reasonably healthy, you earn too much for a decent subsidy, and you want your doctors in network.
- The catch
- A serious or active condition can be rated, excluded or declined. Read what's carved out before you sign. I'll read it with you.
- What I check first
- What's excluded, in writing, before you go anywhere near an application. An exclusion sitting on the exact condition you were covering for is the worst outcome in this business.
Priced on income
ACA Marketplace
Guaranteed issue. Nobody can turn you down or charge you more for being sick. What you pay depends on your household income, and the subsidy can be large enough that nothing else comes close.
Health history changes nothing here: not the price, not the acceptance, not what's covered from day one.
- Wins when
- Your income lands in the subsidy band, or you have a condition that makes underwriting a non-starter. Sometimes the honest answer is "stay here", and I'll say so.
- The catch
- Networks are often narrow, and estimating your own income wrong means paying part of the subsidy back at tax time.
- What I check first
- Whether your doctors and prescriptions are in the network of the PLAN, not of the carrier. Those are different lists. And whether the income you're estimating is the income you'll really earn.
Priced by your employer
Group, COBRA, spousal
If someone else is paying most of your premium, that is very hard to beat and I'll tell you to stay. Where it gets interesting is COBRA after a job ends, or a spouse's plan where the family add-on is brutal.
An employer that contributes generously for you is under no obligation to contribute a dollar for your family, and that is usually where it falls apart.
- Wins when
- Your employer covers a real share of the premium, and especially where they contribute toward dependents.
- The catch
- COBRA means paying the full unsubsidized cost. Losing coverage opens a special enrollment window, and that window closes.
- What I check first
- What the employer pays toward dependents, not what it pays toward you. That one number decides whether a family stays on one plan or splits across two.
Set by age and income
Government programs: Medicare and Medicaid
Both became law in 1965, for the two groups a priced market serves worst. Medicare covers people 65 and older, and some younger people with a long-term disability. Medicaid covers households with low income and is run by each state, so the rules change at the state line.
They sit on this map because they change the other three: qualify for either and Marketplace subsidies generally stop. In a state that never expanded Medicaid, an adult can earn too little for a subsidy and still not qualify.
Where I fit. Medicaid I don't write or help with. Medicare I do, through open partnerships, for families and individuals.
- Wins when
- Someone in the house is turning 65, is on disability, or earns little enough to qualify. Then it's usually where the conversation starts.
- The catch
- Miss Medicare's first window and a Part B penalty can follow you for as long as you have it. Original Medicare also has no yearly ceiling, and a supplement bought after its window can be underwritten in most states.
- What I check first
- Whether anyone in the house qualifies now, or soon. A spouse turning 65 next year, or kids who qualify for Medicaid or CHIP when their parents don't, changes the whole sheet.
Who calls me most
Four situations, over and over.
If one of these is close to yours, it's worth twenty minutes.
Self-employed & 1099
No HR department, no group plan, and a premium that came out of nowhere in January.
Families
One family plan that costs more than covering the spouse and kids separately.
Between jobs
COBRA quotes that make your eyes water, and a special enrollment window already counting down.
Small business owners
Two to twenty people, no benefits budget, and good staff you'd rather not lose over it.
The first step, for all four
Know where you stand before anybody sells you anything.
- 01A bad year's cost
- 02The golden term
- 03Which doctors you keep
- 04Why a person
Four considerations.
03 · Where each network pays
Licensed in 31 states. Coverage that works in all 50.
I'm in Tampa. The call works from anywhere on the map.
Tap it on the map, or choose it from the list. Mine, you get a yes. Not mine, the next best thing.
Illustration only · not a real plan's network
Based in Tampa, Florida · licensed in 31 states, nationwide
HMO. The network is local, usually one metro or one state, so the map zooms in on Florida, and the green circles are the only places routine care is paid for. Everything hatched is not covered, Florida between the circles included: outside the network you have emergency coverage and nothing else. It is the cheapest of the four, and this map is why.
EPO. The green circles here are a Southeast network, and everything between them is hatched instead of blue: a doctor who is not in the network is not covered, outside an emergency, wherever you are. Some EPO networks are national, and then the circles run coast to coast, but the rule does not change with the size of the network. Nationwide in network is not nationwide out of network. There is no out of network.
POS. The same Florida circles as an HMO, with a door out of them: everything outside the circles is blue, not hatched, because care outside the network is paid at the out-of-network rate instead of refused. Your primary doctor still refers you to a specialist, same as an HMO.
PPO, the gold standard of health care. This one is a national network. Every green circle is a city where the plan has doctors and hospitals in network, paid at its best rate, and there are circles in every part of the country. Everything between them is blue: out of network, and still covered, at a worse rate. No hatching anywhere on the map, and no referral to get to any of it. The POS has a door out too, but usually through your primary doctor first; the PPO is the one where you just go. That is the reason I try to get every client approved into one.
Every plan sits on one of four networks. Press HMO, EPO, POS or PPO and the map draws how far it pays. The PPO is the one I aim for.
04 · Why this part is a person
Somebody has to hold all four markets open at once.
Most private carriers don't sell online, and HealthCare.gov shows the exchange alone. With me you answer once, the same answers run through all four markets, and you hear which door is shut.
That's the last complicated thing on this page. Your half is ten questions and twenty minutes.
03 · What happens next
Four steps. None of them costs you anything.
No step costs you anything. Plenty of people decide on the call and we enroll right then, but nobody's pushed before they're sure. Your premium goes to the carrier, on a date you pick. No contract between you and me.
STEP 01
A short call
Your state, roughly your age, who else needs covering, and any health history worth knowing about. I'm listening for which of the four markets you belong in.
STEP 02
You get the sheet
Real options with real numbers: premium, deductible, out-of-pocket max, and whether your doctors are in network. Including the option that pays me nothing, if that's the one.
STEP 03
You decide, then we enroll
Most people do it on the call, once the right one is obvious. Take a day, take a week or talk to your spouse if you'd rather. Either way, when you're ready I handle the application, the health questions and the paperwork. You choose the date the coverage starts, which can be as far as 60 days out, and the first premium is due then rather than today.
STEP 04
The part most brokers skip
Claims, ID cards, a surgery that needs pre-authorization, a rate change next year. It's concierge work that comes with the policy, and it's where you find out whether someone picks up.
04 · Start here
Four questions for you. Then I go and do the work.
No fake number here. This tells me enough to build a real comparison, usually back to you the same day.
Question 1 of 4
Who needs covering?
Everyone who'd be on the policy.
How many dependents?
Everyone who'd be on the policy besides you. A spouse and children both count.
How many employees?
Everyone you'd be covering, yourself included. A rough count is fine.
Roughly how old are you?
Age is one of the few things that moves the price in every market.
What's the main problem?
Be honest here: it changes which market I look at first.
Where do I send it?
I'll call or text first. No mailing list, no drip campaign.
You're all set.
Want to go through it together?
Pick a time that works for you and I'll have your answers when we talk.
Nothing here binds coverage. Your actual quote is personalized and confirmed by a licensed agent.
05 · Questions
The questions I get asked every week.
What does this cost me?
Nothing. Not the call, not the comparison, not the enrollment. Carriers pay a commission when someone enrolls, and that's built into the premium whether you use an agent or not, so going direct doesn't save you money, it just means nobody's reading the fine print with you.
Am I locked into anything?
No, and there are two halves to that. You and I never sign anything. No fee agreement, no exclusivity, no permission needed to go and use somebody else, and you don't owe me an explanation if you do.
The policy is the other half. Individual health coverage runs month to month rather than on a term, so you can cancel it, normally effective at the end of a month, and there's no cancellation penalty on the plans I write.
The catch is on the way back in, not the way out. Leave an underwritten plan and you answer the health questions again at whatever health you're in by then, which may be a different answer. Leave a Marketplace plan and you're generally waiting for open enrollment or a qualifying life event to get back on one. So it's easy to walk out and it isn't always easy to walk back, and you should know that before you do either.
Will you push me toward a specific plan?
No. And I'll go further: a fair share of my calls end with me telling somebody to stay on their employer plan or stay on the Marketplace, which pays me nothing at all. If I burn twenty minutes and you keep what you've got because it was already the right answer, that's a good outcome.
Are you licensed in my state?
Thirty-one of them, and they're named on the map above rather than left as a number. It isn't a list I'm still filling in: the contracts I hold with my carriers set those thirty-one, and I can't legally write outside them myself. If yours is grey, I may know an agent there who can, and it takes five minutes to ask.
What happens after I enroll?
You keep my number. Claims questions, ID cards, a pre-authorization, a rate change at renewal. That's the job. Ask my three-year clients; that's the part they talk about.
What's the real difference between private and Marketplace plans?
Private plans are medically underwritten. You answer health questions and the price reflects your health. Marketplace plans are guaranteed issue and priced on your household income. Private often buys a broader network for less if you're healthy; the Marketplace can be unbeatable if you qualify for a good subsidy or have real health history.
Neither is "better". They're built for different people, which is what the side-by-side sheet is for.
Do I have to be healthy to qualify?
No, and this is the question people get most wrong. Taking medication is not the same as being unhealthy. Blood pressure, cholesterol, something for anxiety or depression that's been working for years: those are ordinary and they're commonly approved. What underwriting reads is the context around them, meaning what the medication is for and whether things are stable.
Serious, active disease is a different conversation and I won't pretend otherwise. Your health is part of the decision, so you can be approved, rated, offered a policy with an exclusion, or declined. I'll tell you straight where I think you'll land before you fill anything in, and if underwriting isn't your lane we'll go straight to the one that is.
I missed open enrollment. Am I stuck?
Often not. Underwritten plans are available most of the year, and a qualifying life event (losing coverage, moving, marriage, a new baby) opens a special enrollment window on the Marketplace. Those windows have deadlines, so it's worth a call sooner rather than later.
Can you cover my employees?
Yes, and for small teams there's usually more than one structure worth looking at. Bring your headcount and what you're hoping to spend and we'll work backwards from there.
What do you do with my details?
I use them to contact you about coverage. I don't sell leads and I don't hand your number to a call center. If you'd rather I stopped, say so and I will. Reply STOP to any text.
How fast will you get back to me?
Usually the same day, often within a couple of hours during the week. If it's urgent, call or text rather than filling in the form. My phone is the fastest route to me.
Have a question I haven't listed?
Bring it. We'll go through it in the same twenty minutes.
Photo slot B · preview only
The claim that most needs a picture
"The software I run this on is my own" is the single least believable sentence on this page, and it happens to be true. A photograph of the screen with your own system on it does more for that paragraph than another hundred words underneath it.
- File
- img/shot-build.jpg
- Shape
- 16:9 landscape · 1920 × 1080 or larger
- Shot
- Over the shoulder or from the side, screen lit, your own client system on it. The screen should be legible enough to look real and not legible enough to read a client's name.
- Careful
- No real client data on any screen in frame. Use a test record, or blur it afterwards. This one picture could undo the whole privacy page.
- Light
- Dim room, screen as the main source. It has to sit on the dark section without a bright white wall fighting it.
Photo slot C · preview only
A face at the point of asking
Everything below this is the ask: call, text, book, send it over. The nearest photograph of you is at the very top of a very long page, which by here is a different visit. A second portrait down here is worth more than a first one up there.
- File
- img/shot-portrait.jpg
- Shape
- 4:5 portrait · 1200 × 1500 or larger
- Shot
- Head and shoulders, straight to camera, warm rather than corporate. Different clothes and a different setting from the hero, or it reads as the same photo twice.
- Light
- Soft and frontal. This is the friendly one, so nothing dramatic.
- Background
- Plain and uncluttered. The hero already has a busy backdrop and the two should not compete.
07 · Talk to me
Twenty minutes now, or another year of guessing.
Worst case, you find out you were already on the right plan and you can stop wondering.