How Health Insurance Brokers Work and Whether You Need One
HSChange Editorial Team
Health Policy Research Team, Consumer Health Guidance
Reviewed by Dr. Sarah Mitchell, MD, MPH, Board-Certified Internal Medicine
Last updated: April 4, 2026
A health insurance broker is a licensed professional who helps you find and enroll in a health plan. Unlike a captive agent who works for one insurance company, a broker works with multiple carriers and can compare plans across them. The service is free to you because the insurance company pays the broker a commission.
How Brokers Get Paid
Brokers earn commissions from insurance companies when you enroll in a plan through them. The commission is built into the premium, so you pay the same price whether you use a broker or buy directly. Some brokers also charge consulting fees for complex group plans, but for individual and family coverage, there's typically no direct cost to the consumer.
What Brokers Actually Do
A good broker starts by understanding your situation: your budget, health needs, preferred doctors, and medications. They compare plans across carriers, explain the trade-offs in plain language, and help you enroll. After enrollment, many brokers continue to help with claims issues, billing disputes, or plan changes at the next open enrollment.
CMS-certified brokers can also help you enroll in ACA Marketplace plans and navigate premium subsidies. They must complete marketplace-specific training and certification annually.
Broker vs. Agent vs. Navigator
A broker represents multiple insurance companies. A captive agent represents only one. A navigator is a federally funded position that helps people enroll in marketplace plans but doesn't sell insurance or earn commissions. All three are regulated, but a broker gives you the widest range of options because they aren't tied to a single carrier.
When to Use a Broker
Brokers are especially useful if you're self-employed or buying individual coverage and find the marketplace overwhelming, if you're a small business owner shopping for group plans, if you have complex health needs and want someone to check provider networks and formularies for you, or if you just want a second opinion on what your employer offers versus what's available elsewhere.
How to Find a Licensed Broker
Every state's department of insurance maintains a database of licensed agents and brokers. You can search by name or ZIP code. For marketplace-certified brokers, Healthcare.gov has a "Find Local Help" tool. There are over 1.2 million licensed insurance agents and brokers in the U.S., though not all specialize in health insurance, so ask about their experience with health plans specifically.