Starting in the health insurance industry: 6 Tips to be successful

health insurance industry

Overview: In order to be successful in the health insurance industry, pay attention to these 6 pieces of advice.

health insurance industry

What makes a successful health insurance agent successful in the competitive zeitgeist of the 21st century? It’s more than what you’re saying or selling.

To be successful as a health insurance agent, you need to have strong sales, marketing, and customer service skills. You’ll be required to locate and attract potential customers. You don’t necessarily have to be born with these skills, but developing them is crucial to your success.

Essential tips for success as a health insurance agent:

Prioritize Good Customer Service

This is a three-part tip. You need to 1) put the needs of the client before your own interests 2) be attentive and available to answer client questions or concerns and 3) have emotional intelligence. All of these tie into prioritizing good customer service. Here’s why:

  • Putting a client into a product that pays a lower commission because it better fits their needs will likely help you retain customers.

  • Customers want to be able to get in contact with their agents. Timely responses to inquiries and phone calls is a must. You almost must be able to do what you say you will do, when you say you will do it, or at least have a good reason as to why you can’t.

  • Listen and empathize with clients on a deeper level in order to discern what they really want and need. A good agent is tactful and knows how to help a client see financial reality clearly, even when the client is dead set against it.

Bonus: Do not prioritize earning a commission! You likely won’t last long in the business. Agents who listen carefully to what their clients and prospects say will be able to earn their trust — which is the hardest part of their job.

Related article(s): 8 Qualities That Make a Good Insurance Agent

Focus On Good Salesmanship (Record/Listen To Yourself)

We all know that health insurance agents (like all types of insurance agents) are salespeople by nature. Sales is namely all about confidence first, knowledge second, and everything else after. One way to develop your sales skills is to record your voice on the phone while talking to some clients.

  • Do you sound smart?

  • Do you sound confident?

  • Do you sound like a little kid who picked up the phone?

You need to acquire strong sales skills and learn the process of acquiring, nurturing, and maintaining quality customers. This might require attending seminars or undergoing a professional training program in sales.

Related article(s): 21 Insurance Sales Tips For Young or Inexperienced Insurance Agents

Develop a Strong Work Ethic

The insurance industry is competitive and you may be working independently for a good portion of the day. You need to develop a strong work ethic to be proactive when seeking out new customers, closing sales, and developing relationships with clients and industry professionals. Prioritizing your time and maintaining a strong work ethic will get you far throughout your career.

Study the Market

You need a plan to target the right prospects and seek out new customers in the right markets. Take the time to study the market and develop a strategy so you are making the best use of your time. Whether you are out on a sales call or conducting a presentation to potential customers, you need a deep understanding of what your customers want and who is the market to buy insurance — ideally, from you.

Learn From the Pros

Every successful agent needs a mentor, coach, or someone to guide them throughout their career. Make the time to connect with someone who is currently working your dream position or someone who is willing to mentor you as you grow in your career. This will provide you with valuable insights about the industry, tips for overcoming challenges you are dealing with, and an opportunity to learn from someone who has been in your position at some point in his or her career.

Related article(s): How to Succeed as an Insurance Broker or Insurance Agent

Stay on Top of Market Trends

Because life insurance policies changes, it’s essential that you stay on top of trends to achieve the success you want. As a result, you’ll not only have a better chance of selling what the client needs but also what they believe they want. With a vast knowledge of life insurance and by remaining enthusiastic yet professional, you can carefully guide an individual toward the best coverage, whether trendy or not.

Related article(s): 5 Pro Tips – How to Be a Successful Insurance Agent in 2021

Debunking 3 common U.S. health insurance myths

common U.S. health insurance myths

Preview: Let’s take a look at 3 popular myths about US. health insurance that might take you by surprise.

Health insuranceHere are some topics of conversation (aka “myths”) we’ve heard people discuss about health insurance in America that need major clarification:

  • The relationship with age and health insurance

  • Is Canada better than the U.S. when it comes to health insurance?
  • Outrageous out-of-pocket costs on top of premiums

Health insurance myth 1: Young and healthy individuals do not need health insurance

After the 2020 pandemic, this myth has likely deceased; however, we’re aware that conversations about health insurance often included this notion.

Research shows that people between 18 and 34 tend to be at their healthiest. So we’re not surprised that those in their early or mid-20s usually do not require much medical attention  However, since many in this age bracket feel that they tend to “not need” medical attention, that also means that many feel they do not need to buy health insurance.  But this is not true.

Young and healthy individuals can become sick. As we mentioned earlier, after the COVID-19 outbreak, many young people fell sick due to the virus and had to be hospitalized. For those who didn’t feel that they “needed” health insurance, this often meant that they would have to pay out-of-pocket.

Even if one isn’t sick or does haven’t signs of preexisting illnesses, buying health insurance early — before one develops any illness — ensures that there isn’t a waiting period. In case of any pre-existing illnesses, there is a waiting period of two to three years in health insurance for such diseases. During that period, if the policyholder is admitted to the hospital due to any ailment related to that disease, it won’t be covered by the health insurance company.

The rundown: Age shouldn’t and doesn’t determine whether a person should buy health insurance.

Related article(s): 6 Health Insurance Myths Busted

Health insurance myth 2: Canada has a better health care system than the U.S.

And so the debate rages on, and with good reason. Many people in the U.S. believe Canada’s healthcare system is superior to the U.S. for various reasons (lower costs, more services, universal access to health care without financial barriers, and superior health status). So, we completely understand this debate.

However, there’s a limit on what you can get with the Canadian healthcare system. Matt Tassey, a spokesman for LIFE, says, “Universal health care isn’t better; it’s just different.” Tassey many Canadians have come to the U.S. for care because they can actually get it. There is no rationing (in America) of any sort, so they can just write a check.

Americans may complain about the high cost of health care in the U.S., but there are two sides to every situation. In this case, Canadian healthcare isn’t necessarily “better.” Especially if Canadians have come here to the U.S. to receive various treatments.

Related article(s): 7 Health Insurance Myths Debunked

Health insurance myth 3: I will have to pay huge amounts out of pocket

We can’t deny that when it comes to health insurance, many people have to pay more than just their premiums. Some of these additional costs include the following:

  • A deductible. This is the amount that you must pay out-of-pocket before your health insurance pays for services. This amount resets each year.

  • A copayment. This is a flat fee that you pay each time you go to the doctor or fill a prescription and is usually printed right on your insurance card.

  • Co-insurance. Coinsurance is your share of costs for healthcare services and is generally figured as a percentage. Coinsurance usually kicks in once you’ve met your deductible.

For the 2021 plan year: The out-of-pocket limit for a Marketplace plan can’t be more than $8,550 for an individual and $17,100 for a family. The good thing is that there is a cap that’s placed on out-of-pocket costs for marketplace plans.

Once your out-of-pocket maximum is reached, your insurer has to pay the rest. For most people, $8.550 or $17,100 is a huge amount. However, if you think of what your costs would be without healthcare coverage, those amounts are pretty tame.

For example, the average cost for each death in a motor vehicle accident is $1,130,000. Meanwhile, the average cost for each nonfatal disabling injury is $61,600. Of course, this is a generalized statement (costs vary from state-to-state and with other factors included).

Nonetheless, there’s no denying that the cost of an accident is a lot. As such, most folks would choose the out-of-pocket maximum amounts over accident figures any day!

Related article(s): Top 5 Health Insurance Myths

The evolution of American health insurance services over the last few decades

evolution of American health insurance services

Overview: How health insurance has evolved for Americans in recent years.

evolution of American health insurance services evolution of American health insurance services

evolution of American health insurance services

From illness trends to the implementation of technology, changes in America health insurance services remain slow, complex, and constant much like the overall healthcare system.

Various healthcare proposals have been introduced over the years, but it’s the complexity of the healthcare industry in its entirety — environmental and technological factors — that remain the primary causes to changes in health insurance services in America.

  1. Increase in technology & cost of medical services

  2. Managed care & ability to select a doctor

  3. Extending Medicare coverage for prescription drugs
  4. How health care will change in the future (technology & more)

1. New technology; increased cost for health insurance

One primary change in American health insurance services is the increased cost for health insurance as a result of new technological treatments. Maybe back in the day, you could get away with surgery and a hospital stay without health insurance but now… not so much. (That goes without saying.)

This goes in tandem with the tremendous medical technology now available. If patients want to reap the benefits of these technologies, they must be willing to accept the ever-increasing medical costs that come with it.

2. Managed health care; limited doctor selection

As the cost for health insurance has risen there’s been a move toward managed health care. This move, in turn, has changed the health American insurance industry and services by creating limited flexibility for someone to choose a doctor.

Managed health care is a term that refers to health plans that involve selective contracting between insurers, health care providers, and employers to direct employees to a specified group of cost-effective health care providers.

This rapidly-changing revolution has affected everyone from physicians and hospitals to patients and insurance carriers.

Says Marc Maraccini, Vice President of Sales and Marketing at North Texas Healthcare Network: “Fifteen years ago, it used to be that a person had an insurance provider that covered almost anything with no questions asked. But this process made it difficult for employers to estimate how much they would pay for their employees’ health care. This is because a physician or hospital could charge almost any amount for a procedure or prescription.

A managed care plan has caused most people to receive coverage through their employer over the last decade. This practice saves money because unlike traditional plans, managed care plans contract directly with the health care providers to set payment for services.

Related article(s): The Evolution of Health Insurance

3. Medicare updated to include prescription drug coverage

In the early 2000s, one major change health insurance services saw was the update to Medicare to include prescription drug coverage. This idea  that was initially proposed by George W. Bush eventually turned into the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (sometimes called Medicare Part D). Enrollment was (and still is) voluntary, although millions of Americans use the program.

For a detailed timeline of the evolution of the American health care industry from Colonial Times (1700s) to now (21st Century), take a look at the related article below.

Related article(s): The History of Medicine and Organized Healthcare in America

4. Changes to expect for the future of health care services for Americans

As the baby boomer generation approaches retirement, thus qualifying for Medicare, healthcare spending by federal, state, and local governments is projected to increase.

Along with policy and technological changes, the people who provide healthcare are also changing. Providers are an important part of the healthcare system and any changes to their education, satisfaction, or demographics are likely to affect how patients receive care.

In the future, healthcare providers are more likely to focus their education on business than ever before. A large-scale analysis of Harvard Business School’s physician graduates indicates substantial growth in the number of physicians pursuing M.B.A. degrees in the last decade. This growth may result in more private practices and healthcare administrators.

Healthcare technology trends that focus heavily on patient empowerment will be on the rise (artificial intelligence, VR/AR, 3D-printing, robotics or nanotechnology). For example, the introduction of wearable biometric devices provide patients with information about their own health. Telemedicine apps allow patients to easily access care no matter where they live. These types of new technologies are focused on monitoring, research, and healthcare availability so patients will be able to take a more active role in their care.

With advances in digital healthcare technologies, healthcare workers have to embrace emerging healthcare technologies with an open mind in order to stay relevant in the coming years.

Related article(s): How We Can Expect The Healthcare Industry to Change in The Future and 10 Ways Technology Is Changing Healthcare

What Are Your Options During Open Enrollment:

open enrollment

Insurance EnrollmentTis the season for giving thanks, festive gatherings, and open enrollment! This is the time in which you have the option to either make changes to your health insurance plan or to switch it out with a new one. So, as we approach 2020, be sure to evaluate your healthcare needs, your coverage plan, and your available options.

When is Open Enrollment?

The period in which open enrollment takes place depends on how you get your insurance. For Medicare recipients, open enrollment spans October 15th to December 7th. Individual plan enrollment extends between November 1st to January 31st. However, if you’d like for you plan to be effective on January 1st, you must enroll by December 15th. Medicare begins from October 15th until December 7th. And if your employer covers you, this period varies and depends on your company.

If you are covered by the Affordable Care Act (ACA), open enrollment is dependent on your state. So if you live in California, this period spans from November 1st until January 31st. Finally, if you are eligible and would like to opt for Medicare or the Children’s Health Insurance Program, you can enroll at any time of the year. See if you qualify for either of these programs here. 

Your Health Insurance Options During Open Enrollment: 

  1. Renew your current policy if needed. You have the option to keep your current health insurance if you are satisfied with your coverage. In this case, you may not need to do anything during open enrollment. However, be sure to look out for any changes to your policy. In the case of modifications, consider how they might affect your particular coverage needs. And if you find that you do require change, open enrollment is the ideal time to do so.
  2. Buy an individual plan. You can do this through a marketplace or via an individual policy provider. If you decide to sign up on the marketplace exchange in California, you must qualify for the tax subsidies that will assist in paying for your premiums. Your family size and income determine your eligibility for this.
  3. Make changes to an employer-based group plan. Most people are insured through their employers. In this case, open enrollment will not affect you. That’s because this season will only pertain to the government-run marketplaces and the Affordable Care Act plans. However, you will need to sign up or renew your coverage during the particular time in which your company has its own open enrollment. Each company will have its own specified renewal dates. Your responsibility at this time is dependent on the policies of your employer. Some will automatically renew your coverage every year, while others will ask you to sign up each time. Also, keep in mind that employer health care providers change with some consistency, so make sure you know what you’ll receive with each change.
  4. Change your medicare plan. If you’d like to opt for different coverage within your medicare plan, do so during open enrollment (from October 15th to December 7th for medicare.) The open enrollment period that is specific to government-run marketplaces will not affect you.
  5. If you are not satisfied with the health coverage plan you initially selected, there is one more opportunity for you to make changes to your plan.  This comes during the year’s final open enrollment, happening January 1st until March 31st.

Open enrollment and all things insurance are a common source of holiday headaches. But don’t let the complicated slew of options get you down this season. For all of your insurance inquiries and needs, do not hesitate to call on us at Bernardini and Donovan. We are experts in health care coverage and are here to care for you and your family. Reach out today!

New California Health Insurance Mandates

California health insurance

For the most part, the Affordable Care Act, or Obamacare, has remained intact since President Trump’s election. However, in 2019, congress repealed what Trump found most troublesome about the plan. As a part of a major tax bill, the enforcement of individual mandates was eliminated in January of this year. Prior to this, individuals who were not covered by health insurance were subjected to a tax penalty of $695 per adult or 2.5 percent of their household income, whichever was higher. This was enforced with several exemptions to address the unique circumstances of each individual.

health insurance

However, California is among the handful of states that have passed legislation to reissue this individual mandate. And in 2020, its residents will be required to obtain qualified health insurance or face a tax penalty. But this time, it will look a bit different than that wish was issued on a federal level.

The penalty for uninsured Californians will remain the same. But if it goes unpaid, other assets of yours, like your home, will be targeted. So, as a Redlands, California local, it is vital that this fee does not go overlooked.

What are your options? 

Not only to avoid this fee, but for your general well-being and good health, be sure to purchase an insurance plan. We advise that you do so for you and your dependants as we approach 2020 and the season of open enrollment. And to simplify your process, be sure to contact us at Bernardini and Donovan for expert assistance in choosing the best plan for your needs.

Amid ever-changing legislature, your health insurance decisions may simultaneously fluctuate. That’s why, for your group and individual plans, and all of your coverage inquiries, we at Bernardini and Donovan are here for you. We are prepared to meet your specific needs with a plan that’s right for your Redlands-based business. Call on us today! 

5 Small Business Health Insurance Pitfalls

small business health insurance

Redlands small businesses face several challenges when it comes to employee health insurance. However, this must be made available for the benefit of each employee and the success of your company. Offering health insurance makes your employees more likely to stick around, keeps them happy and healthy, and can even save you money. So, while it may seem like a daunting endeavor, we advise that no matter the size of your company, you consider offering health insurance.

There are a few mistakes when implementing a health care plan for your employees of which to take note. Make sure that you are aware of their threat and of the ways these pitfalls can be avoided. And rest assured that, even when issues arise, there are often simple solutions.

California health insurance
  1. A misunderstanding of eligibility requirements. 
    There are a few things that might keep an individual from partaking in their employer’s health care insurance plan. That’s because a group insurance plan does not automatically prompt eligibility for every employee. Typically, employees are required to work a minimum of 30 hours a week and must fulfill a distinguished waiting period to gain eligibility. This all depends on your state, your insurance provider, and your particular policy. Make sure that upon implementing a new plan, your employees are aware of these requirements.
  2. Miscommunication about the waiting period.  The waiting period indicates the number of consecutive days an employee must work to gain eligibility for the health insurance plan. This number should be decided based on the time you believe is required to discern an employee’s loyalty to the company. And you must communicate this exact amount clearly to your new employees to avoid miscommunication and confusion.
  3. Paperwork mishaps.  Paperwork is something about which we can all commiserate. But despite its world-renowned nuisance, this is the paperwork you cannot overlook. Incomplete or untimely paperwork will cause several complications in your health insurance plan. So make sure that it is submitted with complete accuracy and on time. And be assured that if an employee is terminated, added, or needs to make changes to their coverage, their corresponding paperwork is updated correctly.
  4. Failing to reconcile carrier bills. If an employee is wrongly included or missing from a bill, you face the issue of someone either not receiving coverage or being overcharged. And while these bills are typically accurate, you ought to review them regularly for assurance.
  5. Neglecting to take action when something goes wrong. The Explanation of Benefits or EOB lists the date of service, cost, negotiated discount and deductible accounting and amount for which the patient is responsible. This must coincide with the patient’s medical bills. So if these are mismatched, or demonstrate an issue, be sure to take action immediately. There is often an easy solution to this problem, but it is best solved with urgency.

While these issues may pose significant setbacks to your business, choosing a local Redlands broker like Bernardini and Donovan will help alleviate their severity and prevalence. We are prepared to assist your choice in plans and to provide exceptional customer services as it is administered.

Health insurance is a vital aspect of one’s well being. It assures that upon unforeseen medical circumstances, an individual will be financially covered. This confidence, as one faces inevitable unknowns, is crucial to living well and happily. So, as a small business owner, be sure to provide insurance to your employees for their peace of mind and the benefit of your company. Please do not hesitate to reach out to us today for a simplified and seamless experience.

Values of Bernardini & Donovan

Values of B&D

Values of Bernardini & Donovan

At Bernardini and Donovan, we love serving our clients and partners. And we are dedicated to providing you,  your families, and your businesses with insurance services. We do this by following a dedicated set of values which directs our communication and service.


We are here to help you. We understand that your health is vital and that many of you need good health insurance to help the cost associated with preventative care as well as care whenever illness or injuries occur. That’s why we want to do everything we can to help you. If you are tired of trying to figure out health care on your own, we are here to answer your questions and walk alongside you to ensure that you get the health insurance that you need.


Our health insurance market has been flooded with change over the last few years. To the point that many people cannot keep up. We know that it’s hard to keep up in a niche market, so that is why we do it for you. As you have questions about new policy, your best options for your business or when you are starting Medicare; we are here to give you the most up to date information.


Webster’s dictionary defines trust as the “assured reliance on the character, ability, strength, or truth of someone or something.” We strive to continue to be above board, up front and honest with all of our clients. We seek to communicate effectively and promptly especially when deadlines are so final with health insurance. And we hope to build lasting relationships with our clients. This isn’t a single transaction, but a desire to see you turn to us for any of your health insurance needs.

We want you to succeed and do everything we can to make the health insurance process as easy as possible. Please contact us today if you have questions about your health insurance.

Did you know… about the 80/20 rule?

80/20 Rule

Did you know… about the 80/20 rule?

We realize that many people may have health care but don’t know how the systems work or what their premiums are going to each month. We understand that life is busy and that you may not have all the time in the world to research and learn an argumentatively complex system of health care insurance and providers. So we thought that we would start a new series of posts focused on “Did you know…” With this blog, we will be looking at the 80/20 rule.


Did you know… that health insurance companies are required to spend a mandated amount on your healthcare? Insurance Companies are mandated to $.85 of every dollar on your Health Care.


This 80/20 rule is also referred to as Medical Loss Provision Ratio in the Affordable Care Act. The rule states for 80% of premiums collected must be spent on health care or on improving actions for the person. The other 20% can go to administrative needs of the medical insurance company such as marketing or other financial needs. These numbers specifically apply to individual and small group markets. If you are part of a large group market, then the numbers change to 85% and 15% of healthcare and administrative needs respectively. The thought process with this rule is to ensure greater transparency within insurance companies so we can truly see where the money is going. If an insurance company does not spend the 80 to 85% of premiums toward healthcare, then they are required to provide a rebate for the portion that was not spent. This rebate looks at the entire corporation and their spending and not just on one individual’s health care expenditures. Are you someone who has received this kind of rebate in the past? If so you know that the rebates usually come in the form of a check to the individual, are applied as a credit to their account or are reflected in the rates of the following year of insurance. Or if you are part of a small or large group then the rebate is given to your employer who passes it along to their employees. We hope that this “Did you know” blog was helpful. If you have any more questions about the Medical Loss Provision Ratio, please feel free to call and ask us.

Our website uses cookies and thereby collects information about your visit to improve our website (by analyzing), show you Social Media content and relevant advertisements. Please see our cookies page for furher details or agree by clicking the 'Accept' button.

Cookie settings

Below you can choose which kind of cookies you allow on this website. Click on the "Save cookie settings" button to apply your choice.

FunctionalOur website uses functional cookies. These cookies are necessary to let our website work.