A health insurance broker is a state-licensed professional who compares plans from several insurance companies and helps you enroll. HealthCare.gov says you won’t pay anything additional for a Marketplace plan when you enroll through an agent or broker, and you keep the same premium tax credit.
Updated October 2026 for the 2027 plan year
Key facts (2027 plan year)
- Agents and brokers must be licensed in their states and sign agreements to sell Marketplace plans; agents may work for one insurer, while brokers may represent several (HealthCare.gov glossary).
- You won’t pay anything additional if you enroll with an agent or broker, and you can still get a premium tax credit if they enroll you through the Marketplace (HealthCare.gov).
- Navigators are trained by the Marketplace, must be unbiased, and their help is free (HealthCare.gov). Federal rules bar them from taking payment from insurers for enrollments (45 CFR 155.210).
- Between June and October 2024, the Centers for Medicare & Medicaid Services (CMS) suspended 850 agents and brokers over suspected unauthorized enrollments or plan switches (CMS).
- A September 2026 federal rule paused registration of new agents and brokers on HealthCare.gov for the 2027 plan year, expected to last until February 1, 2027 (Federal Register).
- Open Enrollment for 2027 coverage on HealthCare.gov runs November 1, 2026 to January 15, 2027; enroll by December 15 for coverage that starts January 1 (HealthCare.gov).
- What does a health insurance broker do?
- Broker vs. agent vs. navigator vs. HealthCare.gov
- Does a health insurance broker cost more?
- Do I need a health insurance broker?
- How do I check a broker’s license?
- What are the red flags of a bad broker?
- What questions should I ask a broker?
- How Honesty works as your agent
- Frequently asked questions
What does a health insurance broker do?
A broker helps you find, compare and enroll in a health plan. A good broker checks your subsidy, lines up plans from different insurers, confirms your doctors and drugs, and submits the application with you. Many keep helping after you enroll.
In practice, a broker’s job splits into four parts:
- Eligibility. Checking whether you qualify for Medicaid, the Children’s Health Insurance Program (CHIP), a premium tax credit or cost-sharing reductions based on your estimated 2027 income.
- Comparison. Showing plans side by side on premium, deductible, out-of-pocket maximum, network type and drug coverage.
- Enrollment. Submitting your Marketplace application, or an off-exchange application, and making sure the first premium gets paid.
- Service. Helping with ID cards, billing problems, income changes, a Special Enrollment Period and renewal each fall.
Brokers must be licensed by each state where they sell. To sell plans on HealthCare.gov they also register with the Marketplace and complete its training. A broker can recommend a specific plan, which Marketplace navigators generally do not do.
Some brokers work through approved websites. CMS lets approved insurers and web-brokers run the full HealthCare.gov application on their own sites through a program called Enhanced Direct Enrollment (EDE). The plans and savings are the same; only the screen you use is different.
Health insurance broker vs. agent vs. navigator vs. HealthCare.gov
A broker usually represents several insurers, a captive agent represents one, a navigator gives free unbiased help but no plan recommendations, and HealthCare.gov lets you do it yourself. All four can get you the same Marketplace plan with the same premium tax credit.
“Agent” and “broker” are often used as one phrase, and many states license them the same way. The practical difference is how many insurers they can sell. HealthCare.gov notes that some agents and brokers may not sell plans of companies they don’t represent, so always ask.
| Who helps | Plans they show | Cost to you | Recommends a plan? | Best for |
|---|---|---|---|---|
| Independent broker | Several insurers, often on and off the Marketplace | Nothing additional | Yes | Comparing many insurers with one person |
| Captive agent | One insurer’s plans | Nothing additional | Yes, from that insurer | People already set on one company |
| Navigator or certified assister | All Marketplace plans | Free; can’t be paid by insurers | No; explains options | Free, neutral help with the application |
| HealthCare.gov or state exchange, on your own | All Marketplace plans in your area | Free to use | No | Confident shoppers with simple households |
| Insurer website or call center | That insurer’s plans | Free to use | Yes, from that insurer | Buying a plan you’ve already chosen |
You can find navigators, certified assisters and Marketplace-registered agents and brokers near you with HealthCare.gov’s Find Local Help tool. For the full step-by-step shopping process, see how to shop for health insurance.
Does a health insurance broker cost more?
No. Using a broker for a Marketplace plan doesn’t raise your premium. HealthCare.gov says you won’t pay anything additional if you enroll with an agent or broker, because insurers file one set of rates for each plan.
Your premium tax credit is the same too, as long as the broker enrolls you through the Marketplace. HealthCare.gov is clear that to get the savings, the agent or broker must enroll you through the Health Insurance Marketplace.
That last point matters. The tax credit only applies to Marketplace plans. HealthCare.gov notes you can’t get premium tax credits for a plan bought outside the Marketplace. If your household is between 100% and 400% of the federal poverty level, make sure your broker is enrolling you on-exchange.
Can a broker be biased?
Yes, in a few ways. Some brokers can sell only certain insurers, and some lean on products they know best, including non-ACA plans that can exclude pre-existing conditions. HealthCare.gov notes that in many states brokers are required to act in a consumer’s best interest, but rules vary by state.
The fix is simple: ask which insurers in your ZIP code they can’t sell, and ask to see ACA plans side by side before anything else. A broker who explains the trade-offs of every option, including the ones they don’t favor, is doing the job right.
Quick test: ask any broker, “Which plan would you pick if you were me, and what is its weakness?” A good broker names the weakness without being asked twice.
Do I need a health insurance broker?
You don’t need a broker to buy coverage. Anyone can enroll on HealthCare.gov or a state exchange. A broker is most useful when your household, income or medical needs are complicated, or when you want someone to compare insurers and handle problems for you.
A broker tends to save the most time and mistakes if you:
- Have variable income, such as 1099 or gig work, where your estimate decides your tax credit. See health insurance for the self-employed.
- Are near an income line, such as 138%, 250% or 400% of the federal poverty level. For 2027, above 400% there is no premium tax credit (2027 subsidy guide).
- Take specialty drugs or see specialists you can’t lose, so network and drug-list checks really matter.
- Are covering a family with mixed eligibility, such as kids on CHIP and parents on the Marketplace (family health insurance).
- Are weighing non-ACA options like short-term health insurance and want an honest read of the exclusions.
If your situation is simple and you are comfortable comparing plans yourself, doing it on HealthCare.gov works well. Either way, use the same method: compare total yearly cost, not just the premium. Our guide to comparing health insurance plans walks through it.
Honesty.AI checks your 2027 subsidy and compares plans for your family. Chat, voice or text, 24/7.
How do I check a health insurance broker’s license?
Check a broker’s license on your state insurance department’s website before you share personal details. Search by the broker’s name or National Producer Number (NPN) and confirm the license is active, covers health insurance and has no disciplinary actions.
- Ask for the full name and NPN. Every licensed agent and agency has an NPN, a unique ID assigned through the National Insurance Producer Registry (NIPR). Honesty’s is 21094885.
- Find your state insurance department. The National Association of Insurance Commissioners (NAIC) lists every state insurance department with links.
- Run the license lookup. Confirm the license is active, includes “accident and health” or a similar health line, and is valid in the state where you live.
- Look for actions. Many state lookups show fines, suspensions or revocations next to the license.
- Confirm Marketplace registration. Agents and brokers who sell HealthCare.gov plans appear in Find Local Help.
A real broker will give you an NPN without hesitation. If someone dodges the question, end the call.
What are the red flags of a bad health insurance broker?
The biggest red flags are pressure to decide on the first call, promises of free coverage or cash, refusing to give a license number, and asking to enroll you without your clear consent. Unauthorized enrollments and plan switches were a large enough problem that CMS changed its rules in 2024.
CMS reported 183,553 complaints of unauthorized Marketplace enrollments and 90,863 complaints of unauthorized plan switches from January through August 2024 (CMS). Since July 19, 2024, an agent or broker who isn’t already on your enrollment can’t change it on HealthCare.gov. To switch brokers, you join a three-way call with the Marketplace Call Center.
The crackdown has continued. In September 2026 a federal rule paused new agent and broker registrations on HealthCare.gov through about February 1, 2027 (Federal Register). Agents already registered for 2026, web-brokers and agents on state exchanges are not affected.
| Red flag | Why it matters | What to do |
|---|---|---|
| “Free” plan, gift card or cash for signing up | A common hook in unauthorized enrollment schemes | Hang up; never share your Social Security number |
| Won’t give an NPN or license number | You can’t verify who they are | Look them up first or walk away |
| Changes your plan without asking | Can move you off your doctors or misstate income | Call the Marketplace Call Center at 1-800-318-2596 |
| Guesses your income for you | You may owe the tax credit back on IRS Form 8962 | Give your own best 2027 estimate |
| Pushes a non-ACA plan without explaining exclusions | Short-term plans can deny pre-existing conditions | Ask for ACA plans side by side |
| Shows only one insurer | You may be missing better-fit plans | Ask which insurers they don’t sell |
If you were enrolled or switched without your consent, CMS says to call the Marketplace Call Center at 1-800-318-2596 (TTY 1-855-889-4325). Check your HealthCare.gov account a few times a year to confirm your plan and income are correct.
What questions should I ask a health insurance broker?
Ask a broker which insurers they can and can’t sell, whether they will enroll you through the Marketplace, and who you call after you enroll. Clear, specific answers are the sign of a broker who works for you.
- What is your full name, agency name and NPN?
- Which insurers in my ZIP code can you sell, and which can’t you?
- Do you show every insurer’s plans, or only some?
- Will you enroll me through HealthCare.gov or my state exchange so I keep my tax credit?
- Can you check my doctors, hospitals and prescriptions for each plan?
- What is my total yearly cost in a low-use year and a high-use year?
- Will you sell or share my phone number or data with anyone?
- Who helps me if a claim is denied or my income changes mid-year?
A good broker will also explain how insurers’ quality ratings and complaint records compare. Our guide to the best health insurance companies shows how to judge any insurer in your area.
How Honesty works as your health insurance agent
Honesty®, a licensed AI insurance agent from Honesty® Insurance Services, LLC (NPN 21094885, licensed in 49 states and DC), does the work of a health insurance broker by chat, voice or text. It compares ACA, alternative and ancillary plans by your family’s needs and enrolls you in minutes, 24/7.
- Unbiased among carriers. Honesty never steers you toward one insurer. It shows the plans that fit your household and explains the trade-offs.
- Subsidy first. It checks Medicaid, CHIP and premium tax credit eligibility before showing prices.
- Your doctors and drugs. Tell it who you see and what you take, and it checks each plan.
- No data selling, no spam calls. We never sell or share your data.
- Enrolls in minutes, 24/7. Honesty is not affiliated with HealthCare.gov or CMS.
See how Honesty.AI works and why unbiased advice matters.
Talk to a licensed agent that works for you
Honesty.AI is the world’s first patented, licensed AI insurance agent. It checks your 2027 subsidy, compares ACA, alternative and ancillary plans for your family’s needs, and can enroll you, 24/7 by chat, voice or text. We never sell or share your data.
Frequently asked questions
Does it cost more to use a health insurance broker?
No. HealthCare.gov says you won’t pay anything additional for a Marketplace plan if you enroll with an agent or broker. Your premium tax credit is the same as long as they enroll you through the Marketplace.
What is the difference between a health insurance agent and a broker?
An agent may work for a single insurance company, while a broker may represent several. Both must be licensed by the state. Always ask which insurers they can sell in your ZIP code.
Is a navigator the same as a health insurance broker?
No. Navigators are trained by the Marketplace, must be unbiased, help for free and can’t be paid by insurers for enrollments. They explain your options but generally don’t recommend a plan. Brokers are state-licensed and can recommend a specific plan.
How do I know if a health insurance broker is legitimate?
Ask for their full name and National Producer Number (NPN), then look up the license on your state insurance department’s website. Confirm it is active and covers health insurance. Marketplace-registered brokers also appear in HealthCare.gov’s Find Local Help tool.
Can a broker change my plan without my permission?
They shouldn’t. Since July 2024, an agent who isn’t already on your HealthCare.gov enrollment can’t change it, and switching brokers takes a three-way call with the Marketplace Call Center. If it happens anyway, call 1-800-318-2596.
Is Honesty a health insurance broker?
Honesty is a licensed AI insurance agent from Honesty Insurance Services, LLC (NPN 21094885), licensed in 49 states and DC. Like a broker, it compares ACA, alternative and ancillary plans by your family’s needs, is unbiased among carriers and enrolls you in minutes, 24/7.
Keep learning: the health insurance marketplace, Open Enrollment 2027, health insurance quotes, the cheapest health insurance and individual health insurance.
