Healthcare insurance brokers are constantly looking for ways to provide the best for their clients while increasing their margins. If this is the case for you, look no further!

Innovative HIA provides the most competitive rates for Minor Medical coverage plans. Our mission as a benefits administrator is to help you—as a healthcare insurance provider—deliver the best for your clients (and a little extra commission wouldn’t hurt).

Below are a few tips on how to increase margins as a healthcare insurance broker (Hint: we saved the best tip for last!)

How to Increase Your Margins as a Healthcare Insurance Broker

As a healthcare insurance broker, you are always looking for ways to provide the best possible coverage for your clients while also increasing your own margins. 

There are a few key ways that you can do this:

Get Higher Commissions

One way to increase your margins is to simply get higher commissions from the insurance carriers you work with. This can be done by negotiating better terms with the carriers, or by simply switching to carriers that offer higher commissions. (But more on this later!)

Get Better Insurance Rates

Another way to increase your margins is to get better insurance rates for your clients. This can be done by:

  • Hopping around for the best rates
  • Using discounts, or
  • Simply being aware of the different rates that are available

Increase Your Efficiency

Finally, you can also increase your margins by increasing your efficiency as a healthcare insurance broker. This means finding ways to work faster and more efficiently, saving you time and money long-term.

How Brokers Can Earn Higher Commissions with Innovative HIA

We told you we saved the best tip for last! Working with Innovative HIA is the easiest way you can increase your margins as a healthcare insurance broker.

At Innovative HIA, our ACA-compliant policies start at a base price with a set commission built-in. Additionally, we work with our brokers to ensure you feel comfortable with the commission you’re earning – no one knows how much your time is worth except for you and we want you to be satisfied with your rate.

Brokers that work with Innovative HIA can set their insurance rates to reflect the market and effort they put into managing their accounts. 

Increase Your Margins by Working with Innovative HIA!

By following these tips as a healthcare insurance broker, you can easily increase your margins. This will allow you to provide even better coverage for your clients while also making more money yourself. So don’t wait, start increasing your margins today!

Get in touch with Innovative HIA today to learn more or read on to learn how brokers can get their employer groups engaged!

At Innovative HIA, we pride ourselves on offering:

  • Affordable Benefits
  • ACA Compliance, and
  • Exceptional Service

Today, we’d like to chat a bit more about the third element—the exceptional service we provide—and why Innovative HIA is, therefore, the gold standard of customer service for Minor Medical insurance providers.

(Hint: Our one-stop-shop benefits portal plays a large role in our successful customer service efforts!)

Let’s dive in.

How Innovative HIA Supports the Onboarding and Offboarding Processes

At Innovative HIA, we support businesses beyond providing Minor Medical coverage. We are proud to support the employee onboarding process so your human resources (HR) teams have more time to focus on the daily tasks that keep your business running.

This is why we offer a complete insurance solution that covers:

  • Implementation
  • Enrollment
  • Administration, and
  • Reporting

Our benefits professionals are fully equipped to support onboarding and offboarding procedures to eliminate the hassle for businesses.

How? Using our benefits portal.

Our Benefits Portal

Employee benefits administration can be a pain for any HR department. At Innovative HIA, we aim to simplify the process by giving you access to everything you need in one place.

Our one-stop-shop portal is proprietary and unlike any other. Our portal grants you access to all of the tools necessary to support a new hire (from beginning to end).

We eliminate the headache of unnecessary paperwork with benefits management portal access. You can:

  • Make plan changes
  • Order ID cards
  • Check claim status online
  • Track onboarding and offboarding
  • And more

Resources are only a click away.

Besides creating a seamless onboarding process with our all-in-one portal, we also provide video tutorials for our partners. These resources provide instructions that assist navigation through the portal.

Read on to view our enrollment portal walkthrough.

Employee benefits administration can be a pain for any HR department. At Innovative HIA, we aim to simplify the process, by giving you access to everything you need in one place. Our enrollment portal houses everything you need for:

  • Onboarding 
  • Off boarding 
  • Enrollment 
  • Portal assistance 

Our employee benefits professionals have the knowledge and expertise that can save your company time and money. We aim to offer comprehensive benefit management, not only with our portal, but also as it pertains to ACA compliance, providing low-cost options, and offering fast and reliable service.

The convenience of SBMA’s employee benefits administration support allows your Human Resources department to work on their daily tasks and responsibilities without the headache of a difficult benefits administrator. Our one-stop-shop portal helps reduce the paperwork your HR department has to deal with and therefore, improves your bottom line.

Employer Resources

Our website is equipped with plenty of employer resources that give easy and secure access to your records and the ability to make plan changes at your fingertips (i.e. (enrollment portal, adding dependents, employee termination, and more). Adjusting benefit plans couldn’t be any easier with SBMA. Additionally, every task includes video tutorials, walkthroughs, and instructions. 


Watch the videos below to see just how easy navigating our portal is. 


Enrollment portal walkthrough


Adding Dependents walkthrough 


Termination walkthrough 



Partnering with us takes the burden off of your HR department and places it on us, your benefits administrator. Ready to get started? Reach out to us today


Innovative HIA supports HR departments with onboarding, off boarding, and more

Article originally published by SBMA Benefits.

The No Surprises Act (NSA) went into effect January 2022. This new law addresses surprise medical billing and requires new disclosures for employers, third party administrators (TPAs), brokers, and all participants in the healthcare industry including, but not limited to:

  • Hospitals
  • Hospital outpatient departments 
  • Ambulatory surgical centers  
  • Payors
  • Providers
  • Facilities 
  • Ancillary providers performing emergency and non-emergency services 

“[Surprise medical bills can] arise in an emergency when the patient has no ability to select the emergency room, treating physicians, or ambulance providers. Surprise medical bills might also arise when a patient receives planned care from an in-network provider (often, a hospital or ambulatory care facility), but other treating providers brought in to participate in the patient’s care are not in the same network.  

These can include anesthesiologists, radiologists, pathologists, surgical assistants, and others.  In some cases, entire departments within an in-network facility may be operated by subcontractors who don’t participate in the same network.  In these non-emergency situations, too, the in-network provider or facility generally arranges for the other treating providers, not the patient.”*

*Surprise Medical Bills, Karen Pollitz (Mar. 17, 2016). 

Now, patients are federally protected against surprise billing for the following services: 

  • Emergency Services *not including ground ambulance* 
  • Post Emergency Stabilization services 
  • Non Emergency Services provided at in-network facilities 

What are the Implications of the No Surprises Act? 

The Consolidated Appropriations Act (CAA), 2021 made major changes in the way that group health plans are regulated and operated. The addition of the No Surprises Act of 2022 adds complex new rules aimed at protecting against surprise billing and beefs up overall group health plan transparency. The many provisions require that plans provide:

  • A robust online price comparison tool
  • Advance explanations of benefits (EOBs)
  • Report claims information to state “all-payer claims” databases
  • Improve the accuracy of plan provider directory information
  • Remove gag clauses in vendor contracts
  • Examine and document compliance with mental health and substance standards
  • Report on pharmacy costs.

In addition, brokers and consultants to group health plans must disclose to plan fiduciaries the direct and indirect compensation they are paid each year. 

Collectively, these new rules impose potentially significant new regulatory and litigation risks on sponsors of group health plans. They also raise the standard for advisors who must keep their clients up to date on, and in compliance with, these new rules.

The new regulation takes the employee out of covering the cost of unexpected medical bills and puts processes in place for employers, insurers, and hospitals to resolve payment responsibilities for out-of-network medical bills. The goal of the No Surprises Act is to support individuals who receive emergency or needed medical services, but end up with a heavy medical bill that puts them in high unexpected debt. 

The new NSA regulations will create increased transparency in medical billing by providing coverage price lists, and potentially creating flat and/or set rates for medical services. The result of the NSA will be that insured individuals who receive medical treatment will not receive higher than expected bills for the treatments they are given. 

What Will the No Surprises Act Mean for Patients? 

Let’s frame the story: 

Andrew falls off the roof cleaning the gutters, the ambulance comes and takes him to the hospital where he is treated for emergency care by an anesthesiologist, a surgeon, and then, post-surgery receives rehabilitation care from a physical therapist.  The anesthesiologist is out of network, the surgeon is in-network and the PT is out of network. The hospital sends a bill to the insurer for $7,100.00.  

The insurer will have an agreed-upon contractual rate that is less than the billed amount, in this case, let’s set that at $4,600.00.  Andrew has insurance with a $1,000 deductible and a 20% co-pay, so he owes $1,720.00. The insurance pays the difference between Andrew’s responsibility and the agreed-upon amount (Contractual Rate) of $4,600.00, so the insurer pays the hospital $2,880.00.  

Before the NSA, the hospital would then bill Andrew not only the $1,720 of his deductible + 20% co-pay but also the additional $2,500.00 to make up the difference between their billed amount and the agreed-upon Plan Recognized amount of $4,600.00. This brings Andrew’s total payment burden to $4,220.00. 

The No Surprises Act would eliminate the ability for hospitals to collect the difference between the Plan Recognized amount and their higher bill.


What Does the No Surprises Act Mean For Employers? 

Employers should have monthly internal governance meetings to go over:

  • Health plans
  • Broker commissions
  • What plans cover
  • What the percentage of enrollment is
  • Every aspect of the health plan design 

Does the No Surprises Act Include Telehealth Services? 

In short, yes, the No Surprises Act does include telehealth services. Patients who see a healthcare provider through a telehealth visit are expected to be charged the in-network rate. 

The Covid-19 pandemic brought on greater demand for telehealth providers, especially in emergency services. As healthcare systems continue to lean on virtual patient services, providers must be aware of preset rates negotiated between insurance contracts and the healthcare network. 

Healthcare finance says it best, “Independent physician groups, which include telehealth docs, must now accept a rate that someone else has negotiated.”

Patients are protected from costly, unexpected fines, however, experts believe these new changes will result in cost shifts in other areas to account for funds. 


What are the Transparency in Coverage Requirements? 

CAA Section 114  dictates that insurance carriers and self-insured plans allow policyholders/participants to compare the amount of cost-sharing they would be responsible for paying for a particular medical item or service.  This tool is to be provided by phone or on a website. 

The Transparency in Coverage (TiC) Regulation permits policyholders/participants to request their cost-sharing liability for a particular medical item or service through an online tool or in paper form. 

Both of these requirements are in place to provide clarity around medical billing for insured individuals.

What does the No Surprises Act Mean for Insurers? 

The transparency in coverage requirements necessitate that group health plans and health insurance issuers in the group and individual markets disclose on a public website in 3 separate machine-readable files the following:

  1. In-Network Rates: Payment rates negotiated between plans or issuers and in-network providers (excluding information related to prescription drugs that are subject to a fee-for-service reimbursement arrangement [reported separately].
  2. Out of Network Billed Charges: Historical pricing information showing unique allowed amounts and billed charges for covered items and services furnished by out-of-network providers.
  3. Prescription Drugs: In-network negotiated rates and historical net prices for all covered prescription drugs by plan or issuer at the pharmacy location level

These files must be updated monthly and must be made available without login, email, password, or other gated requirement to access the information.

What Does the No Surprises Act Mean For Brokers? 

Brokers must make sure they are fully informed about every aspect of the healthcare plans they are selling in order to comply with EOBs.  Additionally, brokers and consultants to group health plans must disclose to plan fiduciaries the direct and indirect compensation they are paid each year.

What Does the No Surprises Act Mean For Plan Sponsors/ Employers?

Internally, increased governance requirements mirror those for 401ks as dictated by the 1974 ERISA Act.  Employers and plan sponsors will be required to have monthly internal governance meetings of their Boards to review plan coverage.  Plan sponsors must know what their plans cover, what their broker fees are and they must provide access to the price comparison tools offered online by insurers.  

These increased internal governance requirements place a burden on the employer/ plan sponsor to be knowledgeable about the coverage offered and create increased liability for failure to implement required internal governance structures, policies, and procedures. 

How Do I Prepare for the No Surprises Act? 

With the NSA in full effect as of January 1, 2022, employers, insurers, and brokers must prepare for its disclosure requirements, internal governance requirements, and adherence to these new, stricter standards. 


As you prepare for the new year, refresh your memory on why millions of Americans enrolled in health insurance this enrollment season, and what it means for you, here. 


Article originally published on SBMA Benefits.