Health Benefit Advisor (Individual & Family Plan Insurance)

Overview

The IFP Health Benefits Advisor serves as a trusted resource for individuals and families seeking health insurance coverage through the individual marketplace, both on- and off-exchange. This role involves guiding clients through plan selection, enrollment, renewals, and ongoing service needs, with a strong focus on compliance, accuracy, and exceptional customer experience.

Key Responsibilities

• Client Consultation & Support
• Provide personalized consultations to individuals and families to assess their health insurance needs.
• Educate clients on available health insurance options, including ACA-compliant plans, subsidies, and off-exchange alternatives.
• Assist clients with the application and enrollment process during open enrollment and special enrollment periods.

• Plan Evaluation & Recommendation
• Analyze plan benefits, networks, costs, and eligibility to recommend suitable coverage options.
• Compare plan options based on the client’s health status, budget, and provider preferences.
• Explain key differences between bronze, silver, gold, and platinum plans, as well as HMO, PPO, and EPO networks.

• Compliance & Documentation
• Ensure all applications and communications comply with federal and state regulations (e.g., CMS, FFM, and state-based exchanges).
• Maintain accurate records of client interactions, plan selections, and documentation in CRM or agency management systems.
• Complete annual certification and training (e.g., FFM Certification, AHIP, or other applicable licensing).

• Customer Service & Retention
• Serve as the primary point of contact for clients regarding billing issues, provider network changes, and claims concerns.
• Conduct annual reviews with clients to ensure continued satisfaction and optimize coverage.
• Proactively identify opportunities for cross-selling supplemental health products, dental/vision, or life insurance.

• Collaboration & Outreach
• Partner with marketing or outreach teams to support lead generation efforts and educational events.
• Collaborate with internal teams (e.g., Group Benefits, Medicare) to refer or receive clients based on life stage or eligibility.

Qualifications
• Active Health Insurance License (as required by state law). (Not necessary, but preferred)
• 1–3 years of experience in health insurance sales, advising, or client services preferred. (Not necessary, but preferred)
• Knowledge of ACA guidelines, state and federal marketplaces, and individual/family health insurance options. (Not necessary, but preferred)
• Strong interpersonal skills with the ability to build trust and rapport quickly.
• Proficiency with CRM systems, enrollment platforms (e.g., Healthcare.gov), and Microsoft Office Suite.

Preferred Attributes
• Bilingual (Spanish or other language) a plus.
• Previous experience with FFM Certification or state exchange platforms.
• Ability to thrive in a fast-paced, client-focused environment with seasonal workload spikes.

#LI-SM1