What must an agent review with a consumer prior to completing an enrollment application?

Prior to completing an enrollment application, it is essential for an agent to review the plan’s network characteristics and potential costs with the consumer. This step is crucial as it ensures that the consumer understands the specifics of the plan they are enrolling in, including the healthcare providers available within the network, the services covered, and any associated costs they may incur, such as premiums, deductibles, and co-pays. This understanding is vital for the consumer to make an informed decision about their healthcare options, thereby promoting transparency and trust in the enrollment process.

While factors like a consumer's previous insurance history, the agent's commission structure, and eligibility for government assistance are important in the broader context of healthcare decisions, they do not hold the same immediacy as reviewing the specific network and cost details of the plan being considered. Being informed about network characteristics and potential costs directly impacts the consumer's experience and satisfaction with their chosen healthcare coverage.