The Role of Agents as a Source of Information

Health Insurance agents and brokers have been very supportive of the creation and development of Inclusive Health. They understand better than anyone the importance of having decent, affordable health insurance coverage - especially for individuals with pre-existing conditions. For this reason, agents and brokers are a critical source of information and referral of eligible individuals to Inclusive Health.

Agent Referral Fee - Federal Option
Inclusive Health will pay agents a referral fee for each individual approved for Inclusive Health, whom they have provided information to about the Risk Pool. The referral fee will be as follows:

• For APPROVED and ACTIVE Policies 1-4 - $ 150.00



• For APPROVED and ACTIVE Policies 5 and up - $ 200.00 Based on calendar year

The number of applications referred for the Federal Risk Pool will be separate from the State Option. The total number of applications will reset each calendar year and the accumulation of the applications will start each January.

Payment will only be made for applicants upon approval for eligibility in Inclusive Health. Payment will be made on the 15th or 30th of the month following the effective date of an application.

Eligibility for the fee is limited to North Carolina licensed agents who are properly identified by an applicant in Section V of the Inclusive Health enrollment application. Please refer to Section V of the Inclusive Health Enrollment Application for further information.

Agent Responsibilities:

• Informing and educating individuals about Inclusive Health eligibility and benefit plans


• Ensuring that the Inclusive Health application is completed and submitted with all necessary paperwork


• Ensuring that the Inclusive Health application is completed on-line


• Following up on any outstanding information needed to complete the application


• Submitting a copy of your Life, Accident and Health License issued by the Department of Insurance


• Submitting a copy of your W-9 and tax information the first time you assist with the completion of an application.

Unfair Referral to the Pool
Under North Carolina law it is unfair trade practice to refer an individual to the pool or arrange for an individual employee to apply to the Pool for the purpose of separating that employee from a group medical care benefit plan provided in connection with the employee's employment. This section shall not prohibit an insurer or insurance producer from informing an individual of other coverage options, including coverage provided by the Pool.