Independent Agent + Advocacy Service

I have worked for a local health insurance agency for 10 years and have had my license for 7. I am striking out on my own with a very small book of business. One thing I have always been interested in is adding an advocacy side to what I do. My old boss and I talked about it often, but I understand that it is a part of the business that would have to be kept completely separate from the health agent side.

I am wondering if anyone here has any insight or tips on how to get more information about doing this properly. To be clear, I am not looking to charge for any of my tasks that are required as an agent. What I am interested in is helping people file appeals, complaints, get to the bottom of messy health insurance claim issues, call providers with issues, etc. Our boss made this a part of our daily job, and I honestly believe that is why our business tanked. We tried so hard, but so much of our time was spent "wasting payroll" on things that were not profitable to us.

Part of my business plan is to make sure my clients are fully educated on how to advocate for themselves. I plan to have all of this information easily available on my website to them, in addition to providing them steps via email, etc. However, I know there are client's who are not going to be able to do that either due to health, age, etc and that is where I would like the advocacy part to come in.

I believe I would need two different tax id numbers and possibly two different business licenses? This is where I need help.

I would like to offer this service to current/new clients and also to people who are not clients who just need help (I definitely get a LOT of those calls). Or, legally would it only be something I could offer to people who are not clients? I would figure out a fair hourly rate for the work to straighten out the issue, and also use a sliding scale for people who are lower income.

And to reiterate again, I am not looking to charge for typical insurance agent duties: provider lists, submitting apps, answering policy questions, etc. I am thinking more along the line of the hours I spend sometimes going back and forth between the billing provider and the health insurance company trying to get things straightened out, that sometimes winds up with a lengthy appeal being filed on the client's behalf and sometimes also results in a complaint with the department of managed healthcare.

Any insight or suggestions you can provide would be very much appreciated. I am in California.

submitted by /u/foremma_foreverago
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