Do I Need an Insurance Broker, or Can I Call Regence or Kaiser Directly?

By Brandon Hoobler | 10/22/2026

Information current as of October 22, 2026.

You can call Regence BlueShield, Kaiser Permanente or any other carrier directly. For small-group plans (1 to 50 employees) and for individual and family plans, the premium is the same whether you buy direct or through a broker. That’s because the broker’s commission is one of the expenses already built into the rates carriers file with the Washington Office of the Insurance Commissioner (OIC). What you give up by going direct is the help: comparisons across carriers, network checks, and someone in your corner when a claim goes wrong.

If you have 51 or more employees, the rules change. We cover that below.

Why small groups and individuals pay the same either way

Washington carriers file their small-group and individual rates with the OIC. When the OIC reviews a filing, it looks at claims, profit and, in its words, “company expenses such as agent commissions.” The commission is already inside the rate.

Three rules keep that rate the same no matter who sells the plan:

Rates can vary only by a short list of factors, such as age, family size and where you live. Whether a broker helped you is not on the list.
Exchange plans carry one price. A plan sold on Washington Healthplanfinder, the state’s health insurance exchange, must have the same premium whether you buy it there, directly from the insurer or through an agent.
No rebates. Washington law bars insurers and brokers from offering a discount, or a share of the commission, that isn’t spelled out in the policy or in a filing with the OIC (RCW 48.30.140).

Put together, going direct doesn’t get you a lower price on the same plan.

One exception: level-funded plans are partly self-funded and priced on your own group, so they aren’t priced from the shared small-group rates described here. If you’re weighing level-funded against fully insured, ask how the broker’s pay is built into that quote.

Where small group ends, and why larger groups are different

Washington defines a small employer as one that employed an average of 1 to 50 employees during the previous calendar year (RCW 48.43.005). Affiliated companies count together, and you keep small-group status until the plan anniversary after you outgrow it. At 51 or more, you’re in the large-group market.

Here, pricing is usually negotiated. The OIC says most employers with 51 or more employees “negotiate the rates with their insurance company,” and Washington law lets large-group plans and their rate schedules be negotiated between the carrier and the employer and filed afterward. For mid-size and large groups, the broker’s commission is negotiable too.

So ask how your broker is paid. Federal law covers any broker or consultant who expects $1,000 or more in compensation for work on a group health plan. They must tell the employer in writing, before the contract is signed or renewed, what they’ll be paid directly and indirectly. That rule comes from section 202 of the Consolidated Appropriations Act, 2021, and took effect December 27, 2021. The Department of Labor says it covers insured and self-insured plans, with no exception for small plans. It applies to plans covered by ERISA, the federal benefits law, so it generally doesn’t reach government or church plans. Our guide to switching brokers covers what the disclosure should include.

What a broker adds

Research

Before quoting, we learn your workforce: ages, where people live, pay levels, turnover and what you can put toward premiums. Then we match that to the market. The answer might be a standard group health plan, a level-funded plan, a high-deductible plan paired with a health savings account (HSA), or an ICHRA (individual coverage health reimbursement arrangement), where you give each employee a monthly allowance toward an individual plan. A carrier rep knows its own plans in depth, but its job is to show you that carrier’s options.

Price comparisons

We run one census (your list of employees with ages, ZIP codes and who each person covers) through several carriers and put the quotes side by side. Small-group rates use the same rating factors at every carrier, so one census gives you quotes on the same footing. A carrier can quote only its own plans.

Network comparisons

A plan only works if your people can use it. We check whether employees’ doctors, hospitals and prescriptions are covered where they live, not just near the office. Service areas vary: the OIC’s list of small-group carriers shows that some serve the whole state and others only certain counties. Our Premera vs. Regence vs. Kaiser guide shows who sells where.

Claims and customer service

When a claim is denied or billed wrong, an ID card doesn’t arrive, or an employee shows up as ineligible, you call us and we work it with the carrier, escalating when needed. The carrier still decides the claim. Our job is to get you a clear answer and help with an appeal if you need one. We also handle adding and removing employees, questions through the year, and each renewal.

What a direct call to one carrier gets you

You’ll reach people who know that carrier’s plans well, and the OIC confirms that a small business can buy directly from an insurance company. The limits are practical:

You see one carrier’s plans, with nothing to compare them against.
Checking networks against your employees’ doctors is up to you.
You manage enrollment, paperwork, changes and renewals yourself.

Going direct can make sense if you already know exactly which plan you want, you’ve checked the network, and you’re comfortable handling the paperwork. That’s a reasonable choice.

Agent, captive agent or independent broker?

In Washington, agents and brokers hold the same license: insurance producer. A producer can act as an insurer’s agent only after that insurer appoints them.

A captive agent sells for one company.
An independent agent or broker is appointed with several carriers, so they can compare them for you.
A benefits broker is an independent producer who focuses on employer plans and keeps serving the account after the sale.

That appointment is also why Washington law treats a producer as the insurer’s agent for business placed with that carrier. Here is what that means for whether your broker is working for you.

Buying your own plan

Individuals and families have two direct routes. You can apply yourself on Washington Healthplanfinder, online or by phone, or buy off the Exchange straight from a carrier. Insurers that sell on the Exchange must offer their plans off the Exchange if you ask.

Before you buy off the Exchange, check whether you qualify for financial help. Premium tax credits apply only to plans bought through the Exchange.

Healthplanfinder’s help page says brokers can recommend a plan, explain financial help and verify whether your providers are in network, and that many brokers don’t charge for that help. Open enrollment for 2027 coverage runs November 1, 2026, to January 15, 2027. Sign up by December 31 for a plan that starts January 1. Our Healthplanfinder guide walks through the steps.

How we work

No fee for our services. Carriers pay us. Third-party administrators, for example for COBRA or compliance filings, may bill their own fees directly, and we’ll tell you about any such cost before you sign up. We also give you a written compensation disclosure for every carrier we work with.
Side-by-side comparisons for employers with 5 to 500 employees, and for individuals and families on and off Healthplanfinder.
Carriers we quote for employer medical plans: Premera Blue Cross, Regence BlueShield, Asuris Northwest Health, Kaiser Permanente, UnitedHealthcare, Aetna, Cigna Healthcare, Nationwide and Angle Health. Which ones can quote your group depends on your size, location and how you want to fund the plan.
Carriers we quote for individual and family plans: Premera Blue Cross, UnitedHealthcare, Molina Healthcare, LifeWise, Wellpoint, Regence BlueShield and Kaiser Permanente.
Association and trust plans for eligible members. These include Business Health Trust and Washington industry trusts such as the Washington Farm Bureau Healthcare Trust and the WTIA Employee Benefit Trust.
Service all year, including online enrollment through Employee Navigator, claims help and renewals.
Local and statewide. We meet in person around Puget Sound and by phone or video anywhere in Washington.

Questions we hear

Do health insurance brokers charge a fee?

A broker can be paid by carrier commission, by a fee from you, or both. If a broker charges a fee, Washington requires written disclosure before the sale. We charge no fee for our services.

Is it cheaper to get health insurance through a broker?

For the same individual or small-group plan, no. The premium is the same either way, and a broker can’t lower the price of a given plan. What a broker can do is show you more plans, so you can weigh premium, network and deductible together.

Can I buy health insurance directly from the insurance company?

Yes. Small employers can buy directly from an insurer, and individuals can buy off the Exchange from a carrier. If you might qualify for premium tax credits, apply through Washington Healthplanfinder, because the credits apply only to Exchange plans.

What’s the difference between a health insurance broker and an agent?

In Washington, both are licensed as insurance producers. The practical difference is reach: a captive agent sells for one company, while an independent broker can compare several.

We have 80 employees. Is our premium the same with or without a broker?

Not necessarily. Groups of 51 or more usually negotiate rates with the carrier, and the broker’s commission is negotiable. Ask your broker for the written compensation disclosure federal law requires. We provide one for every carrier we work with.

Compare your options with us

Want to see your plans side by side before you decide? Call (206) 653-9636 or request a no-obligation quote. We charge no fee for our help.

About the author

Written by Brandon Hoobler, founder of Washington Insurance Brokers and a licensed Washington insurance broker (WA OIC #824207, verify a license). He has worked in insurance since 2009 and helps Washington employers with 5 to 500 employees compare group benefits. Questions about your plan? Call (206) 653-9636.

Sources

Posted in Employee Benefits, Individual & Family