One City Built to Last

y g. levin
Health Agent says
Everyone’s a Potential Client
When Eric Wilson, president
of I Sell Health, Inc.,
researched health insurance
as a business he
might want to try, he learned that most
people had a very limited familiarity
with the industry.
Wilson opened his company – now
a multi-state operation headquartered
near Chicago – in 2004. To his surprise,
it took longer than expected to get the
business rolling.
Wilson already had experience with
insurance professionals, first working
for an auto-replacement firm and later
for an auto-glass company. After
advancing through the ranks at those
companies, however, he was intent on
going into business for himself.
Still intrigued by the insurance industry,
Wilson considered property and
casualty firms. Initially, he switched
to the health sector because overhead
costs were lower. In health insurance,
an office staff managing claims wasn’t
necessary.
Wilson's first impressions – that the
nature of health insurance seemed arcane
– are still relevant today, with the
implementation of Obamacare, or the
Affordable Care Act (ACA). “Clients
need someone who is knowledgeable
– not just about the products, but also
about ACA law, which changes constantly,”
he noted.
Prior to the ACA, his clientele consisted
mostly of self-employed people
and mom-and-pop businesses. “They
didn’t have corporate health benefits,”
Wilson said, “And because there was
underwriting, they had to be healthy.”
Plans for the self-employed tended to
be catastrophic in nature for cost purposes,
as opposed to products for small
groups that had lower deductibles.
Wilson said, “With ACA, underwriting
disappeared and everyone qualifies
health-wise – a good thing. But we’re
seeing more and more large companies
drop their insurance benefits because
the cost of insurance got higher.”
Compared to the more narrow scope
of the clientele he serviced before ACA,
Wilson said, “Now, nearly everyone is
a potential client.” Wilson also works
with people who have Medicare coverage.
Prior to ACA, carriers filed their
health plans in each state where they
issued policies. Some states had mandates,
requiring areas of coverage, such
as mental health or maternity benefits.
Companies differed from each other
in the benefits they provided. Some
would supplement their plans with
add-on areas of coverage. Other companies
specialized in specific types of
coverage. This variety in what companies
offered ended with ACA. Every
ACA-compliant health plan must have
these 10 essential benefits: (1) ambulatory
patient services (outpatient care);
(2) emergency services; (3) hospitalization;
(4) maternity and newborn care;
(5) mental health services and addiction
treatment; (6) prescription drugs;
(7) rehabilitation services and devices;
(8) laboratory services; (9) preventive
THE SUIT MAGAZINE - NOV 2014