20.03.2015 Views

One City Built to Last

The news is in: On November 7, 2014, the justices announced they would decide on a lawsuit claiming that the language of the Affordable Care Act doesn’t allow the government to provide tax-credits to low-and-moderate-income health insurance consumers using federally funded Obamacare exchanges operating in more than 30 states. Indeed, there’s a medical quagmire. And there is a lack of communication between doctors, staffing and patients. For example, the Affordable Care Act isn’t just about insurance coverage. The legislation is also about transforming the way health care is provided. In fact, it has brought in new competitors, services and business practices, which are in turn producing substantial industry shifts that affect all players along health care’s value chain. Read Amy Armstrongs story on page 16. On page 21, our reporter Judy Magness, profiles companies all over the country making incredible advances. Take a look at Functional Medicine and the driving breakthroughs in breast cancer while

The news is in: On November 7, 2014, the justices announced they would decide on a lawsuit claiming that the language of the Affordable Care Act doesn’t allow the government to provide tax-credits to low-and-moderate-income health insurance consumers using federally funded Obamacare exchanges operating in more than 30 states. Indeed, there’s a medical quagmire. And there is a lack of communication between doctors, staffing and patients. For example, the Affordable Care Act isn’t just about insurance coverage. The legislation is also about transforming the way health care is provided. In fact, it has brought in new competitors, services and business practices, which are in turn producing substantial industry shifts that affect all players along health care’s value chain. Read Amy Armstrongs story on page 16. On page 21, our reporter Judy Magness, profiles companies all over the country making incredible advances. Take a look at Functional Medicine and the driving breakthroughs in breast cancer while

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services; and (10) pediatric services.<br />

“Choosing a plan is a little easier,”<br />

Wilson said. Clients view side-by-side<br />

comparisons of carriers on his company’s<br />

website. They can look at co-pays<br />

– how much, for example, one carrier<br />

requires, as compared <strong>to</strong> another.<br />

“In 2011,” Wilson said, “commissions<br />

were cut in half.” He<br />

had <strong>to</strong> reduce his costs and add<br />

new products <strong>to</strong> sell – all part of<br />

changing his business model.<br />

With underwriting then, “if you<br />

wrote 100 policies, maybe 90 percent<br />

qualified,” he said. “Of the<br />

remaining 10 percent, maybe 7<br />

or 8 percent would qualify with<br />

a rate-up.” That is a policy surcharge<br />

<strong>to</strong> accommodate a potential<br />

client’s medical condition.<br />

If people were not going <strong>to</strong> be<br />

able <strong>to</strong> qualify or had limited<br />

resources, then agents couldn’t<br />

spend <strong>to</strong>o much time with them. Time<br />

was critical when, as Wilson put it,<br />

“You had <strong>to</strong> write a lot more policies.”<br />

“As ACA emerged in 2014, commissions<br />

were cut again,” he said. “Though<br />

premiums increased, it wasn’t enough<br />

<strong>to</strong> offset the reduction in commissions.”<br />

Yet, agents no longer had <strong>to</strong> consider<br />

how a carrier would view a potential<br />

client with a pre-existing condition –<br />

underwriting was gone.<br />

“Another change affecting how<br />

agents conduct their business,” Wilson<br />

noted, “is a shrinking selling season.<br />

<strong>Last</strong> year, open enrollment was Oc<strong>to</strong>ber<br />

<strong>to</strong> the end of March. This year, it’s<br />

November <strong>to</strong> February.”<br />

Wilson said that he wrote about 250<br />

applications during the open-enrollment<br />

period last year. In the first eight<br />

months of 2014, he has written 200 applications.<br />

“And, the number of carriers has<br />

diminished,” he said, remarking that<br />

they’ve gone out of business, or more<br />

likely, have left the health-insurance<br />

market.<br />

With its 10 essential health benefits,<br />

ACA has moved the industry <strong>to</strong>ward<br />

uniform standards. “Yet, state control<br />

of pricing should exist,” he said. “Some<br />

states – like Alaska and Florida – just<br />

have different needs.”<br />

“In an ideal world, you’d make every<br />

carrier offer the core benefits, but<br />

you’d get <strong>to</strong> choose what you think you<br />

need.”<br />

When he started in the business, Wilson<br />

said that he’d sit down with<br />

as many people as he could <strong>to</strong><br />

acquire clients. No-shows meant<br />

time wasted. On other occasions,<br />

he’d drive distances <strong>to</strong> see potential<br />

clients, sell the policy, and<br />

then the new client would cancel<br />

it almost immediately. “People<br />

felt compelled <strong>to</strong> buy because you<br />

had driven out <strong>to</strong> see them.”<br />

Contemporary technology like<br />

electronic signatures and web<br />

conferencing, has changed all<br />

that. “There’s no pressure with<br />

online meetings,” he said. Wilson<br />

also blogs <strong>to</strong> drive traffic <strong>to</strong> his<br />

website, writing <strong>to</strong>pical essays,<br />

such as “Not all Cancelled Health Insurance<br />

Policies were ‘Junk.’ ”<br />

I Sell Health, Inc.<br />

Office: 815-372-1363<br />

Toll Free: 888-448-5370<br />

www.isellhealth.com<br />

THE SUIT MAGAZINE p.43

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