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RON GOLDSTEIN:
"AGENTS WILL CONTINUE TO THRIVE!"
By Meg McComb, 2014-15 CAHU VP Communications
Ron Goldstein, CLU, is President and CEO of CHOICE Administrators which provides health insurance options and provider access to small businesses and their employees. He also created and currently manages America's longest-standing, state-approved exchange California Choice.
MM: With "grandmothering" going away this year, and small group defined as up to 100 lives in 2016, will the California marketplace implode?
RG: No, and agents can help employers, especially those now classified as small group, to understand the changes and chart a course to identify the best options for their employees. Agents provide much needed guidance to small businesses that are putting together or updating their benefits packages.
MM: What are the biggest changes you think agents will experience in the next five years?
RG: These will include working with small businesses to maneuver through narrow physician networks, technology-driven products (e.g. online enrollment, determination of group size, physician directories, Rx search) and more.
MM: How important is technology to agents' future success?
RG: It's critical and provides agents with opportunities to increase their role as valuable experts and resources for employers and employees.Agents need to embrace technology, which can include online quoting engines, provider directories, and tech-driven products. These tools allow agents to simplify processes for employers and employees, resulting in better overall service.
MM: Do you believe private exchanges will be a major factor in the California marketplace in the next 24 months? The next 5 years?
RG: First, we need to define a private exchange. Private exchanges come in different shapes and sizes. Most private exchanges feature a single carrier and technology that aggregates information and services. Once a business is enrolled, the carrier facilitates the claims and day-to-day services. The other model is a multicarrier exchange. The goal of the multicarrier exchange is to offer their groups and their employees a range of carriers and plans. Recent studies from groups such as Accenture point to the increasing dominance of private exchanges. We expect these exchanges to continue to remain a major factor in the California marketplace throughout the next 12 to 24 months.
MM: Do you think carriers will be forced to provide "full networks" in the individual marketplace over time?
RG: Based on the regulatory and legislative environment, carriers will continue to work within that framework and offer better network options to individuals and employees in California.
MM: What do you believe to be the biggest threat to California agents-federal or state mandates?
RG: They are both equal threats and many agents have already seen their books of business decline due to the regulatory environment.
MM: Do you think agents will be forced to charge a fee for their services to sustain their income? If so, how soon?
RG: Most large brokerage firms have been charging consulting fees for years. As commissions decline, agents will have to come up with solutions to keep their income steady. Part of the solution might include charging fees.
MM: Do you believe that all medical insurance enrollments will be online within 24 months? Within 5 years?
RG: Online enrollment is already extremely prevalent in the large group market today. I foresee the online enrollment process becoming more accepted in the small group market in the next five years.
MM: Will Health Care Reform compliance become the biggest reason employer groups dissolve medical insurance programs in the next 5 years?
RG: Our feeling is that the Health Care Reform will not result in a massive exodus in the group market. We're currently seeing micro groups (one to four lives) dissolving their health insurance programs and sending their employees to the state exchanges to purchase their benefits. (Editor's Note: And many are coming back to group coverage once their employees provide feedback about their experience.)
MM: Do you believe the small group market will remain viable in California in the next 5 years?
RG: Yes.
MM: Do you think that Congress will successfully pass legislation to remove agent compensation from the medical loss ratio?
RG: It would be great if Congress is able to successfully pass legislation to remove agent compensation from the medical loss ratio.
MM: What do you think the biggest change in health care delivery will be in the next 5 years?
RG: The biggest changes will include a greater number of network changes and Accountable Care Organizations gaining traction in the marketplace. This will include telemedicine, along with the ability for consumers to monitor and manage their health through online services, where they can schedule their appointments, view test results, x-rays and more. Technology will be at the forefront in how patient care is administered.
MM: If you met a young person considering a career as an insurance agent, what would you say to them?
RG: I would advise a young person considering a career as an insurance agent to identify why they want to be in the market. Then I would ask them to really think about what aspects of insurance interest them - health insurance, life insurance, etc. I would tell them to have a good understanding of newer technologies and their benefits, so that you can provide added value and greater service to your clients.
MM: Do you believe CAHU has played a vital role in preserving the role of the agent in California?
RG: Yes, CAHU has played a vital role in preserving the role of the agent in California. CAHU emphasizes the value and service that agents bring to employers in an era of increasing choices, to address the needs of a changing workforce.
MM: To close, what if you had one piece of advice to give agents, what would it be?
RG: Embrace technology and provide quality service - it remains king!
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