The Role. of the Financial Advisor Under the Affordable Care Act
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- Randell Holt
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1 The Role of the Financial Advisor Under the Affordable Care Act Presented by: Daniel R. Meylan, ARM National Sales Director Allied National Overland Park, KS 11142s0413 Edition
2 Daniel R. Meylan Insurance Professional Since 1973 P&C and Benefits Broker Agency Owner Company Senior Executive Acquisitions and Valuations Self Insurance, Captives, RRGs Bank Agency Operations Husband, Father, Grandfather 2
3 Group Healthcare Market Source BLS 2012 Government & Military not included FIRMS 99,000 1,100,000 4,500,000 5,699,000 Large Group > M FTES Small Group >10 < M FTEs Baby Groups < M FTEs TOTAL 111.9M FTEs FTES 65% 24% 11% 100% 3
4 Components of Rate Shock Impact of the Affordable Care Act Increases Cost 4
5 ObamaCare Rate Shock 5
6 Projected Fully Insured ACA Compliant Small Group 5-Year Premium (25 Life Group for illustrative purposes only) Year Fully Insured ACA Compliant 2013 $165, $231, $289, $323, $362,671
7 The New Role Healthcare (financial) Advisor 7
8 Agent vs. Healthcare (Financial) Advisor Skills Health Insurance Agent CURRENT Healthcare Advisor FUTURE Benefit Plan Design Marketplace Options Carriers, Networks Price Modeling ACA Compliance & Exchanges Long Term Strategic Planning Risk Financing (Self Insurance) Risk Management (Wellness) Medical Underwriting Claims Management Employer Cost Allocation HIPAA Compliance ERISA Compliance Employment Law
9 Health Insurance Agent Skills Plan Design Carrier Access and Networks Spreadsheets Fully insured policies Commissions 9
10 Healthcare (Financial) Advisor Additional Skills ACA compliance Exchange functionality Long-term financial planning Risk financing Self insurance Risk Management Medical Underwriting Claims Management Employer internal cost allocation HIPAA compliance ERISA compliance Employment law 10
11 ABC Janitorial Financial Impact 2012 Annual Revenues - $3.2M 2012 Pre Tax Profit $512K (16%) 2012 FTEs Employees with health insurance Employers Cost Group Health $98,000 IMPACT OF THE AFFORDABLE CARE ACT 2014 Estimated Annual Revenues $3.8M 2014 Estimated Pre Tax Profit $218K (6.8%) 2014 Employees offered health insurance Employers Cost Group Health $390,000 11
12 Projected Fully Insured ACA Compliant 50+ Group Total Premium (165 Life Group for illustrative purposes only) Year Fully Insured ACA Compliant (Employer only cost) 2013 $98, $390, $429, $472, $519,000
13 Advisor Communications Challenges Misinformation Regulatory interference Regulatory complexity Lingering uncertainty Ignorance Media distortions Affordability Volatile political responses Non-functional exchanges 13
14 Using ACA to Grow Your Revenues and Profits Build ACA Expertise Embrace and learn self funding for small employers Build fee for services model Sell ancillary financial products Discontinue low revenue, low margin business Partner with competent resources: General Agents Carriers TPAs Larger agencies 14
15 P&C w/benefits Key Agency Metrics Agency Size $1.25M $ M $ M $5.0-10M $10-25M EB Rev $68,000 $158,000 $405,000 $1,173,000 $3,525,000 % of Rev 8.5% 8.7% 11.9% 17.5% 22.6% Producers Account Exec. Support Staff Total Benefits Staff EB Rev/FTE n/a $59,000 $126,000 $158,000 $163,000
16 Critical Agency Operational Metrics Financial Advisor Practice Revenue per policy, per client, per transaction Service hours per client Revenue per hour Cost per hour Agency billing rate Fee structure Producer compensation Staff compensation Client retention rate 16
17 Employee Benefits Annual Agency Revenue per client Large Group >100 $15,000 to $200,000 Small Group Baby Groups Individual <10 $4,000 to $40,000 $100 to $2,000 17
18 Is the ACA a PROBLEM or OPPORTUNITY? 18
19 It is a problem if you are unwilling to... learn adapt work longer and harder tackle adversity 19
20 It is an opportunity if you are willing to... change your thinking learn New ideas New process New skills tackle adversity seek competent help and support build trust by being truthful serve your client Change always comes bearing gifts. 20
21 Final Comments... The True Financial Advisor Will THRIVE The Health Insurance Agent Will DIE 21
22 Suggested Resources for information on the ACA offered by: (Department of HHS) (Kaiser Foundation) (Health Insurance 101) (Employee Benefit Advisor) (Human Resources Professionals) (Self Funding) 22
23 Online: Phone: (678) (Tom Guzzardo) Allied On the Air Topics s0413 Edition
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