What Health Plans Need to Fix Isn’t What Most People Think

At Medicarians this year, one session stood out for a simple reason:

It didn’t try to predict the future.
It focused on what’s actually breaking today.

Hosted by Brendan McLoughlin, the panel, “Health Plans on the Brink: When Giants Fall and Regionals Fight to Survive,” brought together leaders from across the ecosystem:

• Gregory Robbins – CEO at Synergy Insurance Affiliates
• Joe Tretola – President at Reliasure Insurance Services / COO Agency Pilot
• Pete Blasi – President/CEO My Senior Health Plan

Each brought a different vantage point and industry expertise. We were fortunate to have perspective from FMO leadership, agency operations, and sales enablement technology, to respond to the same underlying question:

What is actually making it harder for health plans to grow, and what needs to change?

The Pressure Isn’t Coming From One Place

Early in the discussion, Brendan framed something that’s easy to miss:

Health plans aren’t dealing with a single disruption. They’re dealing with layered pressure.

• Regulatory changes tightening the market
• Commission shifts impacting carrier and agent behavior
• Higher member expectations for both agents and health plans
• Data that’s fragmented or unreliable
• AI entering the picture faster than most systems can adapt

None of these are new individually. But together, they’re forcing a rethink of how the front end of the business actually works. And that’s where many health plans need to focus.

What We Heard

Health plans aren’t dealing with one challenge. They’re dealing with several at once. We’re seeing challenges with compliance and regulation changes, commission pressures, rising agent expectations, fragmented data, and new technology all happening at the same time. On their own, none of these are new. Together, they’re exposing where the front end of the business isn’t keeping up.

Compliance is a good example. It’s made things harder, but it’s also raising the standard. The market is shifting toward higher-quality agents and more disciplined sales practices. At the same time, agents themselves are rethinking what they value. It’s not just about commission anymore. The best producers are choosing partners based on support—training, tools, and clear visibility into their business.

That’s where a bigger issue starts to show up. Most systems still reward the initial enrollment, while the business is moving toward retention and long-term relationships. And the data that should help bridge that gap often isn’t usable or trusted. When agents can’t clearly see what’s happening in their book of business, they fall back on guesswork.

Technology is starting to change that, especially with AI. Not by replacing agents, but by improving the parts of the business around them—training, service, and operations. In some cases, it’s already outperforming human teams in specific workflows.

The takeaway is simple. Growth isn’t just about products or pricing anymore. It’s about how well health plans support the people responsible for selling and servicing them.

Watch the panel discussion:

Where e123 Fits

This is exactly where e123 focuses.

Not on adding another tool, but on fixing the underlying infrastructure that supports growth.

That includes:

• Agent onboarding and readiness
• Hierarchy and relationship management
• Commission accuracy and transparency
• Enrollment visibility
• Reporting that agents and executives can actually use

Growth doesn’t break because of one system. It breaks in the gaps between them. And that’s where the opportunity is.

Ready to see how e123 and the Abacus platform can fuel your growth? It’s time to see what we can do together: https://e123insurtech.com/book-a-demo/