Reform Equals Opportunity

As the stress of complying with the Affordable Care Act puts some smaller employee-benefits brokers out of business, National Healthcare Access has used the transformative law as a chance to thrive

It started more than twenty-five years ago. Two brothers, Michael and Frank Caparso, had been working for major insurance companies when they were recruited to do contracting with a managed-care company. However, the extensive travel took a toll on their young families, so after a few years they decided to set off on their own—and National Healthcare Access Inc. (NHA) was born.

NHA started off as a managed-care consulting firm but has evolved to derive most of its revenue from selling health plans to employers. With clients in twenty-five states and about forty employees in offices throughout Ohio, Nevada, and California, it generally works with groups of fifty employees or more. Since its founding, it has adapted with the changing healthcare environment and developed a track record of success, recently landing on the Inc. 5000 list of the nation’s fastest-growing companies.

“The fact that we’ve strictly stuck with employee-benefit plans–that has really done more to have us stand out in the field than all the investments we’ve made.”

Harnessing that growth has become one of the company’s main areas of focus. The company has been busy the last few years keeping up with new Affordable Care Act (ACA) provisions while continuing to expand, and it plans to double revenue by 2020. That aggressive growth will require acquisitions of smaller firms, which NHA already has done.

“With a growing business and the added compliance issues brought on by the ACA, we’ve had to make a ton of investments internally in software, technology, and additional personnel, just to support the clients we have on the books,” says Michael Caparso.

The company has actually doubled in size since the ACA was passed, thanks to the firm’s sole focus on employee-benefits plans. Prior to reform, employers may have purchased health insurance from the same agent who wrote their car insurance, but the ACA has demanded more attention from brokers to ensure companies are in compliance and getting the best value for their money. “It’s obviously put a lot of stress on the organization,” Caparso says. “We’ve had to really invest in resources to accommodate that.”

Much of the investment has centered on technology and creating online platforms as the industry transitions to become more paperless. For example, enrollments and modifications are done electronically now, and clients have a one-stop solution for HR functions as they pertain to benefits. One such initiative that NHA implemented in 2015 is called the Employee Navigator mobile app.

“We kind of got ahead of that a little bit and started investing in technology a few years back, when we saw this wave coming,” Caparso says, “but we continue to do so.”

Larger employers are increasingly conscious of the compliance issues associated with the ACA, and many are transferring the responsibility to their employee-benefits broker. NHA has had to contract with outside law firms and has brought attorneys on staff to handle those needs. In addition, it has spent the last three years conducting educational seminars across the country, helping current and prospective clients gain a better handle of the law and its implications.

All of these initiatives are reflective of the company itself, which has a history of taking changing landscapes in stride. NHA was able to weather the recession better than some of its competitors, since it didn’t have exposure in a lot of the markets that collapsed, such as construction or casinos in Las Vegas.

“It wasn’t something that we were conscious of—that we said, ‘Oh, let’s not insure casinos or contractors’; we just didn’t have any,” Caparso says. “So it kind of buffered us when the economy fell apart. And when it started picking back up again, since we were a survivor, we actually started getting those types of accounts.”

NHA has set itself apart  from competitors by concentrating on a single line of insurance. Caparso and his brother started off in health because that’s all that they knew, and though they were tempted to diversify, they never got to the point where they thought they’d be able to branch out while maintaining credibility.

“The fact that we’ve strictly stuck with employee-benefit plans—that has really done more to have us stand out in the field than all the investments we’ve made,” he says.

Caparso also credits the success to quality personnel and a low turnover rate among both employees and clients. Its customer retention rate is more than 90 percent.

“That’s really been the cornerstone of our company,” he says. “You get to a size where it’s no longer a by-product of whatever efforts Frank and I have made. It’s more of a by-product of what our entire team has done.”