“Most Americans don’t know this, but when you leave the United States, your US health insurance is pretty much worthless.” James D. Smith regales that point with the tone of someone who’s just learned it for the first time, but he’s known that for years. Smith, who runs Global Benefits LLC with operations out of his northwest Indianapolis office, his home in Fishers, and anywhere else with an Internet connection, has carved an interesting insurance niche for himself in an otherwise tumultuous insurance market.
“I saw the writing on the wall for US health insurance in the early 2000’s, after the demise of HMO’s. It was just too unsustainable the way our healthcare works. It just looked bad to me,” says Smith. In 2004 Smith looked to a new part of the industry. After decades selling individual and group health insurance policies, Smith went to work for an international insurance company as their corporate marketing director. It was here Smith spent time working with clients and other brokers, often asking them how they got started in business, what techniques they used, and learning every bit of information he could while on the job. Six years later in 2010 Smith went out on his own to form Global Benefits LLC, just as President Obama signed the Affordable Care Act into law. “The whole focus of Global Benefits LLC was exclusively international insurance,” says Smith.
It sounds like a market too small to notice, but history routinely shows businesses that focus on a niche develop skills and success for decades. For clients like global organizations, missionaries, expatriates, international students, and frequent business or pleasure travelers it can be difficult finding expert help. It’s a uniquely specific market that requires brokers to navigate things many rarely if ever do, like language barriers, currency exchanges, global healthcare systems, and customs and immigration procedures. This is why, Smith says, “Even if your health insurance policy states that it provides international coverage, it’s one thing to pay a claim after the fact when you return to the US, it’s an entirely different matter when you’re with dealing with a crisis. Because when things go bad abroad…they go really bad.”
Smith adds, almost as if he’s seen this scenario happen, “Say you’re in Africa and on vacation and you fall off a mountain and break your leg. You get air-lifted to a local hospital. The meter’s running from the moment your medical and evacuation care begins. You better have an unlimited American Express card because they’re going to want payment or assurance of payment immediately. When you have travel insurance the staff of the travel insurance company is fully equipped to handle the rescue, paying it, dealing with the hospital, the in-country medical staff, and deciding if you need to get someplace else for better care, and paying for your care via wire transfers. There’s a lot of moving parts. Even if you’re going to Canada or the Bahamas, you better have something in place. Plus, a lot of countries won’t even let you come in without proof of travel insurance.”
Smith’s Global Benefits extends beyond the relatively modest costs and profits of travel insurance to helping expatriates living abroad or in the US. “Frequently there are students studying in the US who can’t get US health insurance, or a business with three or four employees working and living abroad in need of International health insurance that covers them anywhere they go in the world,” says Smith. International health insurance is still one area where underwriting is required and an area where Smith has become skilled at recommending policies to people that meets their budget. Corporations or humanitarian groups may also opt for liability insurance to protect against alleged negligence and lawsuits.
“I’m 61, and when I started this business I wanted a business where I could live anywhere I wanted to. I wanted that freedom.” Today, Smith is married to his wife of forty years, Janice, who enjoys working as an artist. They have two children: a son who just finished medical residency in Cincinnati and a daughter who recently graduated from IU Bloomington and is working as a sales rep for a beverage distributor.
Smith may have moved away from the traditional health insurance industry at a time others may envy in retrospect today, but changes from the ACA still have an impact. Smith says a lot of the ACA “was left to administrators and bureaucrats to decide what it all meant after the law was passed. Regulations were just recently passed requiring US expatriates living abroad for less than 11 months of the year to also purchase US health insurance.” Which means a US citizen living in Asia for 10 months every year is required to purchase US health insurance or face a tax penalty here at home. Wealthy business and leisure travelers can often absorb paying for insurance twice, but students and missionary or faith-based workers likely feel a stronger pinch to their often tight travel budgets.
In July 2016 Smith began a new position as Board President for the Indianapolis Association of Health Underwriters after just two years of regularly coming to events. “I’ve always known about NAHU. The driving factor to join when I did was because I needed more time with my peers. I was getting really out of touch with my own industry. A lot of the relationships I had in the past had disappeared,” says Smith. Past IndyAHU president Jennifer Mitchen invited Smith to lunch which ultimately led him to a leadership role as Communication and Technology chair for the last two years.
After having a prescient awareness of the health insurance market’s future in the early 2000’s, Smith is looking ahead again for IndyAHU. “Most brokers that had been doing just health insurance have had to expand their product portfolio’s now or they die. I would like to see us do more to network with other organizations in our industry and foster joint collaboration. I’d like to see us focusing on helping the brokers that are still doing this kind of work and giving them practical 2016 tools to help them sell. While the legislative piece is important, I personally have concern and care for NAHU members growing their business.”
Smith enjoys success from learning about and focusing on something most other brokers only dabble in because of the complexity and time commitment required. “This has allowed me to work with brokers on an individual basis. And since I’ve been involved in NAHU and IndyAHU I’ve got more and more local brokers asking for my help,” says Smith, adding, “When selling international insurance, especially international employee benefits, it can take an extended period of time, sometimes years, to close the deal. I have a tolerance for these long-term cases and long-term projects.”