Inside the Industry Health Insurance Video Series

AI & the Transformation of Health Insurance with Sam Melamed

Join Sam Melamed, Chief Insurance Nerd for NCD, and Allison Babberl, Content Marketing Manager at AgencyBloc, for a discussion about the role of the health insurance agent and the growth of AI. The presenters explore the evolving landscape of the health insurance industry, the impact of AI technology, the importance of community engagement, and the necessity for agents to adapt to new tools and information to remain competitive. The conversation emphasizes the need for agents to embrace their roles as educators and storytellers in a complex healthcare ecosystem, while also preparing for future challenges in the industry.

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Inside the Industry: AI & the Transformation of Health Insurance with Sam Melamed

Inside the Industry is a recurring video series hosted by AgencyBloc to take an insider's look at the health, group benefits, and senior insurance industry. Learn more about what's happening right now, what it means for your agency, and how your team can stay ahead of these changes.

Transcript for the Episode

Note: AB denotes Allison Babberl, and SM denotes Sam Melamed.

Allison Babberl: Welcome, everyone, to another edition of Inside the Industry. As always, I'm Allison Babberl, the Content Marketing Manager here at AgencyBloc. And I am joined by another great person, pioneer of the insurance industry. Sam, we were talking about 21 years in the insurance industry. Of course, Sam Melamed, Chief Insurance Nerd. I love that title. I think that's the best title you can have, the CIN of NCD. Thanks so much for joining me today, Sam.

Sam Melamed: Pleasure, Allison. It's great to be with you.

AB: Great to be with you, too, and I really enjoy just all the life behind you. You got that great photo of your family behind you and then what's all over the whiteboard? The we something ABBA, is that ABBA for the band?

SM: No, it's not. Abba is Hebrew for dad. And so that's the sign my kids made me of some reasons they love me.

AB: That's so cool. Is it pronounced Abba? Very cool.

Well, we'll jump right into it. I know a lot of people have questions about what's going on and just want more insight into what's happening in the industry, how they can stay afloat, and how they can stay competitive. So my big question for you, Sam, is how did the role of an insurance agent change this year — 2025? We saw a lot of changes. But how did the role of the insurance agent change?

SM: So I'll share some broad themes that we experience in our corners of the market, but I think these really would resonate with any type of agent. I know you have clients who are on the group side, who are on the individual Medicare and the ACA side. I think AI for sure is one of the most important topics that's really taken off. I get a note every day, every week from some new AI company who wants to pitch us their wares. And although I don't have the bandwidth to meet with all of them. It is very cool to see the rate and speed at which the technology is progressing. And so I think this is really the year where we're starting to hear a lot more agents, including old school, older agents say, yup, I'm using AI. At least for my personal production. At least for polishing my emails or coming up with marketing slogans or thinking about targeting, but also understanding a lot of the legislative regulatory changes that are coming this year. And so it's certainly going to be true next year, even more so, that if you as an agent are not using AI, and I'm not talking about big enterprise-wide AI, but I'm talking about just having a paid account on one of the core AI chat apps. To be able to leverage its knowledge base, to increase your efficiency, then you're probably going to fall behind.

And at the same time, outside of AI, we do see tech just becoming more and more a core part of what is necessary for quality agents. And so you see this same concept in the medical field. Doctors are frustrated that they spend so little time treating patients because they're doing so much paperwork and they're dealing with prior authentication and they're taking so many notes. And you kind of see the same thing in an agency, where agents, who are leveraging technology to be more effective, are going to have a lot more of their time available to prospect or to meet with their clients or to do the research necessary to become the real experts that their clients rely on. And those who don't adapt fast enough to technology, they're just going to have less density of their time available for actually selling insurance. So I'd say that was broadly one of the key things.

Think anyone in healthcare, certainly in health insurance has seen just the broad strokes of what the vibes are in healthcare shift even more negative over this last year. And so the role of the agent has to shift with that as well. Agents are often the "Chief Apology Officer" for all of the products that they may introduce their customers to. They are the "throat to choke," so to speak, when something goes wrong. And, you know, certainly with the killing of Brian Thompson and even more unfortunate, you know, the glee that some people in this country responded to that with, I think was a wake-up call to insurance agents. That they're all torchbearers. They all have to tell an effective story, and have to be part of the rebrand of healthcare in a positive way. And so I think there are people who sell insurance who sometimes are embarrassed about that. When they're at a party and someone says, what do you do? It's not the way they describe what they do. Well, I consult around healthcare and...

I say, no, go right at it. I am proud to be an insurance agent. I am proud to represent customers, to bring great products to them. To use my expertise to really evaluate the market, think about the risks that they have, think about their operational considerations, and bring that to them. And so I think at this time with the vibes being so negative in healthcare, the role of the agent is also to be an important and effective storyteller. And then the last thing I'll say, my friend Sachin Jain, who's the CEO of Scan Health Plan, often talks about and has written a few times about this concept of a broker or an agent as a community health worker. And that really is true, whether you're in Medicare or ACA or group benefits, The transaction for which you earn your fee might be selling someone an insurance policy. That might be the thing you got paid for, technically. But the areas where you're adding value are all the hundreds or thousands of hours that you're spending helping your clients really navigate the healthcare ecosystem. And it is dizzying how confusing the ecosystem is. And so for agents and brokers to both improve the brand and tell a better story. I think doubling down on the community health worker concept is a great way that agent life has changed somewhat in the last year.

AB: Definitely. I think two things you said, Sam, we'll touch on AI in a second, but the first, you are part of the community, right? And I think that's just such a really critical thing for agents, no matter what you sell, whether you sell to seniors, you sell to families, you sell to groups, small groups, middle-sized groups, large groups, everything, if you do multiple, if you do life, even if you dabble in the P&C area. You are part of the community. I know my agents, my health insurance agent, my P&C agent, my life insurance agent. I have all of them on speed dial, right? I can call them whenever I have questions. They aren't that far for me. The furthest one I think is 25 miles away from where I personally live. And they are part of my community. They are people I see at the store. They're people I see out and about. And it's really critical for me to have that. And I think that's true for a lot of people throughout, throughout the US especially with changes in technology, there's a lot of different areas. are losing that personability, that personalization of the one-on-one. And I think insurance is still a place where you can uplift that.

But on the AI side, I'm really excited that you mentioned that. I know I've had a look at a lot of different AI options. And I know we didn't talk about this quite as much, Sam, but looking into 2026, agents are going to have to make changes, they're going to have to adapt. What are some of the ways they can adapt with technology to really allow them to be the most competitive?

It's a loaded question.

SM: I'm an information junkie. I read, you know, hundreds of articles a day and posts online. And that is how I spend much of my day when I'm not buried in meetings, which is too often. I'm reading, I'm learning. There's really never been a better time for the intersection. The Venn Diagram has huge overlap of both the opportunity to become a true expert and learn what you can about the ecosystem and how you can serve your clients, intersecting with the need to just know more. To go that extra mile. There is fierce competition. It's certainly more true on the group side than on the individual side, where in group it's really fierce competition. But even in the individual side, you're competing for attention. You're competing for your client's willingness to give you referrals. To be able really build a real business. And so there's never been a time when there's been more information that's truly available, readily available for anyone.

And so AI can be super effective in staying ahead of the curve, whether it's just asking it to create a daily alert for you. Say, all right, pull the 10 stories that showed up in the last 24 hours on healthcare, summarize them for me, and create some bullet points that I can reference in my client conversations today. So I always have something fresh. Or whether it's doing deep, deep research on some arcane law where there's some complicated interpretation that's not so clear. All of these are areas where AI can really augment a savvy agent and really help them do more. And so at the same time that the information economy around healthcare becomes more complex.

There's more federal regulations. There's more state regulations. There's more political considerations. Your clients, especially, are going to be confused and going to need your help and expertise. At the same time, it's never been easier. 30 years ago, if you wanted to learn the secrets of the industry, you had to show up in person to the trade meetings. You had to befriend older agents. You had to order paper copies of things and dig through them. The amount of physical effort and just the amount of time it would take to really develop a true expertise, was not as compatible with actually being in the market and trying to sell insurance where there's a volume game for sure. And so, at this time, and using AI tools to augment your effectiveness, there's really never been a better time where you can sit in your basement and just become one of the world's leading experts on your state and your market and your networks and all the things that your clients are going to really need for you to know.

AB: Yeah, I think that's really critical, too, and, even looking forward into 2026. I'm like you, Sam, you know, I love information. I love to go into rabbit holes. I love to learn and it's hard when you're busy. I'm similar to you. Many days, I have meetings over meetings over meetings and trying to find those hours to take to learn is hard, but I think it is what is going to set people apart in 2026, especially even with AI or any technology, whether it is a new quoting and enrollment system, a new CRM, whatever it is that you're looking to make improvements to, to make more productivity, more efficiency in your agency, it's hard to find the time. But when you do carve out that time, it can really pay back in dividends. It can really build up, even as simple as what you were saying. Tell me the latest 10 articles, sum them up, give me talking points. A lot of our clients, right, as insurance agents, your clients are looking to you for education, they're looking to you for guidance. The more you can provide that, the stickier your clients are gonna be. And I think what you said is just absolutely critical, Sam.

Well, thank you. think that's really great information. I think we hit on everything today and we gave people some really great next steps to getting ready for 2026. It has been a hard enrollment season. I don't know, Sam, if your enrollment season was crazy as everyone's. Probably.

SM: I would call it crazy wonderful. The hard work is a gift for sure, but it's been a long year. And so I'm excited for a wonderful holiday season and get ready for another.

AB: Yeah, crazy wonderful. There you go. Looking forward, where can you really set yourself apart? It's using tech and using education. So thank you so much, everyone. We'll see you here again for another edition of Inside the Industry in the future.

SM: Thank you.

Posted on Friday, January 23, 2026 in Inside the Industry