Family business simplifies health insurance

The phone rings almost constantly on a weekday morning inside a homely office on Avalon Avenue.

Questions range from whether a doctor is still in network to confusion over new insurance cards which arrived in the mail.

For Susan Potter and her daughter, Ashley Taylor, those calls are the heart of their work. They are the reason they built Simple Healthcare Solutions nearly three years ago.

It is a full-service health insurance agency which focuses on helping people understand their options and enroll in coverage that fits their needs. While the agency works with individuals under 65 through the health insurance marketplace, a majority of its clients are seniors navigating Medicare for the first time or reevaluating their coverage.

"A lot of people just don't know where to start," Potter said.

That lack of understanding is something both women have seen repeatedly throughout their careers. Between them, Potter and Taylor bring more than 35 years of experience in the insurance industry. Potter spent about 18 years in health insurance, including 15 years with Humana, where she eventually served as the state director for Medicare in Alabama. Taylor began her career as an independent broker and has worked in insurance for roughly 17 years.

Despite their shared background, the idea of formally working together didn't come until circumstances forced a change. Three years ago, Potter's position with Humana was eliminated during a reduction in force.

That's when she saw an opportunity.

"When that happened, Ashley and I got together and started this agency," Potter said. "It was kind of a moment of, 'are we doing this together or not?'"

They chose together, initially working from home before opening their Avalon Avenue office in September.

The timing was less than ideal.

"Last year was chaos," Potter said. "We were really just getting into the office when enrollment season started."

Even so, the transition reinforced why having a physical office mattered.

"It's just so hard when you don't have somewhere to meet somebody and sit down and talk about things," Taylor said.

Finding the location turned out to be a stroke of luck, and the office has since become a place where clients can sit face-to-face with someone they trust. This is something Potter and Taylor say is increasingly rare in the insurance world.

That personal connection is central to their mission.

Potter said many of the calls they receive now involve people who are confused about provider networks or new plans.

"When you call one of these large insurance carriers, you're on hold, you get transferred, and you may or may not get someone who can actually answer your question," she said. "With our experience, we usually know what's going on beyond what's just on a screen."

For Potter, that knowledge comes from years spent working directly with Medicare at the state level. For Taylor, it comes from finding her place in the industry after an unexpected career pivot.

Taylor originally entered the workforce as a financial advisor just as the stock market crashed in 2008. Fresh out of college, she quickly realized the role wasn't the right fit.

"Nobody wanted to invest money, and they definitely didn't want to invest with a young female," Taylor said.

She shifted into insurance, eventually working in group worksite benefits before returning to Medicare full time. Unlike sales-focused roles she had held previously, Medicare allowed her to lean into education instead of pressure.

"I'm an educator more than anything," Taylor said. "Medicare fits my personality a lot better."

That educational focus extends beyond one-on-one meetings. Simple Healthcare Solutions regularly hosts free, public classes aimed at people approaching age 65. The sessions walk attendees through the basics of Medicare, including when to enroll, what coverage is required, and how prescription drug plans work.

"When people turn 65, they have no clue what to do," Potter said. "A lot of them don't even know they need anything other than Medicare."

Helping seniors make informed decisions has become deeply personal for Potter. She recalls early experiences visiting clients who had to choose between basic necessities and insurance coverage.

"Being able to sit down and help them find solutions for that was a really big difference," she said. "It was very rewarding."

Nearly three years into business, Simple Healthcare Solutions continues to grow, fueled by market changes and ongoing confusion surrounding health care coverage. While the pace can be overwhelming, Potter and Taylor say the demand only reinforces the importance of their work.

"We feel like it's very important that people have their own independent broker," Potter said. "Someone local who actually understands how things work in this area."

This mother-daughter team hopes to continue making sure patients do not have to navigate health care decisions alone.