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Opportunity amid uncertainty in Florida's health care

In 2003, Seth Cohen founded Insurance Care Direct, a Broward County online insurance broker, as a way for consumers to find and compare health insurance options. Cohen says he envisioned the business as the insurance equivalent of travel websites like Expedia, which enable travelers to compare flight schedules and prices online. Like the travel sites, Insurance Care Direct would make money by taking a percentage of each health insurance plan sale made through its site.

But then, in 2010, Congress passed the Affordable Care Act. The law requires a system of state or federally run online "exchanges" that are to function much like Insurance Care Direct, assembling a menu of insurance plans for consumers.

Cohen, now CEO, says his first thought was, "Oh, crap, the government is getting into the health insurance business." But then he realized the law might help him grow his business rather than kill it.

The new law requires everyone to be insured, but Cohen says many healthy individuals or families who aren’t insured through their employers won’t be able to afford the minimum required level of health insurance, which averages more than $5,500 a year for an individual policy.

Cohen says it's cheaper for those consumers to pay the tax penalty of $95 a year in 2014, which rises to $695 by 2016 (or 2.5% of household income), and then buy lower-cost short-term or limited-benefit health care plans that won't be available through exchanges — but are offered through Insurance Care Direct.

Given the confusion surrounding the Affordable Care Act, Cohen believes that customers will turn to his business for information and guidance. Insurance Care Direct has 38 call centers and 1,600 agents in its referral network.

Insurance Care Direct's revenue has doubled each year since the Affordable Health Care Act passed, says Cohen, who expects to reach $100 million by 2015.

As costs continue to rise, the pressure to seek lower-cost plans with less extensive benefits will only grow, he says.