10 ways to promote the value of a private exchange

Great article from Employee Benefits Advisor about 10 different ways to promote private exchanges by Sima Reid

Our world has changed so much and quickly — take the evolution of cell phones in the last decade, for example — but how we approach offering employee benefits is moving at a snail’s pace in comparison. To stay current and modern, employee benefits must evolve.

Many employers see the value in structuring their employee benefit programs to meet the needs of their multi-generational employee population. A private exchange brings all the elements together, creating value for the employer and the employee.
Offering a private exchange to employees is not just about moving to a defined contribution model or promising a silver bullet to reduce benefit costs. A private exchange should bring value to the employer and their employees independent of the products or pricing of those products.

The value proposition of a private exchange:

1) Paternalism. For employers who understand the value of giving up some of the benefit decisions to their employees, a private exchange provides a way to give employees more options — using tools that help them make good decisions based on their wants and needs.

2) Meaningful choice. More choice is good, too much choice is not better. It is important to include options that make sense for each particular workforce, including traditional medical, dental, vision, etc. as well as voluntary benefits. A meaningful line up of benefit options will help employees fill gaps they may have in the areas such as legal services, ID theft, chiropractic care, additional life insurance or disability, and so on.

3) Proper plan election. When employees are allowed to select plans that make sense for them from a benefit/cost perspective, many employers see a right-sizing of their benefit program. This provides them with savings. If an employer only offers one health plan that has low out of pocket, they are over paying for many employees. If an employee would rather pay less per paycheck but more when they have services, choice allows them to do so. This brings value to the employee and the employer.

4) Self-insured and fully insured plans. Being self-insured does not mean eliminating employee choice. For many employers, self-insured plans make more sense than a fully insured plan. A private exchange should be able to accommodate either financing mechanism.

5) Streamlined benefits education and administration. A private exchange is not just a benefits administration system. Private exchange technology provides critical education and tools available to employees for all the plans and programs offered. Gone are the days of trying to include all the information in an employee enrollment communication that the employees likely won’t read. The process for HR is streamlined through the private exchange using a modern, inviting and attractive online platform.

6) 24/7 access. How companies engage and retain employees has changed. The need exists for a year-round platform focused on life’s experiences and challenges. Tools to help employees work on wellness, whether it is health or financial, will provide value to the employee. Messaging employees during the year encourages them to go to the private exchange outside of open enrollment.

7) Decision support. While decision support helps personalize employee decisions, it is important for a private exchange to help people not just pick which medical or dental plan they’d like, but also voluntary benefits offered. If you ask most people how much life insurance they should have, not many can tell you. A tool that helps someone calculate, based on their circumstances, how much life insurance they may need so they can decide if they want to buy additional life insurance above what the company provides can be valuable to many employees.

8) Comparison shopping. How many consumer purchases today have us searching online for information telling us the best products at the best cost? More and more employees find value in this same approach for their benefits. Private exchanges providing employees with side by side comparisons in summary and in detail along with costs can bring value to the employee.

9) Employee experience. Many employers value a positive, friendly platform for the delivery of their employee benefit program. A private exchange brings modern technology to education and enrollment of benefits. How many employees within a company do you think watch YouTube? Whether we think this is an acceptable method of communication or not, it is a powerful, current method of communication. Using videos and other educational tools on the private exchange adds value for many employees.

10) The shopping experience. Allowing employees to shop for their benefits takes the insurance enrollment process to a very different level. It bridges the often disjointed, confusing process of benefit enrollment with our normal daily activities of how we approach buying goods and services. A private exchange allows employees to walk down the aisle of a virtual store of benefits.

A private exchange makes life easier for the employer and their employees by using technology, a modern approach, enhanced educational tools and resources to focus on the employee experience. Private exchanges are the present and the future of employee benefits.

See the original article Here.


Reid S. (2017 January 3). 10 ways to promote the value of private exchange [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/10-ways-to-promote-the-value-of-a-private-exchange

Employers rate private exchanges positively, but use is still low

Great article from Benefits Pro by Gil Lowerre and Bonnie Brazzell

A recent Eastbridge survey of employers found that the use of private exchanges continues to be minimal among all size categories and that a positive correlation remains between use and employer size (with use increasing as employer size increases). Many times, it is the broker who influences these employers to adopt the exchange model, and to offer more options to their employees or to move to a defined contribution approach.

Since brokers are often the ones suggesting an exchange for their clients, it makes sense that most employers (74 percent) continue to use a broker for their employee benefits after implementing a private exchange. Only 19 percent of the employers no longer utilize broker services.

While use has been low, employers that have implemented an exchange believe their employees’ experience with the private exchange has been positive. Forty percent indicated the experience was not only positive, but easier than previous enrollments, and 52 percent said it was positive, but not significantly different from previous enrollment.

The survey also pointed to future interest by employers in private exchanges. Over one-quarter of the employers that are not using a private exchange today are open to using this concept in the future, and another one-quarter are still undecided.

Whether or not to offer a private exchange is a decision that should be based on many factors. Nonetheless, it is important for brokers to at least consider broaching the subject with employer clients — or risk the chance that some other broker will. The fact that most employers rate the exchange process positively should provide comfort to those considering this approach to benefits.

See the original article Here.


Lowerre, G. & Brazzell, B. (2016 November 02). Employers rate private exchanges positively, but use is still low. [Web blog post]. Retrieved from address https://www.benefitspro.com/2016/11/02/employers-rate-private-exchanges-positively-but-us

Study: What benefits do employees go for on private exchanges?

Jack Craver gives insight on the best benefits options for private exchanges

A new study offers insight into the types of benefits and benefit designs employees go for when given the choice.

The study, by the Private Exchange Research Council, analyzed hundreds of thousands of benefit purchases made by workers whose employer offers benefits through a private exchange.

The average employer that uses a private exchange offers 14 different benefits and six medical plans, the study found. Employees purchased an average of 4.4 products in 2015, up from 3.6 the previous year.

Older workers are more likely to buy more coverage, with 44 percent of Gen Xers and 42 percent of baby boomers buying more than four products, compared to only 30 percent of millennials.

While employers are increasingly demanding that employees accept high-deductible health plans accompanied by a health savings account, the majority of workers analyzed in the study appear to have traditional health plans, although the percentage with HSAs is rising. Forty-two percent of employees had an HSA in 2015, up from 38 percent in 2013.

Those who opt for high-deductible HSA-qualifying plans tend to be younger and healthier; that’s no surprise. However, the study also found that men and high-paid employees tend to favor such plans more than women and lower-paid employees.

Perhaps surprisingly, the study also found that nontraditional insurance products, such as pet insurance, legal insurance and identity theft insurance, are more likely to be offered by smaller companies.

Private exchanges and the employers that use them describe them as a way to increase employees’ engagement with their benefits. In a health care system that many have argued is overpriced and inefficient because the costs have been hidden behind health plans largely paid by employers, private exchanges are touted as a way to make individuals more sophisticated health care consumers that make conscious decisions about what services they want and need.

Private exchanges got a big boost earlier this year when Starbucks announced that it would be offering its employees an array of health plans to choose through an exchange run by Aon.

In a statement accompanying the study’s release, Christopher Condeluci, one of the principals of Private Exchange Research Council, described the group and its research as addressing a lack of data on the types of benefits that individual consumers favor.

"Knowing what plans people want and how they choose them will go a long way in helping the benefits industry better meet employers' and employees' needs,” he says.

See the original article Here.


Craver, J. (2016 October 20). Study: what benefits do employees go for on private exchanges? [Web blog post]. Retrieved from address https://www.benefitspro.com/2016/10/20/study-what-benefits-do-employees-go-for-on-private?kw=Study:%20What%20benefits%20do%20employees%20go%20for%20on%20private%20exchanges?&et=editorial&bu=BenefitsPRO&cn=20161024&src=EMC-Email_editorial&pt=Daily

Private Exchanges May Offer Shelter from Cadillac Tax

Originally posted April 03, 2014 by Allen Greenberg on https://www.benefitspro.com

COLORADO SPRINGS, Colo. – Avoiding, or at least putting off, the so-called Cadillac tax in the Patient Protection and Affordable Care Act is on a lot of employers’ minds.

Speaking Wednesday at the 2014 Benefits Selling Expo, William Stuart, a lead consultant at Wellesley, Mass.-based Harvard Pilgrim Health Care, suggested that one of the best ways to do so is by moving employees to one of the burgeoning number of private insurance exchanges.

That alone won’t do the trick, he said, but shifting to an exchange can help “reset the premium base” and “bend the cost curve” – the two things necessary if employers hope to postpone the pain of the excise tax.

The tax – meant to raise money to offset the government’s subsidies to lower-income individuals and families buying insurance under the PPACA – goes into effect in 2018. It is a 40-percent penalty on premium dollars above $10,200 for individuals and $27,500 for families.

This tax is probably not going to go away,” Stuart said. “It might. But we can’t base our strategy on what may or may not happen.”

The premium levels at which the tax is calculated, he said, will include medical premiums, health flexible spending arrangement elections, health reimbursement arrangements and employer contribution to HSAs. “In other words,” he said, “the law has taken some tools (for reducing or putting off the tax) off the table.”

But options do exist, he said, and the sooner employers act, the better, meaning the later the tax will impact them.

Stuart said brokers should consider encouraging their clients to establish wellness programs. The return on investment is often difficult to gauge on wellness, he noted, but a healthier workforce tends to mean fewer health problems, which helps bend the cost curve.

A narrower provider network can also help, he said, especially one that might exclude teaching hospitals where costs tend to be higher.

Stuart acknowledged people prefer all kinds of choices in which doctors they see or which hospital they might use. But that fades once they realize they can save up to 25 percent of their costs.

Health savings accounts, meanwhile, are another option for employers looking to reduce costs, because they encourage employees to be more careful with their health care dollars.

In the end, however, private exchanges may yield the most dramatic results, Stuart said.

Among their advantages: an array of health plans offering in some cases as much as a 40-percent spread in premium costs.

Once in an exchange, the employee mindset shifts to saving money, rather than simply buying without shopping. People, Stuart said, tend to buy down in an exchange once they realize they might have been over-insured. This, too, helps reset the base.

Aon Hewitt, the large employee benefits consultancy, which last year launched its Aon Hewitt Corporate Health Exchange, recently said the average cost increase for three fully insured large companies in its exchange was 5.1 percent.

By comparison, average cost increases for large U.S. employers are projected to be between 6 and 7 percent in 2014, according to Aon Hewitt’s annual cost trend data report.

Should exchanges be part of your company's plan?

Originally posted August 06, 2013 by Justyn Harkin on https://ebn.benefitnews.com

Although considering the new health care exchanges may have seemed radical a few weeks ago, now that everybody gets to drop ten and punton the employer mandate penalty in 2014, the idea may not be so strange.

Sure, migrating employees to the exchanges isn’t right for every organization. If the move would upset your workforce, then keeping your current group plan is probably best. But if employees would view exchange offerings as equal or better than what they current have, then there could be plenty of upsides.

If you think the exchanges would be better than what you have now for both your company and your employees, or even if you just want to get a leg up on communications (and believe me, that’s never a bad idea), then you and your employees have three options — public exchanges, private exchanges (fully insured), private exchanges (self-insured).

Which one might be best for your organization? Let's see.

Public exchanges

One of the most attractive ideas about moving to a public exchange has to be handing over the considerable financial and administrative burdens for running your company’s health benefits.

For some organizations, the move might be cheaper than what they are doing now. Even when you factor in the likely, eventual activation of the $2,000-per-employee fine for not providing insurance, you could still be paying less than what you would if you were covering premiums.

Of course, sending employees to public exchanges isn’t necessarily a slam-dunk move. Your workforce could straight-up riot if you tell them you’re cutting health benefits, and even if you raise salaries (oh, hello there, higher payroll taxes) to help them cover the costs of buying their own insurance, your recruiting efforts could take a hit if your competitors keep their health benefits.

Private exchanges with fully insured plans

Perhaps the biggest advantage of using a private exchange is the ability to shift some of the rising costs of health care to employees and give them the ability to control their spending.

In a private exchange, employees get an allowance from their employer that can be used to buy insurance. The idea is that giving employees control of the purchasing decision takes some of the heat off of your company. After all, if the cost of health care rises, that’s not your fault?

So what’s the downside to this type of exchange? Well, in the worse-case scenario it’s a less healthy, less productive workforce. Because employees will be making purchasing decisions, they may choose lower premiums over better coverage, and that can contribute to poorer health and higher rates of absenteeism.

Private exchanges with self-insured plans

The last of your exchange options are private exchanges with self-insured plans. Compared with the types of plans offered on public exchanges and private exchanges with fully insured plans, the plans available on private exchanges with self-insured plans can seem very attractive employees — generally lower premiums, more generous plan features, and more in-network doctors — but they will be more expensive.

The self-insured private exchange option might be slightly more expensive than what you could do with a fully insured private exchange, that’s true, but the available plans would be more oriented toward long-term health.

Still, using self-insured plans means you’ll have to assume all the risk and pay for all your employees’ claims. Also your employees will become customers of the private exchange insurance companies, and that means you won’t have the same influence (over the companies or choices) that you would otherwise have.

How will you spend the bonus year?

Assistant Secretary for Tax Policy Mark J. Mazur’s July 3 announcement might have seemed like the best health care reform–related thing to happen to employers all year.

If you take the “transition year” at face value, meaning the mandatory employer and insurer reporting requirements are being postponed, then you have the perfect chance to carefully consider your company’s next moves.

Maybe you’ll decide to take the plunge. Perhaps you’ll rule out the exchanges altogether. You might even decide to let other companies test the waters first so you can be prepared later on.

No matter what path you chose, though, the most important thing is taking the time to make the best decision for your company and your employees. And then communicate that decision in a clear and engaging way. Good luck!

What’s Ahead this Year as Health Insurance Exchanges are Rolled-out Nationwide

Original article https://www.theihcc.com

By Cindy Gillespie

Exchanges are a key component of the Affordable Care Act (ACA). Here’s a snapshot of exchange developments across the country, potential regulations to watch for, and where exchanges might be by October 2013 for open enrollment and by January 1, 2014, when they are slated to “go live” nationwide.

Health Insurances Exchanges: The Vision

The ACA directed each state to establish two types of exchanges or have the federal government do so on its behalf — the American Health Benefits Exchange (AHBE) for individuals and the Small Business Health Options Program (SHOP) for small employers. Under the statute, individuals are eligible to buy insurance on the AHBE if they are:

  • a U.S. citizen or legal alien
  • not incarcerated
  • a resident of the state in which the exchange is based


The ACA includes robust premium and cost-sharing subsidies for individuals who purchase insurance through the individual exchange who are living at levels between 100 and 400 percent of the federal poverty level — between approximately $12,000 and $46,000 a year — and who are not eligible for other public insurance programs (i.e. Medicaid, Medicare, Tricare) and who do not receive “affordable” insurance coverage through their employers (that meets minimum value standards).

Employers which have more than 50 employees whom are eligible for tax credit subsidies, either because the employer does not offer coverage or because the coverage offered is unaffordable to the employee according to ACA standards, or not of minimum value, will be subject to a penalty.


Meanwhile, the ACA allows employers with up to 100 full-time employees to purchase insurance through SHOP, although the state has the option to limit access to employers with 50 employees or less for the first two years. Most states have taken advantage of this option in order to maintain consistency with the outside market’s definition of “small employer.” States also maintain the option to allow employers with more than 100 employees to purchase insurance through the SHOP beginning in 2017, with approval of the U.S. Department of Health and Human Services (HHS).

Tax credit subsidies are also available to employers who purchase coverage on SHOP for employers with less than 25 employees who have an average taxable wage under $50,000 per year. Employers cannot claim the tax credit for more than two consecutive years.

Health Insurances Exchanges: 3 Primary Models

Although the ACA envisioned 50 different exchanges championed by individual states, the reality of ACA implementation has been far different. Indeed, political, logistical, and operational challenges faced by both HHS and the states have led only a subset of states to embrace exchanges. The update below provides a snapshot of how exchanges are developing across the country.


Seventeen states and the District of Columbia are developing State-based Exchanges as envisioned under the ACA. These states have received “conditional approval” from HHS to operate them for the 2014 plan year. Under these exchanges, states execute all functions but may turn to the federal government for issues such as tax-credit eligibility determination, risk adjustment, and reinsurance.

While several of these states have been making great strides toward October 1, 2013 open enrollment, others are relatively behind in the planning process and may struggle to meet the impending deadlines. For example, some states still lack legal authority to operate a State-based Exchange, while others have yet to procure any IT-related services necessary to make the exchange function.


Seven states have received conditional approval from HHS to operate State Partnership Exchanges. This exchange model, not envisioned under the ACA, is an option created by HHS for states that may want to play a small role in exchange operations either permanently or as they move toward a State-based Exchange. States have two primary options for pursuing State Partnership Exchanges: a plan management partnership or a consumer partnership. States also have the choice to participate in both partnership models.

States participating in a plan management partnership assume responsibility for issuer account management and issuer oversight as well as monitoring, quality reporting, and data collection. In addition, these states also play a key role in determining qualified health plan (QHP) certification. Plan management partnerships will recommend which plans should be certified as QHPs to HHS, which has the legal authority to make QHP certifications.

States also have the option to pursue a consumer partnership exchange. States choosing this approach control the day-to-day management of Navigators and in-person consumer assistors, and will have the option to engage in outreach, education, and branding activities. Navigators and in-person consumer assistors will be the “boots on the ground” in states to help educate consumers about plan choices and coverage options. For states choosing a Federally-facilitated Exchange (FFE), consumer partnership states oversee and provide technical assistance to Navigators, but HHS retains authority over the Navigator programs.


Twenty-six states have decided not to pursue a State-based or Partnership Exchange. In these states, the federal government is establishing a Federally-facilitated Exchange (FFE). Under an FFE, the federal government performs all exchange functions with states, maintaining the option to make final Medicaid determination and operate its reinsurance program. Although the option to operate reinsurance programs has yet to gain traction, many FFE states have expressed interest in maintaining the responsibility to make final Medicaid determination for individuals assessed as eligible for Medicaid.

Marketplace Plan Management

Several federal requirements necessary for health insurance plans to be qualified in order to be offered on the exchange are already criteria commonly examined as part of routine, state insurance regulatory activities. HHS has indicated that its preference is to integrate states’ existing regulatory activities into its decision-making for qualified health plan (QHP) certification, even in states with an operating FFE.

To further facilitate this relationship, HHS has indicated it will offer states a marketplace plan management option, essentially allowing states to perform activities associated with a plan management partnership but without requiring them to submit a formal exchange blueprint. HHS guidance dated February 20, 2013 also indicates that states can apply for federal funds to support these activities, similarly as it did for the State-based and State Partnership models.

3 Issues to Watch in 2013

As the clock ticks on the path to open enrollment, there are several issues still under consideration that are worth tracking, particularly for the small and large employer communities.

Recent guidance from HHS indicates that employee choice and premium aggregation will not be required of SHOP exchanges in the 2014 plan year. In the same set of proposed rules, HHS also indicates that federally-facilitated SHOPs (FF-SHOPs) will not offer these services in their first year of operation.

As you may recall, employee choice and premium aggregation (the process of collecting premiums from qualified employers and delivering a single streamlined payment to insurers) are two tools at the disposal of SHOP exchanges to help drive enrollment. This recently proposed approach could potentially undermine the viability of SHOP exchanges and the small business market nationwide.

Additional rules from HHS surrounding 10 essential health benefits indicate that to meet these requirements outside the exchange, health insurance plans will need to either embed pediatric oral services, the tenth category of essential health benefits coverage, or be “reasonably assured” that the individual has obtained dental coverage from an exchange- certified, stand-alone dental plan. This is a new proposal from HHS and is therefore receiving significant scrutiny from several stakeholder groups, as the requirements could cause operational challenges in the market. Stay tuned.

HHS released additional details regarding employers’ interface with the exchange in January. Most interestingly, the rules verify that there is no central databank containing details on employer-sponsored health insurance plans. As a result, until that information is available, exchange applicants must attest to the details surrounding their employer-sponsored health insurance plans when seeking health insurance on the exchange. The exchange will then use available data sources to attempt to verify individuals’ claims. Absent inconsistencies in available information, the exchange will be permitted to proceed to enroll the applicant in a health insurance plan along with the applicable subsidies. Employers will be notified of employees who claim a tax credit on the exchange. However, exchanges must select a valid sample of people for whom employer coverage details could not be verified and verbally call employers for additional information. If the exchange cannot obtain information within 90 days, eligibility will remain unchanged.

Looking Toward 2014

The issues described above are only a select set of developments that have emerged in recent months. Indeed, there are a host of unanswered questions and operational challenges that stand between today and open enrollment. ACA implementation process has passed the window for planned delay. Employers and the health benefits industry should expect for exchanges to “go live” and for tax credits to be available beginning January 1, 2014. The Stakeholders should prepare for implementation, albeit with hiccups along the way, as scheduled.