Exchanges

EBA speaks with Jonathan Gruber who created health care reform in Massachusetts

Sam Smith, a member of California’s SHOP exchange advisory group and president-elect of CAHU, predicts a bright future for adviser involvement in PPACA’s state health insurance.

According to most experts, the number is small and keeps getting smaller. We speak, of course, of the number of companies with 50 or more employees that will drop employer-sponsored insurance in 2014 - opting to send employees to state-run insurance exchanges and pay per-employee fines levied by the Patient Protection and Affordable Care Act. After a McKinsey & Company study in 2011 famously concluded that 30% of employers would "pay" rather than "play," survey after survey has revealed that fewer than 5% of employers plan to eliminate employee health benefits. Even the Government Accountability Office, which originally reported as much as 20% of employers would drop coverage, now has backed off that estimate to around 2%.

The $64,000 question on state and federally managed health exchanges will be "what is the broker compensation?" Reliance on state and/or federal government to control your compensation is an uncontrollable factor that could lead to the demise of many brokers whose sole business is groups under 50 lives.

Buck Consultants is the latest benefit and consulting firm to form a private exchange. The move aims to reduce employer uncertainty about 2014 by reducing costs and increasing employee health care options.

The answer to that question is still fuzzy. That’s because while the Department of Health and Human Services has confirmed to Employee Benefit Adviser that HRAs and HSAs will be offered on the public exchanges, the organization still hasn’t released the details and regulations surrounding these accounts.

Mercer is one of the latest companies to enter the private exchange game, and the consulting giant gave employers an opportunity to check out the service during a conference call Thursday. Company executives revealed some of those specifics during the call, especially during the Q&A period for the audience.

What employers and brokers need to know and do to success under the new health care reform model.

With the core of PPACA set to begin in 2014, employers need to start making decisions now. UBA CEO Thom Mangan says that while the “pay” option might be worth considering, there are strong reasons why employers should look carefully at all of their options and do their best to calculate the actual outcomes of each.

EBA editor Elizabeth Galentine on how 2013 is shaping up to be year of the health exchange