Once you have seen one private health care exchange, you have seen just one exchange, as they are all unique, concluded a panel discussing the new marketplaces at Sunday’s Benefits Forum & Expo in New Orleans.

 Tina Provancal, health care exchange product development leader at Aon Hewitt, said that there is a specific reason why we got to where we are today in health care. But now is a time to step back and see what employers can do differently: “Enter private exchanges.”

Many companies across the country are developing their own exchanges, including Aon, but  each model is unique, so from the start, a company must be open minded about the components, Provancal said. Some of those components include:

  • Defined contribution and how to offer that system to your employees, including a straight credit. However, employers must consider compliance with the Affordable Care Act and tax implications.
  • Single carrier versus multi carrier.
  • Benefits design including just medical coverage or a suite of voluntary products. When considering a private exchange, an employer should determine in advance if the exchange will require them to sell multiple products.
  • And most important is fully-insured versus self-insured plans.

However, “regardless of the model, all private exchanges need to stay focused on supporting not only health care reform compliance but addressing the major pain points the ACA is not addressing — increased health care costs,” she said.
In the Aon exchange, there are five plan designs across five carriers offered and all include the same core suite of products, but they vary in the deductible, co-pay and out of pocket maximum.

But the most important move, said Provancal, is not waiting to make the shift after health insurance costs increase. That, she said, is like buying home insurance after your house has already burnt down. She said now is the key time to switch to a private exchange as there are big changes form the ACA, system wide cost shifting and populations getting older, among other factors.

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