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Almost all employers are experiencing rising costs and pressure to move to higher deductible health plans. Wanting another route, Envision Healthcare undertook an eight-month process to decide which private benefit exchange was right for them. Don King, Envision’s VP of compliance and benefits, shared questions all employers should consider when deciding to move to an exchange at EBA’s Workplace Benefits Summit in Orlando.

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1) Does the exchange save money over time?

King says the cost savings in an exchange needs to be sustainable and not simply due to plan migration. “This is not a cost-shifting exercise, this is about providing a better benefit,” he explained. One needs to also understand how a private exchange defines competition. “They are all different and do you agree with how the [exchange operator] defines competition?” King said. “Competition, in my mind, is no different than Travelocity,” by providing options for employees.

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2) How many markets does the exchange have?

Envision Healthcare is a national employer, based in Colorado. King said Towers Watson’s OneExchange has 40 markets, which sounds complex, but other exchange providers have more than 330 markets. “Each one of those 40 markets [plays] to the strength of the carriers,” he said. For example, Aetna is the lowest carrier rate-wise in the Northeast, while Cigna has the lowest rates in Dallas.
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3) Is wellness part of the exchange?

Previously, King’s company was doing wellness as an add-on. But in my “heart of hearts I know wellness does work,” he said. “If someone loses 100 pounds, they are on fewer medications.” Providing wellness programs through the exchange (Towers’ wellness program is managed by RedBrick) with the correct messaging, King said, shows employees that their employer cares about them.
“That’s very important,” he said. “Like smoking, you can shame a smoker. But at the end of the day, they will make the right choice. [It’s] the same thing with wellness.”

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4) What is the exchange’s funding approach?

King said Envision Healthcare was self-funded and before moving to an exchange spent 99 cents for every dollar budgeted. “The issue was why we [would] go back to fully insured,” he said.

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5) Can employees easily understand the exchange?

This is most important, King said. “Can I explain this to employees easily, and do I have the right customer support and mobile-enabled technology?” he explained.

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