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A short walk-through about how private health insurance exchanges work, and why they're so important in the post-healthcare reform environment.
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PRIVATEYOUR GUIDE: HEALTH INSURANCE
EXCHANGES
Drag picture to placeholder or click icon to addToday we’re going to look at “private
health insurance exchanges.”
THEY’RE PRIVATE. THEY’RE
EXCHANGES.
This has been a frequent buzz phrase in the health insurance industry
over the past couple of years for a number of different reasons.
The biggest reason though, is HEALTHCARE REFORM.
Whole new
ballgame.
With the implementation of new
provisions in the Affordable Care
Act, the way that employers offer
health insurance to their employees
is changing.
We’ll take a look at the structure of private health insurance exchanges, and how they
work.
So buckle your
seatbelts.
We’ll also describe the different
components that make-up a private health
insurance exchange, the types of
businesses that should be taking the
closest look at these exchanges, and why
they’re growing in importance.
…They’re exchanges that
are set up privately through
an employer.
PRIVATE HEALTH INSURANCE EXCHANGES ARE EXACTLY WHAT THEY SAY
THEY ARE:
No help from the
government.
#1) Technology and
software.
#2) Group health
insurance plans.
Many private health insurance exchanges utilize TWO important
components:
There are two.
LET’S TAKE A CLOSER LOOK A THESE TWO CONCEPTS. THEY PLAY A
PIVITOL ROLE IN THE STRUCTURE OF “PRIVATE HEALTH INSURANCE
EXCHANGES.”
Software programs help facilitate
administration of private health
insurance exchanges.
This technology keeps the private exchange
concept simple for both the employer and
the employee.
#1: TECHNOLOGY AND SOFTWARE.
Time to tech
up.
One example is www.liazon.com.
Liazon’s platform allows an employer to “define a contribution”
(much like an allowance), and then employees select their own
health benefits.
SIMPLY: Employees decide on the plans that fit them best.
You pick your
plan.
Like a store.
The software keeps track of funds
spent, and also shows the
employee what kind of health
insurance options are available at
the private exchange.
THERE’S AN INTERACTIVE PLATFORM TO WORK WITH ONLINE.
NOW THAT WE KNOW THAT TECHNOLOGY AND SOFTWARE ARE THE FIRST
IMPORTANT COMPONENT OF PRIVATE HEALTH INSURANCE EXCHANGES, LET’S
TAKE A LOOK A THE SECOND.
#2: GROUP HEALTH INSURANCE PLANS.
People had limited
choices.
In the past, many employers only
offered one group health insurance
plan.
Why?: Because administration of multiple
plans could be a challenge.
THE IMPORTANT WORD HERE IS MULTIPLE.
More than one.
So to fix that problem, software companies
(like Liazon) now have arrangements with
insurance companies that allow employers
to offer multiple group health insurance
plans from multiple carriers more easily.
With the software and technology
that’s available, it’s not nearly as
difficult to offer a selection of
group health insurance plans
anymore.
ONE OF THE BIGGEST GOALS OF PRIVATE HEALTH INSURANCE
EXCHANGES IS TO PROVIDE CHOICE.
PRIVATE EXCHANGE =
EMPLOYEE CHOICES.
…But businesses with +50
fulltime equivalent employees
will almost always be utilizing
the two concepts we’ve just
described.
There are additional ways to set up private health insurance
exchanges…
Mandated employers: THAT’S
YOU.
And certain smaller businesses can also work with this exact
same strategy…
Tune in.
…So if you’re a business that is at 20
employees or above, you’ll want to
understand the concepts in this
presentation.
As we’ve mentioned, private health insurance
exchanges provide choice. So instead of being
“stuck” in one group health insurance plan,
employees can more efficiently choose which
plan fits them (and their family) best.
QUESTION: WHY ARE PRIVATE HEALTH INSURANCE EXCHANGES
BECOMING MORE IMPORTANT?
Everyone is
different.
Having choices is now more important than ever before…
THAT’S IMPORTANT.
…Because dependents (spouses and children) will most
likely need to be able to participate in the plan.
If employees’ dependents have access to an
“affordable” group plan, they DO NOT have access to
public health insurance exchange subsidies.
In the past, sometimes it was flat-out too expensive for an employee to
include their dependents.
Affordable options.
The private health insurance exchange concept
helps alleviate that issue.
Dependents will need to have better access to group
health insurance plans in the post-reform
environment.
Additionally: businesses with +50 fulltime equivalent employees are
mandated to provide coverage.
More predicable.
A private exchange is a cost-
effective and budgetable way for
employers in the “large group”
category to provide coverage.
You decide on the amount. It’s called a “defined contribution.” It’s just like an
allowance.
That was easy.
You give that amount to
each employee.
Then they pick the plan
they want.
Lastly: Efficiency. If employees are making their own decisions and picking
their own plans…
Smart consumers.
…The whole system runs more
efficiently.
Instead of you telling them what they get: they
pick what they want. By making choices, they’ll
be more conscience about where money is
being spent.
AS MENTIONED, PRIVATE EXCHANGES CAN BE AN EXCEPTIONALLY IMPORTANT CONCEPT FOR
BUSINESSES IN THE +50 EMPLOYEE RANGE. THEY ACCOMPLISH THREE VERY IMPORTANT
THINGS: #1) BUDGETABLITY, #2) SELECTION, #3) FLEXIBILITY. THOSE QUALITIES WILL BE VERY
IMPORTANT TO BUSINESSES MANDATED TO PROVIDE COVERAGE.
And that’s the basic breakdown of private health insurance exchanges.
Your money. On-
site.
Unlike public health insurance exchanges
(state and federal exchanges), private
exchanges are completely administered
within the private workplace.
We work with private health insurance exchanges at Policy Advantage
Insurance Services.
And that’s a wrap.
If you’re an employer that is interested in
learning more, contact us anytime for further
information. Thanks for stopping by today.
We hope you found our information to be
valuable.
TYSON J LESTER, RHU, REBC
President, Policy Advantage Insurance Services
Toll Free: (800) 617-0089
Los Angeles Area: (424) 442-0170
Email: [email protected]
www.policyadvantage.com | CA Insurance License #0F22799
ARTICLE WRITTEN BY
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Toll Free: (800) 617-0089
Los Angeles Area: (424) 442-0170
Email: [email protected]
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