Ron Goldstein has a distinct perspective on American health careand health insurance. In 1996, Goldstein helped develop one of thenation's first private exchanges, CaliforniaChoice. Now, aspresident and CEO of CHOICE Administrators, the parent organizationof CaliforniaChoice, Goldstein is responsible for a series ofhealth insurance programs, including CaliforniaChoice, which covers 10,000 employers andmore than 200,000 patient lives. Goldstein recently took time toanswer a few questions about how CaliforniaChoice has navigated itspath from founding to success, as well as surviving in a modernindustry dominated by PPACA. Benefits professionals, payattention.

In your view, what's in store for benefits professionals in2015?

Change. Professionals can expect change to be a constant in2015. This is especially true in preparation for small groupsexpanding to 100 lives in 2016. We need to get ready for the fourthquarter now by starting to understand what this expansion will meanand how it will affect business.

What are the best things to know in order to not onlycompete, but to succeed in the upcoming year?

Embrace the change. And fully understand the regulations thatare coming down. Also, have a firm grasp on your block of businessand understand exactly where each group stands—know who is coveredunder a grandfathered policy versus who is not, etc.

Overall, how has PPACA implementation affectedCaliforniaChoice?

The impact of PPACA has been very positive for CaliforniaChoice.We now offer more than ever before, and our rates mirror others inthe market. Our service is second to none, and this combination hascreated a very positive effect on our business.

What are the advantages of offering employees access to aprivate health care exchange?

Through a private exchange, the employer is empowered to offeremployees the value of choice and the ability to select thebenefits that best fit their individual or family needs. We've hadnearly 20 years to perfect and develop our offerings, which affordemployers an advantage when working with our exchange specifically.Once an employee is enrolled with a CaliforniaChoice plan, theyhave access to our CalPerks program, which offers discount priceson many services and entertainment.

And what are the benefits for employers?

Our Business Solutions Suite is a huge perk for employers andemployees. It offers them access to additional products andservices at no additional cost. This includes discount dental andvision, a free Premium Only Plan (POP), COBRA services, and so muchmore. We also offer payroll services, and in the future, we'relooking to offer worker's compensation. Because we work directlywith brokers, the employer will greatly benefit from thisrelationship in working with a trusted, industry professional toguide them in developing a program to fit their employees and theirbudget.

I noticed you offer employees access to acupuncture. How didyour exchange come to offer that?

When we were building CaliforniaChoice, we were working withvendors who would help us offer the most diverse options toemployers and employees. At that time, we were looking to include achiropractic benefit and we were able to extend the acupunctureoffering because of the relationships we had forged with ourpartners.

What other alternative therapies or medicines do you makeavailable to employees through CaliforniaChoice?

This is driven by the carriers—we can only offer what ourcarrier partners offer. But by working with seven health plans, weare able to offer a much more diverse roster of products andservices than any single carrier solution.

CaliforniaChoice's offerings mirror PPACA's four planoptions—platinum, gold, silver and bronze. What's behind alsooffering combinations of those options—platinum-gold, gold-silverand silver-bronze?

Our big belief is that choice is choice. We've been able to workwith our partners to offer what we call tiered choice, and it'sbeen a tremendous success. This gives us the flexibility to offertwo tiers to employers, which gives employees access to even morebenefits and health care providers.

What kind of feedback have you had from employees on thesecombined options?

Employee feedback has been great—being able to select from moreoptions and decide what best fits their health care needs andbudgets keeps employees happy. But the employer feedback has beeneven better. This is largely due to the ability to offer more thana single tier when working with our exchange. Employers appreciatethe expanded options, freedom of choice and increased satisfactionthat our program gives their employees.

How can benefits professionals stay relevant in the face ofemerging technologies that could have the potential to reduceemployees' dependence on brokers and agents?

Embrace the technology—use it as an extension of yourself andmake it work for you. It doesn't actually reduce the dependency ona broker or agent; it enhances it, because brokers can bring thattechnology to the employers. In turn, that simplifies the processfor everyone involved.

What other tips do you give to benefits professionals tohelp grow their businesses?

Execute a lead generation strategy and look into asearch engine optimization/search engine marketing(SEO/SEM) plan. These tools will help you stay relevant. And it'smuch easier to target a smaller geographic area and appear insearch results than it would be to stay top-of-mind for the entirestate. Also, building a robust presence on social media andsupplying your followers with educational and informative contentwill extend your reach to markets that may have otherwise been leftuntouched.

Since CaliforniaChoice is the nation's first multi-carrier,small-business private exchange, why haven't there been moreorganizations that have followed your business model in Californiaor elsewhere?

It's not a simple structure to build—it's multi-dimensional andtakes time. Take a look at the states that are operating their ownSHOP exchanges, or who have tried, and the difficulties they havefaced. It's the same thing on the private side.

What do think is the growth potential for private exchangesin California and the nation?

We first have to define what you mean by private exchange, andif we are talking about single-carrier or multi-carrier. Forsingle-carrier, the growth potential is fairly large, but yoursystem has to be ready to rock and roll today. If you're justgetting in to the market now, you're a late comer. I don't see toomany small business private exchanges being built over the next twoto three years. The carriers themselves can only be stretched sofar in terms of resources.

Given the change of leadership in both houses of Congress,how are you preparing for the next two years in what could be anuncertain regulatory environment?

That is the million-dollar question. For us, it's happeningright now. It's not that we are preparing for the next two years;the uncertainty is every day. We have to live with it as it comesat us. We have to have a solid architecture in our technology that allows us to make moves quickly onregulatory changes. These changes affect how you work through yourbusiness, and if your system isn't built to be quickly manipulated,you will be left behind.

With your background in health insurance and benefits, ifyou could change one thing about PPACA, what would it be?

We need to stop making legislative and regulatory changes thatforces carriers and exchanges to spend more money in order to stayin compliance. PPACA is here and we should commit to it fully untilthere is a change that requires our attention.