How is the exchange organized and what is the owners' business philosophy?
How long has the exchange been in business?
What carriers offer benefits through the private exchange? What are their reputations and levels of experience?
What types of and how many employer groups have committed to participate in the exchange?
What employer industries are represented? Are they a good match for your business in terms of the type of benefits your employees need?

Most employers are looking for insurance partners they can trust to provide the benefits employees need. It's important that they are comfortable with the exchange owners and operations. For example, if the private exchange represents mostly small employers, it may not be a good fit for a larger group. The risk and administrative costs will be spread out across all participating employees, which means those from a larger employer may not receive the level of benefits they had previously.

3. Examine plan designs and options to customize benefits. Many exchanges feature plans with limited options and flexibility. Some have group plans, while others offer individual coverage only. This may be an excellent fit for employers wanting to provide employees with access to insurance benefits. But it may not be satisfactory for employers who are used to customizing their plans, or employees who participate in plans that offer incentives and rewards based on usage. Find out whether the exchange will allow access to other group options that offer more flexibility in plan design and if employees have options if their life circumstances change.

4. Assess the communication process. It's important to know who will own the communication relationship with employees. Many exchanges communicate benefits information directly to employees, and employers may not be involved in the process. Some employers will welcome the opportunity to hand over this responsibility, while those who have communicated benefits proactively with employees may not.

5. Explore wellness program options. Some private exchanges include wellness programs as part of their services. It's important to know how these programs will operate, including use of information gathered about employees' health and lifestyle habits. Employers need to determine the role they will have in keeping employees healthy and should make sure they can maintain these goals within the private exchange partnership.

6. Evaluate cost savings. The Centers for Medicare and Medicaid Services projects that health care costs will increase more than 6 percent in 2014, and 6.2 percent thereafter for the following eight years. Employers feel significant pressure to keep health care costs under control.

The private exchange model, featuring defined contributions for employee benefits, may be an appealing idea to many employers, but it's important to have a complete picture of associated costs. For example, if the private exchange offers only plans with limited options, will employees be satisfied with this choice? Could employers experience unexpected turnover, resulting in lost productivity and higher costs for hiring and training new employees?

Finding the Right Benefits Solution. Historically, employers have worked alongside producers and insurance carriers to design benefit plans that fit their employees' goals and needs. Private exchanges may be an excellent option for some employers, but remember that not all private exchanges are the same. Employers should first clearly define their benefit goals and philosophy. Then they can explore private exchanges, reviewing the structure, plans, communication process, wellness services and projected savings to find the best partner.

To find appropriate solutions for employers and employees in 2014 and beyond, partner with a trusted dental and vision insurance carrier that can interpret the true impact of the ACA. If you have questions or need information about dental and vision plans, your Ameritas dental and vision representative can help.

For more information, contact Karen Gustin, senior vice president – group field sales, national accounts and broker blocks, at kgustin@ameritas.com.

For information about dental and vision insurance and updates and the ACA, visit www.ameritasgroup.com/reform.

Instant Insights /

Private Exchanges: The Best Option for All Businesses?

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