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If workers end up using employer cash to buy their own health coverage, one result could be a worker-led shift toward smaller provider networks.
Mark Bertolini, the chief executive officer of Oscar Health, talked about that possibility Thursday, during a conference call the company held to go over results for the third quarter of the year with securities analysts.
Oscar has focused on selling individual health insurance, and it's now trying to court employers by supporting the employers' individual coverage health reimbursement arrangement plans.
A worker in an ICHRA plan can use employer cash to buy cash from HealthCare.gov or another Affordable Care Act public exchange, such as Covered California.
The open enrollment period for ACA exchange coverage for 2026 started Nov. 1 and is set to end Dec. 15 in much of the country.
Exchange plan enrollment activity during the first five days of the enrollment period was much stronger than Oscar had expected, Bertolini said.
Oscar is not counting on the rest of the enrollment period to be like the first five days, but it's still hoping that this will be a good year for ICHRA plan sales, Bertolini said.
"Our pricing is competitive across our major markets compared to group plans," Bertolini said. "We expect to see continued conversion from small and midsized employers who are suffering from double-digit group rate increases."
Bertolini — who is the chairman of Verizon as well as the CEO of Oscar — said one reason he thinks that Oscar can succeed in the exchange plan market, at a time when some competitors are backing away from it, is that it has focused on offering small, carefully picked, low-cost provider networks, rather than simply giving enrollees access to the huge networks that most employer plans offer.
An employer plan offers access to a large number of providers to meet all of the participants' needs, Bertolini said.
In the individual market, consumers "have the opportunity to buy their network and the plan design that works for them, versus having an employer offer them a broad network that costs more," Bertolini said. "We do spend a ton of time to make sure that we have the right set of doctors and the right set of hospital systems."
By offering a well-tailored network, Oscar can take share away from issuers with big, one-size-fits-all networks and still earn more, Bertolini said.
Some other successful competitors also seem to be using similar narrow-network strategies, Bertolini said.
What it means: Workers at employers with ICHRA plans might lose some of the benefits from the bulk purchasing power that traditional employer group health plans enjoy, but, if Bertolini is right, they might be able to make up for some or all of that loss by choosing coverage that better suits their needs.
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