Private Health Insurance Exchanges. National Health Policy Forum November 21, Gary Claxton Kaiser Family Foundation

Transcription

1 Private Health Insurance Exchanges National Health Policy Forum November 21, 2014 Gary Claxton Kaiser Family Foundation 0

2 Exhibit 1 Health benefits relationships in employer-sponsored insurance Traditional Private exchange Employer Employer Private exchange Employee Carrier Employee Carrier SOURCE: KFF Interviews with private exchanges

3 Exhibit 2 Two types of private exchanges, with many variations Overview Single carrier exchange Operated by a single carrier, many times in partnership with a technology platform, where the carrier will offer exchangespecific plans to the employer Multi-carrier exchange Operated by a 3 rd party that puts together a line-up of health plans and ancillary offerings from multiple carriers that often (but not always) compete side-by-side on the platform Selected platforms Powered by Powered by Additional detail Carriers bring benefits to existing group accounts with increased choice and defined contribution, paired with an improved technology platform Target small to mid-size employers, depending on carrier Range from highly customizable markets, to fully competitive exchanges mirroring the public marketplaces Targets employers of all sizes, with the fully competitive exchanges reserved for jumbo employers SOURCE: KFF Interviews with private exchanges, KFF analysis

4 Exhibit 3 Among Large Firms (200 or More Employees) Offering Health Benefits, Percentage of Firms Considering Offering Health Benefits Through a Private Exchange, by Firm Size, Workers 1,000-4,999 Workers 25% 5,000 or More Workers ALL LARGE FIRMS (200 or More Workers) 23% 24% 25% 23% 18% 15% 12% 13% 1 5% Firm Considering Offering Benefits through a Private Exchange Firm Considering a Defined Contribution Approach NOTES: A private exchange is one created by a consulting company, not by either a federal or state government. Private exchanges allow employees to choose from several health benefits options offered on the exchange. SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2014.

5 Exhibit 4 Among Large Firms (200 or More Employees) Offering Health Benefits, Enrollment in Private Exchanges, by Firm Size, Workers 9% 8% 1,000-4,999 Workers 5,000 or More Workers ALL LARGE FIRMS (200 or More Workers) 8% 7% 6% 6% 5% 4% 3% 2% 1% 3% 3% 3% 3% 3% 2% 2% 2% 2% 4% Percentage of Firms Which Currently Offer Benefits to Active Workers through a Private Exchange Percentage of Active Covered Workers Who are Currently Enrolled in a Plan Offered through a Private Exchange Percentage of Firms Offering Retiree Health Benefits Through a Private Exchange~ NOTES: Two percent of large firms did not know if they were considering a private exchange and 3% did not know if they were considering a defined contribution approach. A private exchange is one created by a consulting company, not by either a federal or state government. Private exchanges allow employees to choose from several health benefits options offered on the exchange. ~ Among large firms offering retiree coverage. Twenty-five percent of large firms (200 or more workers) that offer health benefits to their employees offer retiree coverage in 2014 SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2014.

6 Exhibit 5 Employers adopting private exchanges within 5 years % Most major surveys put expected adoption between 20-33% 45% 3 33% 32% 33% 25% 26% 23% 1 Accenture Aon Hewitt Deloitte JD Power Mercer Marketplace National Business Group on Health Oliver Wyman Private Exchange Evaluation Cooperative SOURCE: Accenture (2013), Aon Hewitt (2014), Deloitte (2013), JD Power (2012), Mercer (2013), National Business Group on Health (2013), Oliver Wyman (2012), Private Exchange Evaluation Cooperative (2013)

7 Exhibit 6 Number of medical plan choices recommended (and offered) SOURCE: KFF private exchange interviews. Some firms which offer only one plan type (HMO, PPO, POS or high-deductible plan with a savings option) may offer workers the choice of multiple plans in that plan type

8 Exhibit 7 Selection of HSA-eligible plans on private exchanges % of enrollees National Average (2013) Aon (2013) bswift (2014) Bloom (2014) Liazon (2014) Towers Watson SOURCE: 2013 EHBS, Aon (2013), bswift (2014), Bloom (2014), Liazon (2014)

9 Exhibit 8 Employee Health Plan Selections Relative to Previous Year Coverage on Private Exchanges Choose similar coverage Choose more coverage Choose less coverage 42% 66% Most (68-77%) switch coverage from previous year, and majority of those buy less coverage 12% 7% 18% 12% 4 26% 32% 11% 23% Most (70-81%) maintain coverage level from previous year 81% 7 Aon Bloom Aon Bloom Year 1 on exchange Year 2 on exchange SOURCE: Aon and Bloom Health coverage data. Aon 2013 and 2014 press releases, Bloom 2013 White Paper.