Your Guide: Private Health Insurance Exchanges

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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.

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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  • 1. PRIVATEYOUR GUIDE: HEALTH INSURANCE EXCHANGES
  • 2. Today 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.
  • 3. 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.
  • 4. 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.
  • 5. …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.
  • 6. #1) Technology and software. #2) Group health insurance plans. Many private health insurance exchanges utilize TWO important components: There are two.
  • 7. LET’S TAKE A CLOSER LOOK A THESE TWO CONCEPTS. THEY PLAY A PIVITOL ROLE IN THE STRUCTURE OF “PRIVATE HEALTH INSURANCE EXCHANGES.”
  • 8. 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.
  • 9. 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.
  • 10. 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.
  • 11. 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.
  • 12. #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.
  • 13. 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.
  • 14. 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.
  • 15. …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.
  • 16. 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.
  • 17. 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.
  • 18. 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.
  • 19. 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.
  • 20. 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.
  • 21. 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.
  • 22. 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.
  • 23. 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.
  • 24. 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.
  • 25. 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.
  • 26. TYSON J LESTER, RHU, REBC President, Policy Advantage Insurance Services Toll Free: (800) 617-0089 Los Angeles Area: (424) 442-0170 Email: info@policyadvantage.com www.policyadvantage.com | CA Insurance License #0F22799 ARTICLE WRITTEN BY
  • 27. We help individuals and businesses sort out all of the aspects when designing an individual or business health plan. Please contact us if you have questions. We share high-value information and look forward to working with you. Thanks for stopping by. Toll Free: (800) 617-0089 Los Angeles Area: (424) 442-0170 Email: info@policyadvantage.com www.policyadvantage.com | CA Insurance License #0F22799 WE HELP INDIVIDUALS AND BUSINESSES
  • 28. Nearly 10,000 Followers at Twitter: www.twitter.com/policyadvantage Catch up at Facebook: www.facebook.com/policyadvantage We’re also at Pinterest: www.pinterest.com/policyadvantage www.policyadvantage.com WE’RE SOCIAL