Quick tips for an initial exchange evaluation

“When you’ve seen one exchange, you’ve seen one exchange!”

“Exchange” is all the buzz. Every consulting and brokerage firm seems to be jumping into the business, and employers are scrambling to learn what they can. As we like to say, when you’ve seen one exchange, you’ve seen one exchange. A few quick tips to help guide your discussions with prospective exchanges:

"When you've seen one exchange, you've seen one exchange!"

• What’s included? With the emergence of varying models, one of the first questions you should ask is, “What’s included”? Learn more about the insurance products, administration capabilities, and decision support tools for the employees both during enrollment and throughout the year.
• How much can you customize? Some models are simply providing the “shop and compare” platform, but the products you place on that platform are completely customizable. Others have a fixed set of products – both carriers and plan designs – that you are required to offer. And yet others provide a portfolio from which an employer can choose what to offer to their employees.
• How sustainable is the solution? While every employer would love to find the silver bullet to fix the employer responsibility, how sustainable is that to your employees? Ask questions about the out-of-pocket cost impact to the employees in year one, and in future years. How will the exchange support truly driving costs out of the delivery of health care vs. simply shifting cost somewhere else in the ecosystem?
• How much choice is right for your employees? Many exchange models pride themselves on the plethora of choices offered to employees. But even with employers spending millions of dollars every open enrollment period, many employees continue to be befuddled by the complexities of current choices. Think about the decisions you are asking your employees to make, the adequacy of the support they will have to make decisions, and if those choices truly add value. How do you value multitude of choices vs. meaningful choice?
• What role does HR now serve? Let’s be honest. It’s on the top of every HR and benefit professional’s mind…how will exchanges impact your job? It comes up in every meeting I have, and it should. Be sure to understand your role after the exchange is deployed. Does it allow you to operate more strategically within your organization by relieving administrative burden from your plate? Or will it put you too far removed from your data to be able to impact the productivity of your workforce?
• How much exchange experience do they have? My last words of advice are to find out why the organization chose to invest in the exchange business. Do they have the right combination of expertise in benefit design, actuarial analytics, and technology? Is this a new adventure for their organization, or will the exchange be delivered on a proven, stable platform? Be confident that the level of investment and commitment to the exchange supports both a successful launch and a sustainable solution.

 

Author: Sherri Bockhorst, principal and leader, Buck Health Exchange Solutions