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Employee Benefits and the New Health Care Landscape: How Private Exchanges are Bringing Choice and Consumerism to America's Workforce

Book Description

We shop for everything else online…why not benefits? Using private benefit exchanges (a.k.a. “online benefits marketplaces”), employers can bring a consumer-centric online shopping experience to benefits. Alan Cohen, a benefits technology pioneer, details how these platforms can offer unprecedented flexibility and choice to employees, revolutionize the way employers attract and retain talent, strengthen cost control in an era of skyrocketing premiums, and promote much-needed innovation in the U.S. health care system.

Discover How To

  • Make sense of today’s challenging benefits landscape and plan breakthrough changes that have succeeded for thousands of employers of all sizes
  • Leverage the lessons of the online shopping revolution to drive radical innovation
  • Incorporate the 7 key pillars of a true private benefits exchange into your benefits mindset
  • Gain indispensable practical insights from early adopters’ experiences
  • Clarify the new roles of employers, HR, insurers, brokers, employees, and other stakeholders
  • Accelerate your transition away from inefficient employer-managed plans
  • Assess the ongoing impact of health care reform, public exchanges, health care consumerism, and other trends

Alan Cohen created one of the first private exchange platforms and has pioneered this approach for more than a decade. Now, in a candid discussion of how the economic principles of choice, consumerism, and defined contribution are at work in an exchange environment, he breaks down the concept for HR professionals, entrepreneurs, brokers, insurers, health care reformers, policy makers, and employees. Cohen looks to social and economic implications to forge a future in which all eyes are on a new model of the consumer for the benefits age. With insights from industry veterans, Employee Benefits and the New Health Care Landscape brings a fresh perspective to the debate on health care and health insurance in America.

Table of Contents

  1. Cover Page
  2. Title Page
  3. Copyright Page
  4. Contents At a Glance
  5. Table of Contents
  6. Acknowledgments
  7. About the Author
  8. How to Read This Book
  9. Introduction
    1. Attracting and Retaining Employees
    2. A New Paradigm Shift for Benefits
    3. The Exchange Evolution
    4. “Try It, You’ll Like It”
    5. Overcoming the “Wait and See” Mindset
  10. Part I: The Changing Benefits Landscape
    1. 1 Building a Better Benefits System
      1. Principle #1: Give Them Money and Let Them Shop
      2. Principle #2: Provide True Price Transparency
      3. Principle #3: Provide Meaningful Choice
      4. Principle #4: Offer Guidance in the Form of Decision Support
      5. Principle #5: Optimize the Shopping Experience
      6. Principle #6: Ensure a Cultural Fit Within the Organization
      7. Principle #7: Refine, Iterate, and Improve
      8. Summary
    2. 2 Benefits: The Accidental Entitlement
      1. Not Really an “Exchange”
      2. “Modern-Day” Insurance
      3. Benefits as Compensation
      4. So Where Does This Leave Us?
      5. Brokers Join the Bandwagon
      6. Summary
    3. 3 They Don’t Know What They’re Missing: Flipping the Status Quo on Its Head
      1. The Problem with the Status Quo
      2. Disrupting the Status Quo
        1. Meaningful Choice
        2. Price Transparency and Defined Contribution
        3. Personalization
        4. Consumerism
      3. Summary
    4. 4 Making Sense of Benefits Solutions: Public Exchanges and Private Exchanges
      1. The View from the Top: Public Versus Private Exchanges
      2. Who Runs These Things Anyway? Types of Private Exchange Operators
        1. Pure-Play Providers
        2. Benefits Providers
        3. Benefits Advisors
        4. Traditional Benefits Administration Companies
      3. What Should You Consider When Moving to a Private Exchange?
        1. Single- Versus Multi-Carrier Exchanges
        2. Self- Versus Fully-Insured Models
        3. Funding Strategies
      4. Who Can Benefit from Private Exchanges? Markets Served
      5. A Look at Products in Private Exchanges
      6. What Else Can Private Exchanges Offer?
      7. Summary
  11. Part II: Stakeholders: Making the Move from “One Size Fits All”
    1. 5 Employers Find Skin in the Game
      1. A Big Bet Pays Off: TitleMax, Part of the TMX Finance Family of Companies
      2. Customer-Focused Luxury Resort Gives Back to Its Employees: Sandestin
      3. Summary
    2. 6 Six Questions to Ask Before You Choose a Private Exchange
      1. What Makes for a True Private Exchange?
        1. 1. Is Elasticity Built into Its Foundation?
        2. 2. Does It Include Decision Support and Educational Tools?
        3. 3. Are Prices Transparent?
        4. 4. Does It Integrate with Value-Added Services?
        5. 5. Does It Provide Year-Round Support?
        6. 6. To What Extent Does It Handle Benefits Administration?
      2. Summary
    3. 7 Brokers and Exchanges: Better Together
      1. Rick Strater, Arthur J. Gallagher & Co.
        1. The Role of the Broker
        2. Overcoming Misconceptions
          1. Employees Don’t Care About Choice
          2. Cost Is All That Matters
          3. Defined Contribution Is “Cost Shifting”
      2. Rob Harkins, Willis Towers Watson
        1. The Changing Role of Brokers
        2. How Can Brokers Win?
        3. The Role of HR
        4. Technology Is the Future of Benefits
      3. Summary
    4. 8 Insurers Find a New Way to Move Product
      1. The Private Exchange: A Bridge to the Future?
      2. What Insurers Can Gain from Private Exchanges
      3. Innovators Embrace Private Exchanges Early On
        1. Jessica Moser, MetLife
        2. Kevin Hill, Oxford Health Plans/UnitedHealthcare
      4. Insurers Aren’t the Only Ones Innovating
      5. Summary
  12. Part III: Future Vision
    1. 9 Innovation in Benefits (Yes, Benefits)
      1. Expanding the Aisles in the Benefits Store
      2. Letting Individuals Create Their Own Preferred Networks
      3. Creating a National Individual Insurance Market
      4. Summary
    2. 10 The “Law of the Land,” Insurance Tax Reform, and the November Surprise
      1. “The Law of the Land…for the Foreseeable Future”
      2. The Viability of the Individual Market
      3. What Else to Note on the Legislative Front
        1. The “Cadillac” of Taxes—And Other Pending Legislation
        2. The Medicare Marketplace as a Model
        3. Small Businesses and Individual Benefits Marketplaces
        4. Tweaking the Tax Code
      4. Summary
    3. 11 Who’s Afraid of the American Consumer?
      1. Some Potential Ways Forward
        1. Tax-Protected Savings Accounts
        2. Employer Funding for Individual Insurance
        3. Consumer-Centric Provider Networks
        4. Data and Digital Tools for Patients and Consumers
        5. Patient-Empowered Healing
      2. The Utopian Vision
        1. Shopping for Care
          1. Using a Marketplace to Purchase Non-Emergent Health Care on an As-Needed Basis
          2. An “In-Network” Conundrum?
        2. Final Thoughts
  13. Part IV: Appendixes: A Practical Guide to Private Exchanges
    1. A Private Exchanges 101
    2. B Making Sense of Benefits Terms
      1. Terms Related to Benefits
      2. Terms Related to Health Care Consumerism
      3. Terms Related to Private Exchanges
      4. Guide to Common Benefits Products on a Private Exchange
    3. C Real-World Data and Applications
      1. What Really Happens on Private Exchanges?
        1. Data from the 2017 Private Exchange Research Council (PERC) Analysis
      2. What Do Employers and Employees Really Think About Liazon Exchanges?
        1. Data from the Liazon 2017 Employer and Employee Surveys
        2. The Exchange Experience: A Look at How Benefits Are Selected on Liazon Exchanges
        3. For the Benefits Geeks: A Health Care Timeline
  14. Index