HRO Benefit Providers Go Exchange Wild

Linda Merritt, HRO Research Analyst, NelsonHall

Activity is picking up again in readiness for the fall benefits enrollment season with HR benefits service providers adding various types of new health insurance exchanges (HIEs).

New HIE Entrants

Towers Watson has just launched its HIE platform, OneExchange, for employees, pre-65, and Medicare retirees. It builds on Towers Watson’s 2012 acquisition of Extend Health and offers employers both private and public exchange-based health insurance options for full and part-time employees and retirees.

Features include:

• Support from initial financial analysis for employers, to plan comparison, purchase and enrollment, and post-enrollment support and advocacy for individuals
• ExtendRetiree: Medicare-eligible retiree assistance to identify and select supplement health plans from the myriad of available products
• BenefitView: real-time dashboard for employers.

Buck Consultants, a Xerox Company, launched a private HIE, RightOpt, for employers with more than 3,000 employees. The exchange will offer:

• Both a self-funded and fully-insured model
• Personalization based on a family’s health, adversity to risk, and preferences
• Member education, decision-support tools, and health engagement resources.

RightOpt will complement Buck’s retiree HIE, My Medicare Advocate, and will be available for Fall 2013 enrollment.

RightOpt intends to differentiate from other private HIEs by allowing employers to use a national network of providers so employees can access the more deeply-discounted networks of providers by metropolitan area; a model that was historically too administratively complex for many employers.

New HIE Alliances

Fidelity Investments announced a strategic alliance with Extend Health, a Towers Watson Company, to provide HIE services to retiring employees to identify and select Medicare and private health care options through Extend Health.

Fidelity is also expanding its own capabilities to incorporate retiree health care into retirement planning including retiree medical account support services to plan sponsors. Examples include:

• Recordkeeping and reimbursement services
• Retiree workshops and meetings
• Strategic communications expertise.

New HIE Exchanges

Those already in the market, including Aon Hewitt and Mercer, are not sitting still.  Mercer has added Mercer Marketplace, for employers with more than 100 employees, to expand its suite of private HIEs. The exchange utilizes a cloud-based technology platform with call center services and online decision support during enrollment.

Affordable Care Act Will Drive Growth and New Services

Once the final ACA regulations kick-in, there will be even more complexity for both employers and employees. Benefits providers like Towers Watson are already preparing more services to roll out including:

• Connecting workforce segments such as pre-65 retirees, part-time, contract, and seasonal workers to plans offered on public exchanges
• Providing financial analysis, modeling tools, and consulting to help employers decide whether to use private or public exchange solutions
• Enabling employers to transition active employees to exchanges offering individual health plans or group-based plans.

HIEs provide many positive benefits:

• Employers gain help in controlling cost and caring for employee health care needs
• Employees gain access to wider choices at group discounted rates as well as advanced decisions support tools
• Benefits providers can use existing outsourcing capabilities, as well as leverage consulting services and allied services such as Medicare, Medicaid, and the new public exchanges.

No wonder benefits provider have gone HIE wild!

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Opportunities Expand for HRO: Health Care Exchanges

Private health care exchanges are a hot topic, and the number of HRO service providers with such an offering is expanding. In addition to current providers including Aon Hewitt, Extend Health, and Xerox/ACS, Mercer announced a suite of health care exchange offerings last week.

It’s no surprise that health care exchanges are increasingly popular since the benefits extend to both employers and employees. While employers reduce liability and administration while accessing better plans or prices, employees obtain access to competitive pricing, employer subsidies, and assistance with selecting the plan best-suited for their needs.

Here is a brief synopsis of the existing health care exchanges in the market.

Retiree exchanges: These exchanges typically help retirees select a Medicare plan and/or supplemental insurance products based on their medical needs and budget. Service provider offerings typically include:

• Call center services to assist retirees in selecting a plan including assessing needs, evaluating options, and enrollment into a plan
• An online portal for shopping plans
• Written materials / communications such as booklets, letters (e.g., appointment, confirmation of coverage, and annual enrollment letters), appointment reminders, etc.

Retiree exchanges were the first type of exchange to appear in the market, and as a result, there are a few service providers with such offerings available. Extend Health has its ExtendRetiree exchange. Aon Hewitt added its retiree health care exchange in March 2010 when it acquired Senior Educators, Ltd. In 2011, the exchange was renamed “Aon Hewitt Navigators.” Xerox/ACS launched its retiree exchange, “My Medicare Advocate,” in October 2010.

Among the exchanges it announced last week, Mercer launched its Retiree Medical Exchange. Its exchange leverages any employer subsidies available for coverage by converting current and future retirees to a DC model where they purchase individual coverage most-suited for them.

Active employee exchanges: While the retiree exchanges are focused on individual coverage, the exchanges for active employees are focused on group plans.

Aon Hewitt’s offering, for example, provides employees with a credit to purchase health coverage that can be accessed through its private exchange. Once employees log-on to the exchange, they will select health care coverage from group options that are standard levels of coverage with varying levels of reimbursement.

The Mercer Benefits Choice Exchange (MBCE) allows employers with 100 – 1,000 employees to contribute a set amount to a HRA. Employees then use decision-support tools to select coverage and enroll online.

Mercer’s other offering, Mercer Health Advantage (MHA), allows self-funded employers with >3,000 employees to enroll employees in new medical plans beginning January 1, 2013 that will save the employer 5% or more. Employers will also get access to dedicated MHA clinical care management with ongoing oversight and audit capabilities.

Benefits administration is a major and mature HRO service line. Health care exchanges present a welcome new growth opportunity for HRO and more options for employers and active and retired employees. Expect more benefits service providers to add to the available service offerings.

Amy L. Gurchensky, Research Analyst, HRO, NelsonHall

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