Smart Benefits: More Exchanges, More Choice for Small Employers

Smart Benefits: More Exchanges, More Choice for Small Employers

The article “New Competition for HealthSource RI Emerges” in GoLocalProv on February 4 reported that UnitedHealthcare caused a stir with a recent announcement that it would start a private exchange for small businesses in the state. In the piece, Christine Ferguson, Executive Director for HealthSource RI, was quoted as saying UnitedHealthcare’s exchange would limit options because employers who chose the private exchange would only get United plans compared to plans from a variety of carriers available through the public exchange. 

But with small business enrollment in HealthSource RI at just 107 employers (658 covered lives) as of February 4, the low numbers signal that a mix of carrier plans may not be that important.
 
Private Exchange Open Up Options

Most employers are used to dealing with one carrier, and they place cost and plan design above other considerations. For an employer who already offers UnitedHealthcare and has no desire to switch to another insurer or has selected United because its costs are less than the other carriers, United's private exchange will make sense. The only difference is that the employer’s employees will need to be computer savvy enough to embrace the exchange’s online, self-service approach to plan selection and enrollment.

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And to compete with United, other major carriers and benefit advisors are expected to launch other private exchanges in Rhode Island soon that will further expand choices for employers. That’s because, with the private exchanges, the employer is still free to choose the carrier, but will have a new option within the product portfolio.
 
Moreover, the private exchanges can also offer more than just medical plans, including dental, life/disability, vision and even voluntary plans, enhancing their efficiency.

The Real Concern?

Rather than be concerned about UnitedHealthcare’s exchange plans, perhaps Ferguson's should be focused on justifying the $23 million she has requested for the next state budget to keep the HealthSource RI operating. 

After the $80-plus million it cost to build HealthSource RI, the state’s General Assembly is leery of the added cost. And four major business groups have teamed together to demand that the users of HealthSource RI pay for it - not the taxpayers, the insurers (by passing fees to employers) or employers. Rhode Island Business Group on Health, the Chambers of Commerce, the Rhode Island Manufacturers Association and the National Federation of Independent Businesses have requested in writing that Governor Chafee, the legislators and other members of Chafee's administration assess the user fee and have these participants incur the cost.

So it’s not whether the United’s private exchange is better or worse for employers than HealthSource RI that’s the real question, but how to make HealthSource RI accountable to the taxpayers. 

Amy Gallagher has over 21 years of healthcare industry experience guiding employers and employees. As Vice President at Cornerstone Group, she advises large employers on all aspects of healthcare reform, benefit solutions, cost-containment strategies and results-driven wellness programs. Amy speaks regularly on a variety of healthcare-related topics, and is often quoted by national publications on the subject matter. Locally, Amy is a member of SHRM-RI, the Rhode Island Business Group on Health, and the Rhode Island Business Healthcare Advisory Council.