Articles | January 8, 2021

Private Exchanges: Are They Right for Your Organization?

Since the passage of the ACA, various organizations have designed and marketed their version of the ideal private exchange to employer plan sponsors. 

Segal is one of the only comprehensive full-service HR and employee benefit consulting firms that doesn’t offer a private exchange: we believe that doing so would compromise our objectivity when advising on whether to adopt one. 

In this primer, we summarize the basics of private exchanges and look at some pros and cons.

Businessman Looking Outside The Window From His Office

What are private exchanges?

A private exchange is an online resource, usually a website, where employers (or employees themselves) can shop for health insurance and enroll in a plan.

Private exchanges now come now come in all shapes and sizes:

  • Fully insured, self-funded, or a combination
  • Comprehensive or simple
  • Fully baked or customizable
  • For active employees or for retirees.

Some employers have found these designs to be an attractive way to deliver health coverage that expands choices for employees and improves services and support.

They may even reduce costs. But other employers find the private exchange landscape complex and misleading and believe it to make promises without a return on investment.

Private exchanges: pros and cons

Before switching to a private exchange, ask yourself these questions. 

  • Does the plan design meet the healthcare insurance priorities of your workforce?
  • Will the cost and coverage keep you competitive?
  • Who would be the named fiduciary of your plan?
  • What components of the plan are required vs. customizable?
  • Does the exchange provide data about workforce healthcare trends and utilization?
  • What point solutions or vendors are part of the exchange and how are they paid?
  • What are the service guarantees promised by the exchange?

Evaluating existing private exchanges

If you already sponsor a private exchange, is it doing everything it promised?

Some organizations that chose to join an exchange are now reevaluating their options and determining if it is still the right fit.

If that description applies to your organization, perhaps it’s time to take a fresh look at whether your exchange is doing all it promised.

For example, Segal is one of the only comprehensive full-service HR and employee benefit consulting firms that doesn’t offer a private exchange, because we believe that it would compromise our objectivity.

If you're looking to assess your existing sponsorship of a private exchange, or to begin sponsoring one, we can get help you evaluate. Get in touch. 

Segal is one of the only comprehensive full-service HR and employee benefit consulting firms that doesn’t offer a private exchange

Why? Because we believe that it would compromise our objectivity.

Start a conversation about private exchanges

If you have any questions about private exchanges (or anything else), we'll put you in touch with someone from our health practice.

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This page is for informational purposes only and does not constitute legal, tax or investment advice. You are encouraged to discuss the issues raised here with your legal, tax and other advisors before determining how the issues apply to your specific situations.