Why brokers should associate with Private Health Insurance Exchanges?

The final health insurance exchange ruling released under the Affordable Care Act, mandates all states to ready and submit their health insurance exchange plans by October 2013. States need to set up their local health insurance exchanges by 2014, failing which the federal government would set up its own health insurance exchange in the state. Beginning 2014 and until 2015, states would be given an option to decide if they want to allow small businesses with 50 or less employees or small businesses with 100 or less employees to participate in the exchange. Only by the year 2016, states would be able to throw open the exchange for all the businesses irrespective of their organizational size.

There are a lot of uncertainties revolving around the public health insurance exchanges in terms of their organizational structure, time of implementation etc. There is a lot of indecisiveness and vagueness about the role that health insurance brokers and agents would play in the health insurance exchanges. With most private health payers and carriers setting up their own exchanges, private exchanges are rapidly emerging as the hottest current trend in the healthcare industry. Brokers may find it beneficial to get associated with the private health insurance exchanges as these exchanges provide growth opportunities to the brokers.

Many small businesses may not meet the eligibility criteria for participating in the public health insurance exchanges and are likely to turn to private health insurance exchanges for purchasing insurances for their employees. Private exchanges are increasingly adopting and introducing defined-contribution plans for employers under their health products. Brokers with their large network and client pool, may prove valuable in garnering business for the private exchanges.

Despite the successful launch of private exchanges, most small businesses may be hesitant to purchase their health insurance directly through the private exchanges. Brokers may prove to be a valuable help and can work as 'navigators' to guide and advise businesses on selecting the best fit plan from a private health insurance exchange, for their clients. With still a lot of uncertainties and confusions on how 'insurance exchanges' will operate, brokers may find a lot of opportunities to learn and grow at private exchanges by formulating smart strategies for enhancing customer insurance shopping experience, adding and retaining clients, innovating in insurance service administration etc.

The deadline for setting up public health insurance exchanges is still a few months ahead, but health insurers are entering into business partnerships and M&As to set up their insurance exchanges now. Brokers thus may find it advantageous to get associated with private exchanges and assist employers in easily purchasing insurances off the private exchanges.

With the ACA awaiting jurisdiction in the Supreme Court, it cannot be said with certainty whether or not insurance exchanges would survive the constitutionality ruling. Even if the entire ACA gets repealed, health payers and insurers would continue with their health insurance exchange implementation processes, thus paving way for brokers to participate and become a leader in selling insurance and bringing in clients for the private health insurance exchanges.