Role of Private Health Exchange brokers in driving growth

Corporate Exchanges or Private Health Exchanges being set up by large health payers or coalition of several carriers may succeed in alleviating most of the health insurance related administrative concerns of the small businesses. But will businesses that traditionally have relied on brokers and agents to purchase group insurance shift to corporate exchanges for purchasing insurance?

The SHOP exchanges for small businesses are scheduled to arrive on the U.S. healthcare horizon only by January 1, 2014. With state-sponsored public health insurance setting-up deadline still over a year away, private health plans are setting up private health exchanges to avail of the early-bird advantage. Despite all this activity happening on the public and private health exchange sectors, there is still a lot of uncertainty around role brokers will play at these exchanges.

With the entire U.S. healthcare shifting to defined contribution business model from the current defined benefits model, small businesses and individuals are likely to be apprehensive and ill-educated on the benefits, options and possibilities that a shift to defined contribution model offers. Private health exchange brokers can inform and support small businesses and entrepreneurs and assist them in smoothly transitioning to a defined contribution business model.

Private health exchange brokers can also serve as health exchange ‘navigators’ and assist consumers in searching for a health plan that best fits their financial and health profile. The ACA suggests that brokers and agents group can be considered for a role of exchange navigators considering however that the selected brokers clear the exchange eligibility criteria. As navigators, private health exchange brokers would be responsible for making consumers aware of their health plan options, assisting them in determining their eligibility for the exchange or a health coverage plan and help them enroll in a health plan that meets the health requirements of the consumers.

Brokers and agents usually enjoy reliable and long standing relationships with their clients. A study conducted some time back revealed that small businesses and individuals that enjoy long and trustworthy relations with brokers often rely on the health insurance related advice of their brokers. Carriers setting up private exchanges are likely to benefit from brokers’ access to individuals and small businesses. Private health exchange brokers may be able to assist private exchanges in spreading awareness about the exchanges, answer and resolve consumer queries and doubts and help private exchanges become a recognizable brand even in the far reaches of the country.

Private health exchanges enjoy distinctive advantage over the public exchanges in terms of registering maximum number of small businesses before the state-sponsored SHOP exchanges become operative in January 2014. Private health exchange brokers can help carriers tap the available opportunity to maximum advantage.