Sneak Peek: Top 10 Private Exchange Statistics that Matter (and Some That Don't)

#1) Did you know that there are approximately 200 companies purporting to be “private exchange” providers? This matters for many reasons. One, this signals there is demand. But, demand for what? Many of these providers are learning quickly that they’ve built the perfect product that nobody wants. A great deal of uncertainty remains on many private exchange fronts, but a few facts are very clear:

  • Benefits are broken.
  • Brokers and employers are looking for help. 
  • Experienced companies are booming. 
  • Automating the process is mandatory.

We predict that the industry will consolidate, and providers with a broad set of simple solutions combined with superior service will survive. 

#2) Only 14% of insured Americans are able to define the basic cost-sharing concepts fundamental to most health insurance plans. 

Private exchanges promise more choice, which sounds good. As a matter of fact, it is good. That said, if employees don’t understand key elements involved in choice, it creates a dilemma. Editorially speaking, healthcare insurance literacy is as important as expanded choice.


It is key to understand basic insurance concepts:

  • Deductible
  • Co-Insurance
  • Premiums
  • Max Out of Pocket

The elite of the 200 companies that advertise themselves as a “private exchange” provider focus as much on education as they do on choice. Interestingly, education will happen organically due to other changes. Scenario: Employee chooses low premium plan. Gets new insurance card. Goes to the doctor with whom they’ve had a 20 year relationship. Doctor says: “Sorry, I’m no longer covered by your plan.” Instantly, they will learn the term “narrow network” and learn more about deductibles and out-of-pocket costs. 


Register for Session 108: "Top 10 Private Exchange Facts That Matter (and Some That Don't)" at IHC's Forum & Expo on Tuesday, June 23rd from 4:45-5:45, and stay tuned to the Maestro Health Blog for more.

Follow Jeff Yaniga (@Jeff_Yaniga) and Maestro Health (@meastrohealth) on Twitter for real-time industry news and insights.