We are happy to report that we’ll be serving the Ohio Public Employees Retirement System (OPERS) in 2016. For more details about OPERS and the transition, click here for the full press release.

OneExchange today marked an important milestone: 50 employer clients have used our private Medicare solution to transition multiple groups of customers.

Workforces can be complex, and changing benefits for multiple groups at once may not always be possible. Union contract negotiation timelines differ. Employers may want to test-drive a new approach like an exchange with a portion of their population first. And newly acquired companies may present an opportunity to streamline benefits administration after an initial group has already transitioned.

These are all reasons why employer clients have come back time and time again to OneExchange in addition to the reasons they chose Towers Watson’s Medicare solution in the first place.

Read first-hand what Phil Belcher, U.S. Health & Welfare Plans Manager for Eastman Chemical has to say about Eastman’s experience with OneExchange.

71% of companies that offer retiree health care report that they already offer retirees access to a private Medicare exchange or plan to by 2016 – just 10 years after our inaugural enrollment season as the U.S.’s first private Medicare exchange in 2006.

Read the full announcement here.

TowersWatsonOneExchange-MedicareSolutionFuture

71% of companies that offer retiree health report that they already offer retirees access to a private Medicare exchange or plan to by 2016

OneExchange on TowersWatson.com

Find out more about OneExchange

Welcome to our new look! The OneExchange blog.

The blog’s new name and face reflect changes that began over a year ago when Towers Watson launched OneExchange.

Building on our private Medicare exchange roots, this blog has expanded to include news, research, trends and insights for all workforce populations – from full-time and part-time employees to pre-65 retirees in addition to our original Medicare perspective.

See OneExchange everywhere

You can see the new OneExchange look at all our sites, including:

  • On Twitter:
    • @OneExchange– Check out the new face of our tweet stream.
    • @brycewatch
      On Twitter at @OneExchange & @BryceWatch

      Follow us on Twitter at @OneExchange & @BryceWatch

      Check out the latest from our managing director, Bryce Williams, at his tweet stream.

  • Online:
    • medicare.oneexchange.com Check out the new face of our private Medicare exchange

      Towers Watson's private Medicare Exchange

      Towers Watson’s private Medicare Exchange

>> Stay tuned later this week when the Extend Health blog gets a new name and look. <<

For a hint at what’s to come, check out our new look on Twitter – @OneExchange is the new face of the @ExtendHealth stream – tweeting all the healthcare, benefits & reform trends we’re known for.

The recent expansion of our Exchange Solutions business segment is a good opportunity to look back at the news from our private Medicare exchange over the past few years. Here are highlights from our early days to today.

Towers Watson Announces Expansion of Exchange Solutions Segment
1/23/2014

Towers Watson Acquires Liazon to Expand Private Benefit Exchange Offerings Through Multiple Channels
11/27/2013

Towers Watson Signs Agreement With Federal Government to Facilitate Public Exchange Enrollments
9/9/2013

Towers Watson Selects WageWorks to Administer Health Accounts on Towers Watson’s New Private Health Insurance Exchange
7/8/2013

Towers Watson Names Woody Sides Exchange Solutions Regional Vice President of Sales in the West
7/1/2013

California State Association of Counties Partners With Towers Watson
6/11/2013

Leading Health Insurers to Provide Health Plans on New Towers Watson Private Exchange for Active Employees
4/29/2013

Towers Watson Kicks Off “Ready for 2014: Road to Exchange Solutions” Road Show
2/26/2013

Fidelity® and Extend Health Partner to Help Retiring Employees Transition to Private Health Coverage
2/5/2013

Towers Watson Announces OneExchange, a Health Benefit Solution for Full- and Part-Time Employees, and Pre-65 and Medicare Retirees
1/31/2013

Towers Watson Announces Expansion of Exchange Solutions Segment
1/23/2013

Extend Health Wins Inc. Magazine Hire Power Award for Leading U.S. Job Creators
12/21/2012

Extend Health Survey: 74% of Seniors on Medicare Confident that Medicare Will Be There for Them for the Rest of Their Life
11/5/2012

Read the rest of this entry »

The opening date for the exchanges inches closer and the states continue to make announcements regarding the carriers, plans, and rates on their exchanges. Advertising and outreach campaigns are also swinging into high gear across the nation, hoping to raise awareness and promote participation. The State Exchange Table summarizes the latest information on carrier participation and plan rates as they occur.

Latest Developments:

State Run Exchanges-

California: California’s largest health insurer for small businesses, Anthem Blue Cross, says it will not be participating on the state’s small business marketplace this fall. Because it is no longer a condition for insurance companies to participate on both the small business and the individual marketplaces, Anthem has chosen to sell only on the individual market.

Last Thursday, California released rates on its small business health insurance exchange. Average premiums for a 40 year old employee in the Los Angeles area could fall by as much as 17%.

To get a comprehensive look at California’s rates, pricing regions, and participating insurers, click here

DC: Another insurer, Kaiser Permanente, announces dropped rates on the DC exchange. This makes three out of four carriers on the DC exchange with lowered rates since preliminary rates were announced last month. Rates will decrease by 4.4 percent for small-business employees and half a percent for individuals.

Idaho: Nine insurers will sell medical and dental plans on the Idaho health insurance exchange. Altius Health Plans, Blue Cross of Idaho, BridgeSpan Health Company, PacificSource Health Plans and SelectHealth will sell medical plans on the exchange. BEST Life and Health Insurance Company, Blue Cross of Idaho, Delta Dental of Idaho, Dentegra Insurance Company, PacificSource Health Plans and The Guardian Life Insurance Company of America will sell dental.

Maryland: Rates on the Maryland exchange have been reduced by as much as 33%. The new rates will bring costs down, and monthly premiums for a 25-year-old nonsmoker buying a “bronze plan” in the Baltimore area will range from $131 to $237. For a 50-year-old nonsmoker buying a silver plan, prices range from $267 to $470 per month.

Washington: Four insurers have been approved to sell plans on Washington’s state exchange. BridgeSpan Health Company (an affiliate of Cambia Health Solutions, the parent company of Regence BlueShield), Group Health Cooperative, Lifewise Health Plan of Washington and Premera Blue Cross will sell plans on the individual marketplace. Rates on the marketplace may cost more than plans available today, but residents are expected to gain increased choice. A single 40-year-old non-smoker in King County could pay premiums ranging from $213 a month to $351. A 21-year-old single non-smoker could pay from $166 to $274, and a similar 60-year-old from $451 to $744 a month.

Partnership Exchanges-

Delaware: Delaware has approved three insurance companies to sell plans on its health insurance exchange. Highmark Blue Cross Blue Shield, Coventry Health and Life Insurance, and Coventry Health Care of Delaware will sell plans whose premium rates will be announced next month.

Federally Facilitated Exchanges-

Florida: Rates on the Florida exchange are expected to rise by 5 to 20 percent for small businesses and 20 to 30 percent on the individual marketplace. Average state-wide silver level plan premiums range from $315-$464.

Georgia: Two health insurance companies, Aetna and Coventry, have exited Georgia’s federally facilitated exchange. There are still five remaining carriers offering plans on the state’s exchange.

Indiana: Premium rates on Indiana’s exchange will jump by as much as 72% and could reach up to $570 for the most comprehensive plans. Although plans on the Indiana exchange are not “cheap,” the numbers are not outrageous, as they largely align with the rest of the nation’s rates. Estimates indicate that 45 percent of Indiana’s enrollees will pick bronze and 38 percent take up a silver plan. Although Indiana has not released information on metal-level premiums, estimates project that a 47-year-old male who does not smoke would be charged, on average, $307 per month. Sample plans from another plan, MDWise, predict a 47-year-old man will be charged $294 and $391 for a bronze and silver plan respectively.

Maine: Unlike many states that are launching high powered advertising efforts (California, Oregon, Vermont), Maine does not have any plans to market or advertise the Affordable Care Act this fall. The state has granted $2 million to community groups and health centers to promote and educate citizens about the health care law, but is taking a “hands-off” approach when it comes to advertising and wide outreach efforts.

Mississippi: Insurance carrier Humana announced that it will provide coverage options in 36 Mississippi counties that would have otherwise been left out of the exchange. Mississippi is home to some of the poorest and sickest populations in the nation, and the agreement with Humana guarantees that all counties in the state will have at least one company offering insurance on its exchange.

North Carolina: Three insurance companies will sell plans on the North Carolina state exchange: Blue Cross and Blue Shield of North Carolina, Coventry Health Care of the Carolinas and First Carolina Care Insurance Co. The state has approved plan rates for the three companies but has chosen not to publically release rate information until the exchanges go live in October.

Ohio: Ohio announced yesterday that the premiums on its federally facilitated exchange will jump by as much as 40%. This substantial rate increase announcement has been refuted by democratic lawmakers as incomplete. Ohio chose to take the average prices of gold and platinum plans that the majority of Ohioans won’t purchase. They also didn’t take into account tax credits provided by the federal government to ease the cost of insurance. The Ohio Insurance Department says the average premium in the individual market is currently $236.29 per month. The new average under the health care law will be $336.44, the department says.

South Dakota: Three insurers will sell plans on South Dakota’s health insurance exchange. Avera Health Plans Inc., Sanford Health Plan and South Dakota State Medical Holding Company, Inc. (DAKOTACARE) will sell plans on both the individual and small business (SHOP) marketplaces. The three insurers will offer a total of 56 plans. An average 21 year old could expect to pay $182 for a catastrophic plan, $305 for a silver plan or $333 for a premium platinum plan. An average 40 year old could pay $390 for a silver level plan and $405 for a platinum plan. And an average 60 year old could pay $830 for a silver plan and $860 for a premium level plan.

Virginia: Virginia will spend the second lowest amount per capita on education and outreach efforts for the Affordable Care Act’s state exchange. The $3.9 million in spending amounts to only 49 cents per resident. The only state spending less is Wisconsin, which is spending 46 cents per person. The overall trend shows that states opting for federally facilitated exchanges and those that are especially resistant to the health care law are receiving less in federal grant money. Private organizations and non-profit groups will provide additional outreach money and materials to Virginians to help get them enrolled in October.

Click here to view the consolidated information on the State Exchange Table

We’ve heard a lot about exchanges in the media, especially as the implementation date approaches for the first wave of the Affordable Care Act (ACA). With phrases like “public exchanges” and “online marketplaces” making headlines, it raises the question – what are exchanges and how do they work?

One group of people that knows is the Medicare-eligible retirees who have purchased individual private Medicare plans on our exchange. In a survey of 567 of our retirees fielded between July 27-July 29, 2013, respondents demonstrated a clear understanding of exchanges, with 46.4 percent identifying them as “a marketplace that makes it easier to compare healthcare plans from different health insurance companies.” Just 12.4 percent responded, “I don’t know.”

Based on their experience with our private exchange solution, 52.3 percent of retirees said they consider “exchanges a welcome addition to the U.S. health insurance system.” Just under a quarter (23.5%) even said, “I wish my employer had allowed me to select and enroll in health insurance plans through an exchange when I was an active employee.”

Our retirees also reported that they are using web-based decision support tools when evaluating and comparing health insurance plans. While our retirees historically preferred talking with benefit advisors over the phone to evaluate plans on exchange – and that has not changed – a large number of respondents to our recent survey said they also compared different plans using the exchange website (47.8 percent).

When it comes to purchasing a plan, however, just 8 percent said they purchased online on their own, with no help from a benefit advisor. This reinforces our long-held belief that while technology powers health insurance exchanges – and helps people compare plans, make purchase decisions and enroll in plans – technology is no substitute for direct human interaction.

As we’ve said many times before, an exchange is more than an interactive website.

Details on survey questions and answers follow.


Which statement best describes a health insurance exchange?

A marketplace that makes it easier to compare
health plans from different health insurance companies
46.35%                     

A marketplace that promotes competition between
health insurance companies that results in lower
prices
15.33%                                           

A marketplace where buyers have more choice
in health plans
14.78%

An organized marketplace for buying and selling
health insurance
11.13%  

I don’t know
12.4%

Based on what you know about health insurance exchanges, which of the following statements are true? (Please select all that apply.)

Health insurance exchanges are a welcome
addition to the U.S. health insurance system
52.27%

I prefer to purchase my private Medicare plans
through an exchange
45.45%

Everyone should have access to a health
insurance exchange
45.55%

I wish my employer had allowed me to select
and enroll in health insurance plans through
an when I was an active employee
23.48%

Health insurance exchanges are unnecessarily
adding little or nothing of value to our
health insurance system
13.64%

When you evaluated or purchased a health plan on an exchange, which of the following types of support did you use before making your purchase? (Please select all that apply.)

Talked on the telephone with a benefit advisor
75.05%

Compared different plans using the exchange
website
47.84%

Reviewed ratings of health insurance plans and
companies
28.14%

Talked with family members or friends
26.45%

Read articles, blogs or forums online
13.51%

When you evaluated or purchased health insurance plans on an exchange, did you:

Evaluate and purchase plans only with
the help of a benefit advisor
37.70%

Evaluate and purchase plans online by
yourself with no help from a benefit advisor
8.01%

A combination of the two
54.28%

In a new survey from Health Pocket released this week, 65 percent of respondents said they would prefer to choose their own insurance carriers rather than have their employer choose for them. But the majority of Americans don’t have the ability to choose their own insurance company. Sixty-six percent of insured Americans receive coverage through their employer, where health care options are limited to the insurers selected by the company.

Private exchanges emerging into the market today from a number of companies, including Towers Watson, offer the kind of choice that the survey indicates people want. A report by Accenture predicts that private exchanges will surpass enrollment in public exchanges by 2018.

Read the Health Pocket survey here: http://www.healthpocket.com/healthcare-research/surveys/group-health-insurance-plans-americans-prefer-to-choose-provider

The national conversation on exchanges has reached a new milestone this year – It just got real for a lot of employers.

And while the news is focused on public exchanges and whether employers will drop coverage, inside companies there are a lot of open-ended questions, starting with,

How? What’s the right path?

The answers employers are looking for are different than what consumers need. Employers have to get under the hood and kick the tires. They can’t afford to find out down the road that their employees and businesses have a need that their exchange is not equipped to deal with.

For most large, high-performing employers who provide health benefits today, the exchange option does not mean letting their employees seek coverage solo on the public exchanges. It involves moving to a new model of managing health benefits – one where employees take a more active role for themselves and one where the employer’s role is also evolving.

When employers interact with exchanges, they need everything consumers need – and a lot more:

  • A proven, end-to-end technology foundation – There’s a lot of new code being written right now. Most large, sophisticated employers do not want their employees to be quality assurance testers for a new system. An exchange with a history of sound technology and a track-record of success stands out from the crowd.
  • Reports for managing health benefits, population by population – When working with an exchange, employers need to be able to track their employee populations, active and retired. Exchanges must offer a sophisticated suite of business intelligence tools to let employers see how their people are faring so they can continue to execute proactive health benefit strategies.
  • Data to manage and workforce health and wellness – High-performing wellness programs are getting more and more recognition as ways to influence population health and contain costs. Employers who have group plans or who self-insure need to manage their health benefits strategically.
  • Benefit advisors to manage the questions their in-house HR departments cannot – An exchange needs enough expertise on staff and a sophisticated customer management system to answer the questions that HR cannot. Without an adequate advisory component – including knowledgeable, licensed benefit advisors – employers could risk a flood of questions and concerns from worried employees.
  • Individual tracking capabilities that synch with eligibility for federal subsidies – Access to subsidies is a very important to evaluating how employees will fare. It’s not an easy metric to track, as it could depend on criteria like household income, which can vary week to week.
  • Funds and claims management tools – Most large employers are looking to exchanges to let them fund greater choice and value for employees – not to end funding but to make it sustainable.
  • A great interface – Last but not least, an exchange should have a great user interface that helps consumers crunch a lot of data into practical chunks and provides effective decision support tools.

We put the web element last because that’s the first place people tend to go, and it really is the tip of the iceberg: As you can see, an exchange is a lot more than a website.

We advise employers to get under the hood of an exchange. Kick the tires by checking out analytics, service features and management tools.

An exchange needs to be a lot more than a pretty interface, because there’s no latitude for buyers’ remorse down the road.

Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.

We’re kicking of a series of seminars in eight cities this week, starting in Falls Church, VA. The purpose of this road show is to help employers get ready for 2014, when some of the most important provisions of the health care reform law go into effect.

The events will feature high-level discussions of potential health care benefit strategies in light of health care reform. They will also introduce employers to OneExchange, a strategic health benefit solution that helps employers leverage health care reform to their advantage using proven, end-to-end, integrated, private and public exchange-based solutions for full-time, active employees; part-time employees; and both pre-Medicare and Medicare-eligible retirees.

Confirmed events are as follows:

  • Falls Church, Virginia — March 6
  • Atlanta — March 19
  • Houston — March 28
  • Minneapolis — March 28
  • Cincinnati — April 4
  • Dallas — April 11
  • San Francisco — April 18
  • Chicago — April 24

Employers interested in attending may contact Alissa Federspiel, alissa.federspiel@extendhealth.com for more information.

Read the Towers Watson  Press Release >

In this second installment of our two part series on rate review, we’ll take a closer look at transparency, requirements for an “effective” state program, and how the rate review grants program is helping states improve their review processes.

Transparency is an important element of the Affordable Care Act (ACA). The rate review provision of the ACA provides an “unprecedented level of scrutiny and transparency to health insurance rate increases” to protect consumers from unjustified premium increases. Consumers in all 50 states will have access to the proposed rate increases, an explanation from the insurer as to why it believes an increase is necessary, and, for the first time, be able to comment on the proposed rate increase. After analysis and public comment the final determination, and the reasoning behind it, are made public.

Rate review information is available on HealthCare.gov at: http://companyprofiles.healthcare.gov/. You can look up proposed rate increases by insurance company or overall by state.

The transparency that the rate review program provides not only protects consumers from unjustified rate increases, it promotes competition and encourages insurers to keep costs down. It builds on other provisions (such as the Medical Loss Ratio 80/20 rule) and aligns with the ACA’s goal to make health care more affordable.

Every state must have an “effective” rate review program. If it doesn’t, HHS will review rates for the state. The Center for Consumer Information & Insurance Oversight defines “An effective rate review system” as follows:

  • Must receive sufficient data and documentation concerning rate increases to conduct an examination of the reasonableness of the proposed increases.
  • Must consider the factors below as they apply to the review:
    • Medical cost trend changes by major service categories
    • Changes in utilization of services (i.e., hospital care, pharmaceuticals, doctors’ office visits) by major service categories
    • Cost-sharing changes by major service categories
    • Changes in benefits
    • Changes in enrollee risk profile
    • Impact of over- or under-estimate of medical trend in previous years on the current rate
    • Reserve needs
    • Administrative costs related to programs that improve health care quality
    • Other administrative costs
    • Applicable taxes and licensing or regulatory fees
    • Medical loss ratio
    • The issuer’s capital and surplus
    • Must make a determination of the reasonableness of the rate increase under a standard set forth in State statute or regulation.
    • Must post either rate filings under review or preliminary justifications on their websites or post a link to the preliminary justifications that appear on the CMS website.
    • Must provide a mechanism for receiving public comments on proposed rate increases.
    • Must report results of rate reviews to CMS for rate increases subject to review.

Source: CCIIO http://cciio.cms.gov/resources/factsheets/rate_review_fact_sheet.html

Forty-four states and the District of Columbia have rate review programs that the HHS has deemed “effective.”  Some states have the power to deny or modify the proposed rate increase if it is deemed unreasonable. Other states can determine the rate is unreasonable, but don’t have the authority to stop the insurer from implementing the increase. HHS will review proposed rate increases for states that do not have an “effective” review program, but it lacks the authority to deny rate increases.

The $250 million Rate Review Grants Program is designed to provide states with funding to improve their rate review programs. These funds have made it possible for states to build and improve the quality and efficiency of their rate review programs and provide consumers with greater transparency and protection from unjustified rate hikes. HHS anticipates awarding additional funds in 2012 and 2013 to help states further improve their ability to protect consumers.

According to the 2012 Annual Rate Review Report: Rate Review Saves Estimated $1 Billion for consumers, the rate review grants program has helped 21 states expanded the scope of their rate review efforts, 41 states have improved the quality and efficiency of their rate review process, and 42 states have increased consumer transparency. In addition, it has helped states empower consumers with information that was previously not available.

Before the ACA most consumers were left in the dark regarding premium rate increases. Many experts believe this lead to insurance company abuses and unnecessarily high premiums. The Rate Review Program and the Rate Review Grants Program have helped states provide consumer protection by analyzing and disclosing proposed double digit rate increases to consumers.

Read: Rate Review – Protecting Consumers from Unjustified Premium Increases: Part One

Resources:

2012 Annual Rate Review Report: Rate Review Saves Estimated $1 Billion for Consumers

http://www.healthcare.gov/law/resources/reports/rate-review09112012a.html

Quantifying the Effects of Health Insurance Rate Review

http://www.kff.org/healthreform/8376.cfm

http://www.kff.org/healthreform/upload/8376.pdf

CCIIO http://cciio.cms.gov/resources/factsheets/rate_review_fact_sheet.html

Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.