Introduction 1 <br>Attracting and Retaining Employees 3 <br>A New Paradigm Shift for Benefits 5 <br>The Exchange Evolution 8 <br>“Try It, You’ll Like It” 9 <br>Overcoming the “Wait and See” Mindset 11 <br> <br> PART I: THE CHANGING BENEFITS LANDSCAPE 13<br>Chapter 1 Building a Better Benefits System 15 <br>Principle #1: Give Them Money and Let Them Shop 19 <br>Principle #2: Provide True Price Transparency 23 <br>Principle #3: Provide Meaningful Choice 24 <br>Principle #4: Offer Guidance in the Form of Decision Support 27 <br>Principle #5: Optimize the Shopping Experience 29 <br>Principle #6: Ensure a Cultural Fit Within the Organization 33 <br>Principle #7: Refine, Iterate, and Improve 33 <br> Chapter 2 Benefits: The Accidental Entitlement 35 <br>Not Really an “Exchange” 38 <br>“Modern-Day” Insurance 40 <br>Benefits as Compensation 41 <br>So Where Does This Leave Us? 46 <br>Brokers Join the Bandwagon 49 <br> Chapter 3 They Don’t Know What They’re Missing: Flipping the Status Quo on Its Head 51 <br>The Problem with the Status Quo 53 <br>Disrupting the Status Quo 56 <br> Meaningful Choice 57 <br> Price Transparency and Defined Contribution 59 <br> Personalization 67 <br> Consumerism 70 <br> Chapter 4 Making Sense of Benefits Solutions: Public Exchanges and Private Exchanges 75 <br>The View from the Top: Public Versus Private Exchanges 75 <br>Who Runs These Things Anyway? Types of Private Exchange Operators 79 <br> Pure-Play Providers 79 <br> Benefits Providers 80 <br> Benefits Advisors 80 <br> Traditional Benefits Administration Companies 81 <br>What Should You Consider When Moving to a Private Exchange? 83 <br> Single- Versus Multi-Carrier Exchanges 83 <br> Self- Versus Fully-Insured Models 84 <br> Funding Strategies 86 <br>Who Can Benefit from Private Exchanges? Markets Served 86 <br>A Look at Products in Private Exchanges 89 <br>What Else Can Private Exchanges Offer? 95 <br> <br> PART II: STAKEHOLDERS: MAKING THE MOVE FROM “ONE SIZE FITS ALL” 97<br>Chapter 5 Employers Find Skin in the Game 99 <br>A Big Bet Pays Off: TitleMax, Part of the TMX Finance Family of Companies 100 <br>Customer-Focused Luxury Resort Gives Back to Its Employees: Sandestin 104 <br> Chapter 6 Six Questions to Ask Before You Choose a Private Exchange 109 <br>What Makes for a True Private Exchange? 111 <br> 1 Is Elasticity Built into Its Foundation? 113 <br> 2 Does It Include Decision Support and Educational Tools? 114 <br> 3 Are Prices Transparent? 116 <br> 4 Does It Integrate with Value-Added Services? 118 <br> 5 Does It Provide Year-Round Support? 119 <br> 6 To What Extent Does It Handle Benefits Administration? 120 <br> Chapter 7 Brokers and Exchanges: Better Together 123 <br>Rick Strater, Arthur J Gallagher & Co 127 <br> The Role of the Broker 128 <br> Overcoming Misconceptions 128 <br> Employees Don’t Care About Choice 128 <br> Cost Is All That Matters 129 <br> Defined Contribution Is “Cost Shifting” 129 <br>Rob Harkins, Willis Towers Watson 130 <br> The Changing Role of Brokers 131 <br> How Can Brokers Win? 131 <br> The Role of HR 133 <br> Technology Is the Future of Benefits 133 <br> Chapter 8 Insurers Find a New Way to Move Product 137 <br>The Private Exchange: A Bridge to the Future? 139 <br>What Insurers Can Gain from Private Exchanges 143 <br>Innovators Embrace Private Exchanges Early On 148 <br> Jessica Moser, MetLife 148 <br> Kevin Hill, Oxford Health Plans/UnitedHealthcare 150 <br>Insurers Aren’t the Only Ones Innovating 152 <br> <br> PART III: FUTURE VISION 155<br>Chapter 9 Innovation in Benefits (Yes, Benefits) 157 <br>Expanding the Aisles in the Benefits Store 163 <br>Letting Individuals Create Their Own Preferred Networks 165 <br>Creating a National Individual Insurance Market 169 <br> Chapter 10 The “Law of the Land,” Insurance Tax Reform, and the November Surprise 175 <br>“The Law of the Land…for the Foreseeable Future” 178 <br>The Viability of the Individual Market 183 <br>What Else to Note on the Legislative Front 185 <br> The “Cadillac” of Taxes—And Other Pending Legislation 186 <br> The Medicare Marketplace as a Model 187 <br> Small Businesses and Individual Benefits Marketplaces 188 <br> Tweaking the Tax Code 190 <br> Chapter 11 Who’s Afraid of the American Consumer? 193 <br>Some Potential Ways Forward 196 <br> Tax-Protected Savings Accounts 197 <br> Employer Funding for Individual Insurance 198 <br> Consumer-Centric Provider Networks 200 <br> Data and Digital Tools for Patients and Consumers 201 <br> Patient-Empowered Healing 204 <br>The Utopian Vision 206 <br> Shopping for Care 208 <br> Using a Marketplace to Purchase Non-Emergent Health Care on an As-Needed Basis 209 <br> An “In-Network” Conundrum? 212 <br>Final Thoughts 213 <br> <br> PART IV: APPENDIXES: A PRACTICAL GUIDE TO PRIVATE EXCHANGES 215<br>Appendix A Private Exchanges 101 217<br>Appendix B Making Sense of Benefits Terms 223 <br>Terms Related to Benefits 223 <br>Terms Related to Health Care Consumerism 226 <br>Terms Related to Private Exchanges 227 <br>Guide to Common Benefits Products on a Private Exchange 230 <br> Appendix C Real-World Data and Applications 233 <br>What Really Happens on Private Exchanges? 233 <br> Data from the 2017 Private Exchange Research Council (PERC) Analysis 233 <br>What Do Employers and Employees Really Think About Liazon Exchanges? 237 <br> Data from the Liazon 2017 Employer and Employee Surveys 237 <br> The Exchange Experience: A Look at How Benefits Are Selected on Liazon Exchanges 240 <br> For the Benefits Geeks: A Health Care Timeline 246 <br> Index 251 <br> <br> <br>