Employee Benefits and the New Health Care Landscape: How Private Exchanges are Bringing Choice and Consumerism to America's Workforce

by Alan Cohen

Overview

2018 International Book Awards Finalist in "Business and Management" Category


We shop for everything else online…why not benefits?

Using private benefit exchanges (a.k.a. “online benefits marketplaces”), employers can bring a consumer-centric online shopping experience to benefits. Alan Cohen, a benefits technology pioneer, details how these platforms can offer unprecedented flexibility and choice to employees, revolutionize the way employers attract and retain talent, strengthen cost control in an era of skyrocketing premiums, and promote much-needed innovation in the U.S. health care system.

Discover How To

• Make sense of today’s challenging benefits landscape and plan breakthrough changes that have succeeded for thousands of employers of all sizes
• Leverage the lessons of the online shopping revolution to drive radical innovation
• Incorporate the 7 key pillars of a true private benefits exchange into your benefits mindset
• Gain indispensable practical insights from early adopters’ experiences
• Clarify the new roles of employers, HR, insurers, brokers, employees, and other stakeholders
• Accelerate your transition away from inefficient employer-managed plans
• Assess the ongoing impact of health care reform, public exchanges, health care consumerism, and other trends

Alan Cohen created one of the first private exchange platforms and has pioneered this approach for more than a decade. Now, in a candid discussion of how the economic principles of choice, consumerism, and defined contribution are at work in an exchange environment, he breaks down the concept for HR professionals, entrepreneurs, brokers, insurers, health care reformers, policy makers, and employees. Cohen looks to social and economic implications to forge a future in which all eyes are on a new model of the consumer for the benefits age.

With insights from industry veterans, Employee Benefits and the New Health Care Landscape brings a fresh perspective to the debate on health care and health insurance in America.

Product Details

ISBN-13:	9780134666273
Publisher:	Pearson Education
Publication date:	09/15/2017
Sold by:	Barnes & Noble
Format:	eBook
Pages:	288
File size:	15 MB
Note:	This product may take a few minutes to download.
Age Range:	18 Years

About the Author

Alan Cohen co-founded Liazon, operator of one of the industry’s leading private benefits exchanges for businesses of all sizes, in 2007. Liazon was acquired by Towers Watson, now Willis Towers Watson, in 2013.

Alan has been a leader in the benefits space for over two decades. Prior to cofounding Liazon, he was CEO and cofounder of Online Benefits, one of the first web-based benefits technology companies in the United States. He led the company through its sale to A.D.A.M, a global provider of consumer health information and benefits technology solutions, and later served as president of A.D.A.M. Prior to cofounding Online Benefits, he worked in the insurance industry for Prudential, Mass Mutual, and Cigna and served as managing director for a division of Northwestern Mutual Life.

Alan is often sought out for his insights on private exchanges, their role in the new health care landscape, and their effect on businesses. His expert commentary has appeared in Bloomberg Businessweek, Forbes, The New York Times, USA Today, The Washington Post, Yahoo! Finance, CNBC.com, and numerous benefits publications, including Employee Benefit News and Benefits Pro. In 2016, Alan was a recipient of an “Industry Innovator” award by the Institute for HealthCare Consumerism (IHC). IHC’s 11th annual “HealthCare Consumerism Superstars and Industry Innovator Awards” recognized the year’s top executives for their work in transforming the landscape of corporate health and benefits.

In this book, Alan draws on his in-depth experience in the benefits industry to share how the key principles he used to create one of the first private exchange platforms over 10 years ago is still relevant to anyone interested in forging a better system for all.

Alan holds a BA from Cornell University, an MBA from Columbia Business School, and an MBA from London Business School, where he won the Award for Academic Excellence.

Alan resides in Westchester, New York, with his family and spends summer weekends in Woodstock, New York. The Cohens are avid skiers and outdoors people.

Table of Contents

Introduction 1
Attracting and Retaining Employees 3
A New Paradigm Shift for Benefits 5
The Exchange Evolution 8
“Try It, You’ll Like It” 9
Overcoming the “Wait and See” Mindset 11

PART I: THE CHANGING BENEFITS LANDSCAPE 13
Chapter 1 Building a Better Benefits System 15
Principle #1: Give Them Money and Let Them Shop 19
Principle #2: Provide True Price Transparency 23
Principle #3: Provide Meaningful Choice 24
Principle #4: Offer Guidance in the Form of Decision Support 27
Principle #5: Optimize the Shopping Experience 29
Principle #6: Ensure a Cultural Fit Within the Organization 33
Principle #7: Refine, Iterate, and Improve 33
Chapter 2 Benefits: The Accidental Entitlement 35
Not Really an “Exchange” 38
“Modern-Day” Insurance 40
Benefits as Compensation 41
So Where Does This Leave Us? 46
Brokers Join the Bandwagon 49
Chapter 3 They Don’t Know What They’re Missing: Flipping the Status Quo on Its Head 51
The Problem with the Status Quo 53
Disrupting the Status Quo 56
Meaningful Choice 57
Price Transparency and Defined Contribution 59
Personalization 67
Consumerism 70
Chapter 4 Making Sense of Benefits Solutions: Public Exchanges and Private Exchanges 75
The View from the Top: Public Versus Private Exchanges 75
Who Runs These Things Anyway? Types of Private Exchange Operators 79
Pure-Play Providers 79
Benefits Providers 80
Benefits Advisors 80
Traditional Benefits Administration Companies 81
What Should You Consider When Moving to a Private Exchange? 83
Single- Versus Multi-Carrier Exchanges 83
Self- Versus Fully-Insured Models 84
Funding Strategies 86
Who Can Benefit from Private Exchanges? Markets Served 86
A Look at Products in Private Exchanges 89
What Else Can Private Exchanges Offer? 95

PART II: STAKEHOLDERS: MAKING THE MOVE FROM “ONE SIZE FITS ALL” 97
Chapter 5 Employers Find Skin in the Game 99
A Big Bet Pays Off: TitleMax, Part of the TMX Finance Family of Companies 100
Customer-Focused Luxury Resort Gives Back to Its Employees: Sandestin 104
Chapter 6 Six Questions to Ask Before You Choose a Private Exchange 109
What Makes for a True Private Exchange? 111
1 Is Elasticity Built into Its Foundation? 113
2 Does It Include Decision Support and Educational Tools? 114
3 Are Prices Transparent? 116
4 Does It Integrate with Value-Added Services? 118
5 Does It Provide Year-Round Support? 119
6 To What Extent Does It Handle Benefits Administration? 120
Chapter 7 Brokers and Exchanges: Better Together 123
Rick Strater, Arthur J Gallagher & Co 127
The Role of the Broker 128
Overcoming Misconceptions 128
Employees Don’t Care About Choice 128
Cost Is All That Matters 129
Defined Contribution Is “Cost Shifting” 129
Rob Harkins, Willis Towers Watson 130
The Changing Role of Brokers 131
How Can Brokers Win? 131
The Role of HR 133
Technology Is the Future of Benefits 133
Chapter 8 Insurers Find a New Way to Move Product 137
The Private Exchange: A Bridge to the Future? 139
What Insurers Can Gain from Private Exchanges 143
Innovators Embrace Private Exchanges Early On 148
Jessica Moser, MetLife 148
Kevin Hill, Oxford Health Plans/UnitedHealthcare 150
Insurers Aren’t the Only Ones Innovating 152

PART III: FUTURE VISION 155
Chapter 9 Innovation in Benefits (Yes, Benefits) 157
Expanding the Aisles in the Benefits Store 163
Letting Individuals Create Their Own Preferred Networks 165
Creating a National Individual Insurance Market 169
Chapter 10 The “Law of the Land,” Insurance Tax Reform, and the November Surprise 175
“The Law of the Land…for the Foreseeable Future” 178
The Viability of the Individual Market 183
What Else to Note on the Legislative Front 185
The “Cadillac” of Taxes—And Other Pending Legislation 186
The Medicare Marketplace as a Model 187
Small Businesses and Individual Benefits Marketplaces 188
Tweaking the Tax Code 190
Chapter 11 Who’s Afraid of the American Consumer? 193
Some Potential Ways Forward 196
Tax-Protected Savings Accounts 197
Employer Funding for Individual Insurance 198
Consumer-Centric Provider Networks 200
Data and Digital Tools for Patients and Consumers 201
Patient-Empowered Healing 204
The Utopian Vision 206
Shopping for Care 208
Using a Marketplace to Purchase Non-Emergent Health Care on an As-Needed Basis 209
An “In-Network” Conundrum? 212
Final Thoughts 213

PART IV: APPENDIXES: A PRACTICAL GUIDE TO PRIVATE EXCHANGES 215
Appendix A Private Exchanges 101 217
Appendix B Making Sense of Benefits Terms 223
Terms Related to Benefits 223
Terms Related to Health Care Consumerism 226
Terms Related to Private Exchanges 227
Guide to Common Benefits Products on a Private Exchange 230
Appendix C Real-World Data and Applications 233
What Really Happens on Private Exchanges? 233
Data from the 2017 Private Exchange Research Council (PERC) Analysis 233
What Do Employers and Employees Really Think About Liazon Exchanges? 237
Data from the Liazon 2017 Employer and Employee Surveys 237
The Exchange Experience: A Look at How Benefits Are Selected on Liazon Exchanges 240
For the Benefits Geeks: A Health Care Timeline 246
Index 251

Editorial Reviews

When Alan Cohen opened the doors at Liazon in 2007, he revolutionized the way insurance was sold. Though the idea was simple, it was also ahead of its time. Liazon was among the first companies to establish a private health insurance exchange, a trend that has since exploded. Employee Benefits and the New Health Care Landscape gives us a rare, inside look into the mind that created ‘the exchange wave’ ten years ago.”
—Kathryn Mayer, Editor-in-Chief, Employee Benefit News

“Regardless of your political affiliation, sitting out the current debate on health care and benefits is no longer an option. Private exchanges offer one solution to one part of the problem; this book explains why.”
—Christopher E. Condeluci, CC Law & Policy PLLC, ACA expert

“It has been my pleasure to work with Alan Cohen over the years and observe the private exchange evolution firsthand. The industry has been in need of a book like this for a very long time.”
—Rhonda Marcucci, Vice President, HR & Benefits Technology Consulting Practice at Gruppo Marcucci, a division of Gallagher Benefit Services, Inc.

From the Publisher