Private health insurance exchanges: New and old players selling online

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SUMMARY: If you’re a health insurance broker, you’re probably hearing the sound of thundering feet. More and  more competitors are coming to the marketplace, both online and off. And what’s the deal with all those places selling insurance online that are not healthcare.gov.?

 

 


 

The state and federal exchanges for selling insurance are augmented by a slew of private, non-government options, also called private exchanges.

These players — some of the big ones are eHealth, GetInsured, GoHealth, ExtendHealth (from Towers Watson) and ConnectedHealth — are selling insurance online, some with private options and some a mix of  Affordable Care Act plans and non-A.C.A. plans. Many of them pre-dated the Affordable Care Act, but have ramped up operations in light of A.C.A. options.

Towers Watson, for example, is a big benefits company. They bought ExtendHealth and turned into a private exchange called OneExchange, which  “offers employers both private and public exchange-based health insurance options for their full- and part-time workers, and for all retirees.”

These private exchanges, called web-based entities or web-based brokers, have both A.C.A. plans and plans that differ from the A.C.A. ones, and also may have vision and dental insurance and other products, while the state and federal exchanges have specifically A.C.A. options.

They signed an agreement with the government to be part of the Federally Facilitated Health Insurance Exchange (FFE), the new federal health data system.  HealthCare.gov is perhaps the best-known part of that system.

Many of these exchanges have been in business for some time. EHealth, for example, was founded in 1998.

The private exchanges are paid by insurers for bringing in customers. Since they offer plans that are not A.C.A. plans, they may have more variety — bigger or smaller networks, bigger or smaller price tags, and differing options. Non-A.C.A. plans on the private exchanges do not qualify for subsidies, however.

Private exchanges may have broker-advisers to help people through the process. Those brokers will be paid by how much business they bring in. On the A.C.A. exchange sites, both state-run and federal, there are advisers available by phone; navigators trained in the process also give advice. They don’t get paid by the business they bring in.

There are some unusual players entering the marketplace: Intuit’s Turbotax has a new page allowing people to see the costs and penalties of health insurance. It also sends people to either Healthcare.gov or  EHealth, suggesting that they’re getting paid for directing people there.

A new entrant, healthsherpa.com, is a web-based entity that was founded by San Francisco entrepreneurs with background in real estate. They used their tech chops to launch a site called opscost, comparing hospital pricing information released by the government. Then, in advance of the Affordable Care Act, they launched healthsherpa, collecting and sorting A.C.A. plans. When the problems with healthcare.gov during the launch kept people from finding information, healthsherpa had it. Now they’re qualified to sell both A.C.A. plans and non-A.C.A. plans.

There are also a number of A.C.A. scams — entities that purport to be reputable businesses, but aren’t. If you have any questions about who you’re dealing with, here are some suggestions from the Federal Trade Commission. Much of it is common sense: don’t give personal information to just anybody, be cautious about medical discount plans (No! they’re not insurance! and some of them exist just to get your information and your money!) and just generally, don’t give your money to just anybody who asks for it. Be thoughtful.

Think you’re seeing a scam? Call 1-877-FTC-HELP (1-877-382-4357) or go to ftc.gov/complaint. “Your reports give the FTC the information it needs to launch investigations, and put scammers out of business,” the FTC web site says.

Here’s the rest of our series on insurance exchanges, collected into one page.