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When it comes to employee benefits, one size does not fit all.

A public exchange is set up through the federal or state government, or a combination of both. Health insurance companies or brokerage firms set up private exchanges. You may not feel completely equipped to take on the responsibility of choosing your own health insurance on a public exchange. A variety of options is wonderful, but can sometimes become overwhelming when tasked with making an informed decision in a complex marketplace.

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The Pearl Health Care Exchange offers support that extends beyond the online portal. Licensed advisors will work with you and make plan recommendations based on your specific needs. I have insurance through my employer. Can I still get coverage from the exchange? During the open enrollment period, you are free to compare plans and pricing available on public or private exchanges with the coverage available through your employer. The Affordable Care Act created government subsidies to help lower and middle-income families pay for health insurance. These subsidies help pay for monthly health insurance premiums, as well as health insurance costs, such as co-insurance, copays, and deductibles.

Eligibility for a health insurance subsidy is based on comparing your income to the federal poverty level. The federal poverty level changes every year, and is based on your income and your family size. You can estimate your tax subsidy and apply your savings directly to the plans offered on the exchange. Most plans offered after January 1, cannot refuse to cover you or charge you a higher premium based on a pre-existing health condition.

This remains true through the public as well as the private health care exchanges.

Understanding Health Insurance Exchanges

No, not at this time. Due to complexities and differences in health insurance providers and the public exchange rules in each state, the health insurance products offered through the Pearl Health Care Exchange are not available in all states. State availability for the Short Term Health Plan is listed above. Pearl's Licensed Product Specialists are available to assist you.

Private Exchanges Are Not For Everyone

Just call CST or email exchange acsplanadministrator. Pearl Health Care Private Exchange.

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The fastest growing part of the health insurance market these days is the private exchange. The consulting firm Accenture predicts 40 million will do so by In general, private exchanges are online health insurance marketplaces. Employers often give their workers a defined contribution, used to pay premiums for the products of competing health plans.

What is a Benefits Exchange?

Firms like Aon Hewitt, Mercer and Connecture are all in the business of building these marketplaces. In the American health care system no one ever sees a real price for anything. No patient.

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No doctor. No employer.

Private health exchanges: Coming to your employer?

No employee. Nowhere is that more true than in the market for health insurance. What difference does that make? As I wrote in Priceless , when everyone faces the wrong price, everyone ends up buying the wrong product. In the process, people face perverse incentives created by artificial prices, artificial markets and artificial competition. When they act on those incentives they tend to do things that make costs higher, quality lower, and access to care more difficult than otherwise would have been the case.

Take the buyer side of the market for health insurance. In the fact of community rated premiums, people who are under-charged the relatively sick will tend to over-insure.

The people who are over-charged the relatively healthy will tend to under-insure. Perverse incentives are even worse on the seller side of the market. Health plans have strong incentives to attract the healthy on whom they make a profit and avoid the sick on whom they incur losses. After enrollment, the incentive is to over-provide to the healthy to keep the ones you have and attract more of them and to under-provide to the sick to encourage the exodus of the ones you have and discourage enrollment by any more of them.

See my testimony on this issue and my Wall Street Journal editorial on it. An example of the perverse outcomes generated by perverse incentives is the Obamacare exchange. The plans are convinced that healthy people buy on price. Only sick people pay attention to networks.

Embracing HR Changes After Moving to a Private Health Insurance Exchange

Here is my advice to employers. This is especially true with the private exchanges. In theory, the private exchanges follow the same basic model as the Obamacare exchanges. However, they work a lot better.



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