What are Health benefit exchanges?

Under the Affordable Care Act, each state will be required to set up health benefit exchanges. These provide each state with marketplaces in which consumers, typically individuals and small businesses, are able to shop for a variety of health coverage options. Exchanges which are set up specifically for small business owners are known as small business health insurance programs or SHOPs. The exchanges will be user friendly for the consumer, making it easier for consumers to compare coverage options side by side. In conjunction with this, insurance carriers have responsibilities to make the content of their coverage transparent, detailing exactly what their plans do and do not cover. However, the exchanges also offer additional benefits, helping to advise consumers during their decision making process. This includes helping small companies to determine if they are eligible to receive tax credits to help fund their group coverage.         The plans offered by the benefit exchanges will also be analyzed to ensure that they meet new health care reform regulations. Consumers will be able to compare plans through the exchanges website or web portals. Each plan may also be rated based on their quality and cost, and customer service operators will be available for consumers.

Benefit exchanges will also take into consideration feedback from consumers using the exchanges to identify any problems with the plans or coverage. This helps them to revise how the exchanges are run and to resolve any issues with the carriers themselves. Some exchanges may also provide additional administrative services for small companies, helping to collect premiums and act as an intermediary between the company and the carrier. However, companies will continue to be responsible for many administrative tasks and should continue to ensure that they have appropriate software solutions and applications to manage health benefit administration. Integrated HR applications can help to connect existing software with those of the carrier’s external website. Finding ways to streamline and integrate benefit administration with payroll and accounting departments is particularly important. Integrated software solutions also integrate other administrative tasks, such as W2, tax and timesheets. Many applications can be implemented quickly and configured to meet the individual needs of the business. They also enhance communication between departments, including allowing employees to easily access their benefit information at their own convenience, update their information, and engage in open enrolment.

Many integrated software solutions are flexible, this is particularly useful for businesses who may wish to make updates to their processes or change benefit carriers. Outsourcing benefits administration is another option. Here, consulting companies offer advice regarding the most appropriate options for the company and they are able to suggest suitable software options. They work closely with the company during the implementation of these and provide ongoing support. With the current changes occurring under the health reform, ensuring that benefits administration is compliant and that companies are able to find cost effective ways to continue to offer health care coverage to their employees, is particularly important.

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