HealthCare Exchange Solutions

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Accelerating Consumerism 2014’s Power Couple: Private Exchanges and Health Savings Accounts Playing the Exchanges Waiting Game

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INSIDE

FEATURE 11 The Power of Choice: The Game-Changing Combination of Private Exchanges and Health Savings Accounts Private exchanges are coming. Regardless of which study you pick or which representative sample of employers you survey, the numbers suggest a sizable number of U.S. employers will adopt some form of private exchange solution by the end of the decade. But what effects will the emerging private exchanges really have on employer-sponsored health care? Benefit plan designs? Account-based plans and the health care consumerism mega-trend?

In this feature, John Young and Todd Berkley — two veterans of health care consumerism through former roles at Cigna and Optum respectively — present groundbreaking research on private exchanges, particularly examining the symbiosis between private exchanges and health savings accounts — two generations of health care consumerism coming together to accelerate the mega-trend.

By Jonathan Field, Managing Editor, The Institute for HealthCare Consumerism, with John Young, CEO, Consumerdriven, LLC

9 Mercer Creates Complete Workforce Exchange Solution Through Partnership with GetInsured

March 2014. Earlier in March, the company, which also recently acquired Transition Assist to bolster its retiree exchange offerings, announced a partnership with Silicon Valley’s GetInsured that will bring the Mercer Marketplace exchange brand into an entirely new sector: the individual market.

With 67 employers already utilizing its private exchange, global consulting firm Mercer has been one of the most visible leaders in the emerging private exchange space. Through its active and retiree exchanges, Mercer currently provides benefits to over 280,000 individuals as of

By Jonathan Field, Managing Editor, The Institute for HealthCare Consumerism

4 Publisher’s Letter CEO/Publisher Doug Field covers the latest in private exchanges and defined contribution and shares what’s happening at The Institute for HealthCare Consumerism around exchanges.

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Briefs & Innovations Keeping you up-to-date with the latest news, research and innovation in defined contribution and health insurance exchanges. t Cigna Launches Private Health Care Exchange in Four Metro Areas

PlanSource Announces $12 Million Series B Investment to Expand its Private Exchange

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First Niagara Launches Private Insurance Exchange Regions Insurance Offers Private Exchange Solution to Employers Maestro First to Feature New Solution for EmployerSponsored Health Care Market

DEPARTMENTS

10 Is 2014 the Year of ‘Evaluate then Decide’ When it Comes to Exchanges?

They are some of this year’s biggest buzz words. Exchanges — whether private or public — have people talking, wondering how they will fare, how many employers will adopt them and so on. As managing director of exchange solutions for Towers Watson, a global professional services company, Bryce Williams has a unique view into the exchange world. From his perspective, while 2013 was the year of “wait and see” for exchanges, 2014 is the year of “evaluate then decide”.

By Heather Loveridge, Senior Editor, The Institute for HealthCare Consumerism

HealthCare Exchange Solutions™ I www.TheIHCC.com I March/April 2014

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PUBLISHER

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!"#$%&'#($&)$*+,-&.##$/"&01# At The Institute for HealthCare Consumerism, we have long discussed private exchanges as being a key component of health care consumerism. In 2011, Liazon was named an Industry Innovator in the annual HealthCare Consumerism Superstars issue for its Bright Choices exchange. Since acquired by global consulting firm Towers Watson, Liazon is now one of the most recognizable names in exchange solutions today. What a long trip it has been for everyone that has advocated the potential of private exchanges.

A “buzz word” in health care and employee benefits media today, the success of private

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exchanges is really no surprise to those who have been following and evaluating the solutions for

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the last five years. The most effective private exchanges understand how to unleash the power

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of consumer choice.

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In the cover feature for this issue, Managing Editor Jonathan Field talks with John Young, chief executive at Consumerdriven, LLC, and Todd Berkley, president, HSA Consulting Services, LLC, on recent research the two consultants have recently conducted.

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As veterans of health care consumerism through previous roles at Cigna and Optum respectively, Young and Berkley recently turned their focus toward the combination of private exchanges and health savings account, a symbiotic relationship that will accelerate consumerism at even a greater rate.

Beyond the pages of this issue, John and Todd will be presenting the completed report of the same name as this issue’s cover feature at the 2014 FORUM & Expo on May 7. Around the same time, they will also be publishing a white paper containing all of their findings.

Finally, I hope all of our readers can join us at the upcoming FORUM & Expo, which will feature industry-leading information on private exchanges, public exchanges and defined contribution.

And if you cannot make it to the event in Atlanta, I hope you consider FORUM West this December in Las Vegas.

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Sincerely,

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Doug Field CEO/Publisher dfield@fieldmedia.com

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March/April 2014 I www.TheIHCC.com I HealthCare Exchange Solutions™

NEWS BRIEFS & INNOVATIONS

NEWS BRIEFS Benefitfocus Achieves Web-Based Entity Certification to Offer Employers a Whole Workforce Solution Benefitfocusannounced the company’s wholly owned subsidiary BenefitStore, Inc. has signed an agreement with CMS to confirm its status as a Web-Based Entity. With this agreement, Benefitfocus creates a channel for employers to facilitate enrollment in Qualified Health Plans for employees who may be eligible for an advanced premium tax credit through the Federally Facilitated Marketplace. Benefitfocus HR INTOUCH provides employers a comprehensive benefits solution that accounts for all segments of their employee population as the ACA introduces new health care coverage options for individuals.

Array Health to Offer Private Exchange Solution Through AHIP Connect Program Array Health announced its approval to participate in the AHIP Connect program. AHIP Connect is an industry solution provider sourcing and independent evaluation program that helps AHIP’s health plan members choose companies to implement operational business solutions that reduce costs; increase efficiency, safety and quality; and enhance the consumer experience. Health plans can leverage the Array Spectrum™ private health insurance exchange platform to support end-to-end consumer engagement for marketing, selling, enrolling, managing, renewing and administering health and ancillary benefits for their large and small group, individual and retirement business segments.

Laurus Strategies Launches Private Exchange Consulting Practice Laurus Strategies, a leading business resource firm specializing in HR, employee benefits and risk management solutions, announced the formal launch of its Private Exchange Consulting practice. The PEC practice was created in 2013 to provide independent, best-inclass health care benefits consulting in the rapidly evolving exchange market. With health care reform underway and private health insurance exchanges gaining momentum, many company executives are struggling to understand what is legally mandated and what the most efficient and effective solution is for their workforce. Adding to this dynamic is the fact that several well-known benefits consulting firms have developed or purchased their own private exchanges.

Liazon Welcomes Humana to the Bright Choices Exchange Liazon has announced that Humana medical and ancillary products will be offered on their Bright Choices Exchange in six select states.

Markets will begin quoting in March and April. Future expansion will incorporate Humana medical and ancillary products in additional states throughout 2014 and 2015. Bright Choices’ users with a Humana medical plan can participate in Humana’s wellness and rewards solution, HumanaVitality, a proven, data-driven wellness and rewards program that focuses developing and reinforcing healthy lifestyles.

SelectQuote Benefit Solutions Forms Comprehensive Partnership with GetInsured Through a partnership with GetInsured, SelectQuote Benefit Solutions has added health insurance for pre-65 individuals to their employer benefits portfolio. The integrated partnership allows households to

manage their health insurance benefits — for both pre- and post-65 individuals — through one comprehensive exchange platform. The private exchange marketplace offered by SelectQuote Benefit Solutions and GetInsured allows employees and retirees a broader range of choices, offers plan savings and allows both pre- and post-65 health care coverage independent of the employer.

Bloom Health Advances Its Private Exchange Platform with Empyrean Benefit Solutions Partnership Bloom Health has announced their partnership with Empyrean Benefit Solutions, one of the fastest-growing, most advanced benefits technology and service firms, to enhance the Bloom Private Exchange Platform solution. Bloom Health has been operating private exchanges for health plans, employers and insurance agencies since 2009. The Private Exchange Platform gives employees industry-leading decision support to make informed benefit decisions, while providing employers with cost predictability and administrative relief for HR staff. Bloom Health sells its platform with insurance company sales representatives, through agents and brokers and direct to employers.

bswift to Accelerate Growth With Investment From Great Hill Partners bswift recently announced that it has received a minority equity investment of $51 million from Great Hill Partners, a Boston-based private equity firm focused on partnering with rapidly growing technology and technology-enabled services companies. bswift’s existing leadership team will use proceeds from the financing to further strengthen its service and technology offerings and solidify bswift’s position as a market leader. Great Hill Partners’ investment was funded with equity financing from Great Hill Equity Partners IV, LP, its $1.1 billion committed pool of capital that provides significant availability for follow-on investments.

Moody’s: Benefit Consultants Early Winners in Private Health Exchanges Major benefit consulting firms are investing resources to develop private exchanges, said Moody’s Investors Service in its new report “Benefit Consultants Are Early Winners in Building Private Health Exchanges.”

The rating agency notes that enrollment in private exchanges could grow to tens of millions of active employees by the end of this decade from fewer than one million enrolled currently. Moody’s report noted that exchange-related earnings for leading consultants — Aon Hewitt, Mercer and Towers Watson — will be partly offset in the near term by the costs of developing exchanges and by the fact that many enrollees in active employee exchanges are existing clients transitioning from company-specific health plans to exchange-based plans.

Q4 Announces Private Exchange Contract With the Largest Insurance Agency in Arkansas Q4 Systems Corporation announced that they will be implementing their comprehensive QHIX Health Exchange Platform for The Hatcher Agency, Arkansas’ largest insurance group. Hatcher is also the largest agency for Blue Cross Blue Shield in Arkansas with more than 600 employers as clients. QHIX, built by Q4 Systems Corporation, is an industry-leading, cloud-based platform for managing all elements of a private exchange offering.

HealthCare Exchange Solutions™ I www.TheIHCC.com I March/April 2014

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The Collective Voice on Innovative Health & Benefit Management

HealthCare Consumerism Radio Show Listeners will LEARN about the latest trends and best practices in health care consumerism, will CONNECT with healthcare industry thought leaders, and can SHARE their ideas by contacting the hosts of the shows afterwards.

Archives of each show are also available. !"#$%#&'(")&*#$)+,-./#*0-/$1&20+$3"+4$ 0-$5+6"+-(#2$78$!"#$9,-(0(.(#$:+*$%#&'(")&*#$ )+,-./#*0-/$);<$&,2$=+.,2#*$ >+.?$=0#'2$&'+,?$40("$;20(+*0&'$)"&0*/&,$ 1+,$@&5"/&,$&,2$A*+2.5#2$0,$)+,B.,5(0+,$ 40("$C/#*05&D-$E#7$1&20+ Join the Conversation by Sharing Your Thoughts and Questions:

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NEW PRIVATE EXCHANGES Presented by PrivateHealthCareExchanges.com

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First Niagara Launches Private Insurance Exchange First Niagara Benefits Consulting, a division of First Niagara Risk Management, Inc., has announced its launch of the First Niagara Benefits Exchange. This private insurance exchange can accommodate a wide range of employer contribution approaches to offering employee benefits. This exchange will be offered to businesses with 100 or more employees. Employers can reduce their overall health care spend by using the First Niagara Benefits Exchange to offer their employees more choices and enhanced understanding of their health care expenses. FNBC will partner with bswift, a leader in software and services for employee benefits administration and exchange solutions.

Regions Insurance Offers Private Health Insurance Exchange Solution to Employers Regions Insurance has announced the company is offering employers in four states access to a private health insurance exchange platform that will help companies better manage benefits while offering a wide array of insurance options for their employees. The private exchange, called Regions TruSelect, will be available to employers that are based in Georgia, Indiana, Tennessee or Texas and have 50 or more eligible employees. Regions TruSelect will serve as an online benefits marketplace, connecting employees of participating companies to a wide array of medical, dental and vision coverage plans through a variety of providers. Life and disability coverage, 401(k) enrollment and other ancillary benefits will also be available later this year.

New Private Exchange to Open for Employers Health Members Employers Health, a national coalition of employers seeking to reduce the costs and improve the quality of health care, has announced the creation of the Employers Health Benefits Accelerator, an integrated and comprehensive health benefits platform that facilitates employers’ efforts to provide access to high-quality health care while controlling overall health care costs. The Employers Health Benefits Accelerator is an online private marketplace that Employers Health members will be able to access by August 1, 2014. By partnering with Bloom Health, Anthem Blue Cross and Blue Shield and CVS Caremark, Employers Health members will have access to industry-leading technology that powers the nation’s foremost medical, pharmacy and ancillary health care products.

Oswald Companies Launches Private Exchange Powered by Assurex Global A custom-built, comprehensive private health care marketplace and benefits management platform is now available for businesses through Oswald Companies. The Oswald Private Exchange, powered by Assurex Global, is a private marketplace platform that gives employers an unprecedented range of administrative flexibility and employee health benefit options. Oswald Companies, an Assurex Global Partner, is proud to offer this flexible insurance plan customization to employer groups of 50 or more employees. In collaboration with a leading employee benefits out-

sourcing partner, Businessolver, this private exchange allows employers to maintain a competitive advantage by offering best-in-industry benefits while removing the heavy lifting of benefit administration.

Maestro First to Feature New Solution for Employer-Sponsored Health Care Market Rob Butler, CEO of Maestro Healthcare Technology, a cutting-edge health benefits service company, has announced that they are introducing an employer benefit solution that is the first to feature both private exchange and self-funding capabilities on a single platform.

The innovative Maestro solution is designed to significantly contain costs, simplify administration and enhance convenience for employers by integrating medical management, consumer driven payment solutions, and other product offerings in an exchange or self-funded model — all on one, proprietary technology platform.

New Keenan Public Agency Marketplace Offers Comprehensive Resources for Selecting, Managing Benefits Keenan, the largest privately held insurance brokerage and consulting firm in California, announced the launch of the Keenan Public Agency Marketplace to provide California’s public agencies and their employees the ability to more effectively navigate employee benefits decision making, enrollment and access to both private and public exchange markets in the post Affordable Care Act environment.

Launching the Keenan Public Agency Marketplace is a natural evolution of Keenan’s BenefitBridge platform which is a centerpiece of the firms public agency strategy.

The Graham Company Launches Private Exchange The Graham Company, one of the Mid-Atlantic region’s largest insurance and employee benefits brokerages, announced it is now offering a private health care marketplace for businesses. The Assurex Global Private Exchange is a private marketplace platform that gives employers an unprecedented range of administrative flexibility and employee health benefit options. The Graham Company, as an Assurex Global Partner, is proud to offer this flexible insurance plan customization to middle market employer groups. In collaboration with leading employee-benefits outsourcing partner Businessolver, this private exchange allows employers to maintain a competitive advantage by offering best-in-industry benefits while removing the heavy lifting of benefits administration.

New Regence Marketplace Launching for Private Exchange Health Insurance Regence Health Insurance Services announced it is launching Regence Marketplace, a new private exchange health insurance option for select businesses in Idaho, Oregon, Utah and Washington.

Regence Marketplace offers employers a number of advantages, including the ability to control health insurance costs, predictably plan for future benefit needs, and cater to a demographically diverse workforce. Through Regence’s private exchange, employees have the freedom to choose coverage that best fits their unique needs and budget, enabling more ownership over their health care decisions.

This new model provides mid- and large-sized businesses with a customizable private exchange containing multiple Regence coverage options for safe, affordable and effective quality care.

HealthCare Exchange Solutions™ I www.TheIHCC.com I March/April 2014

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NOMINATE & RECOGNIZE INNOVATIVE HEALTH & BENEFITS MANAGERS

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Do you know someone who goes the extra mile as a creative problem solver and innovator?

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Nominate a Superstar Today!

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NOMINATION CATEGORIES: 5FQ)H"G)FH+9"G@UF#)@?+aF#+e--+k+,e--+@Q(*FB@@?I+,e-.+k+Ne--+@Q(*FB@@?I+"HA+Ne--^+@Q(*FB@@?

For details, please visit www.theihcc.com. !"#$%&'$"%()*+"(,)-*'".,/)01)2304.

E-mail your Superstar nomination to nominations@fieldmedia.com or nominate online.

INDIVIDUAL EXCHANGES

BY JONATHAN FIELD MANAGING EDITOR THE INSTITUTE FOR HEALTHCARE CONSUMERISM

Mercer Creates Complete Workforce Exchange Solution Through Partnership with GetInsured

W

ith 67 employers already utilizing its private exchange, global consulting firm Mercer has been one of the most visible leaders in the emerging private exchange space.

Through its active and retiree exchanges, Mercer currently provides benefits to over 280,000 individuals as of March 2014.

Earlier in March, the company, which also recently acquired Transition Assist to bolster its retiree exchange offerings, announced a partnership with Silicon Valley’s GetInsured that will bring the Mercer Marketplace exchange brand into an entirely new sector: the individual market.

“Most employers don’t have a single, uniform workforce, but a collection of different groups — including part-timers and retirees, each with a very different set of benefit needs,” said Julio A Portalatin, president and chief executive officer, Mercer.

“Now, Mercer Marketplace can meet all of these needs through a single point of access. This expanded reach is part of Mercer’s commitment to ensuring that all Americans have easy access to the best insurance products available on the market today.”

This move coincides with a greater trend within the private exchanges to offer a solution that addresses each segment of an employer’s population, including retirees, part-timers and full-time employees — what Cindy Gillespie, senior managing director, Public Policy and Regulatory Affairs practice at McKenna Long & Aldridge LLP, has called the “sorting hat” exchange solution.

In the new partnership, GetInsured, a federally approved webbased entity, will provide access to individual medical plans both on and off the public exchanges. The Palo Alto technology company is also a key partner for several state-based health insurance exchanges.

The Way to...

Manage Health Care Costs & Increase Health Plan Choice Manage health care costs and increase health plan choice with Towers Watson’s OneExchange—an integrated and flexible private health care exchange that delivers value and choice to your entire employee and retiree populations. OneExchange provides coverage options that promote value and sustainability for employers. In our exchange environment, your people will engage as consumers in the purchase and use of their health care benefits.

One call does it all. OneExchange: +1 855 372 3944 or visit towerswatson.com.

Benefits Risk and Financial Services Talent and Rewards Exchange Solutions towerswatson.com

HealthCare Exchange Solutions™ I www.TheIHCC.com I March/April 2014

9

IS 2014 THE YEAR OF

‘Evaluate then Decide’

When it Comes to Exchanges?

BY HEATHER LOVERIDGE » SENIOR EDITOR » THE INSTITUTE FOR HEALTHCARE CONSUMERISM

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10

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.% S%@+"$G)FH?+Fa+FG%@#+*"#U@+$FQ("H)@?+)H+ G%@)#+)HA=?G#B .% ;#FT)A)HU+ "AA)G)FH"*+ %@"*G%+ $"#@+ (*"H+ $%F)$@?+GF+@Q(*FB@@? .% S%@+)H">)*)GB+GF+?G"B+>@*Fc+G%@+@L$)?@+G"L+ =?)HU+G%@)#+?@*akQ"H"U@A+QFA@* '$$F#A)HU+GF+\)**)"Q?I+S%@+'9'g?+@L$)?@+F#+ l9"A)**"$m+G"L+GF+>@+)Q(F?@A+)H+,-.n+)?+(*"B)HU+ 7%5;P%D<#"%;A%"6?#<9"D@g%5"A"30@%?#7AA;AP%D;PG0% A<Q(% !G"D"% 7D"% <A#9% 7% C"Q% 898#"@% <C% 5"A"30@% $%"HU@?+ >@aF#@+ @Q(*FB@#?+ c)**+ >@+ G"L@A+ F#+ HFG+ j+A@(@HA)HU+FH+G%@+?G#"G@U)@?+G%@B+?G"#G+(=GG)HU+ )H+(*"$@+GFA"B6 l'?+ "+ #@?=*GI+ c@+ AF+ ?@@+ "+ Q"??)T@+ ?%)aG+ GF+ 2"3A"2% 8<A0D;5L0;<A% T"D@L@% 2"3A"2% 5"A"30(% YC% 8<6?7A;"@% 2<% A<0% G7T"% 7% 2"3A"2% 8<A0D;5L0;<A% (*"HI+ G%@B+ "#@+ #"$)HU+ GF+ )G+ GF+ Q"H"U@+ $F?G?+ j+ "*G%F=U%+ G%@B+ Q"B+ HFG+ >@+ $%"HU)HU+ $"##)@#?+ F#+ (*"H?+"G+G%)?+(F)HGIm+%@+?")A6 2FF])HU+ >"$]+ GF+ a"**g?+ F(@H+ @H#F**Q@HGI+ ?@T@#"*+G%)HU?+?G"HA+F=G+)H+#@U"#A?+GF+@L$%"HU@?6+ lCF#+(#)T"G@+@L$%"HU@?I+>@$"=?@+@Q(*FB@#?+ "#@+G"])HU+"+c")G+"HA+?@@+"((#F"$%I+G%@?@+(*"H?+ "#@+>@)HU+a"G%@#@A+)H+c)G%+?=$$@??6+CF#+@L"Q(*@I+ c@+ ?c)G$%@A+ F=#+ FcH+ $FQ("HB+ GF+ F=#+ (#)T"G@+ @L$%"HU@I+"HA+)G+c"?+?QFFG%+?")*)HUIm+\)**)"Q?+ ?")A6 l1H+ G%@+ a@A@#"*+ "HA+ ?G"G@+ ?)A@I+ G%@B+ c@#@+ >FQ>"#A@A+c)G%+Q)**)FH?+Fa+$FH?=Q@#?+c%F+c@#@+ @)G%@#+ HFG+ )H?=#@A+ F#+ =HA@#)H?=#@A6+ ;*=?I+ G%@+ UFT@#HQ@HG+ (#FU#"Q?+ c@#@+ "**+ H@c+ (*"H?+ "HA+ H@c+ G@$%HF*FUB6+ <+ %"T@+ ?")A+ )G+ c"?+ *)]@+ AF)HU+ "+ ?("$@+*"=H$%+)H+GcF+B@"#?+)H?G@"A+Fa+"+A@$"A@6+EF+ )G+%"?+>@@H+>=Q(BI+>=G+)?+?G"#G)HU+GF+?QFFG%+F=G6

If companies do not have a defined contribution plan, they are racing to it to manage costs — although they may not be changing carriers or plans at this point. l\@+ %"A+ @L(@$G@A+ G%@+ *"=H$%+ Fa+ G%@+ ?G"G@+ "HA+ a@A@#"*+ @L$%"HU@?+ $F=*A+ >@+ >=Q(B+ j+ G%@+ ?$"*@+Fa+G%@)#+*"=H$%+)?+=H("#"**@*@A+>B+"HB+FG%@#+ @L$%"HU@6m 4H#F**Q@HG?+T)"+SFc@#?+\"G?FHg?+$FH$)@#U@+ ?@#T)$@+ GF+ G%@+ (=>*)$+ @L$%"HU@?+ %"T@+ H"G=#"**B+ QFT@A+"G+G%@+("$@+Fa+G%@+UFT@#HQ@HG+@L$%"HU@?6+ '?+G%@+?G"G@+"HA+a@A@#"*+@L$%"HU@?+%"T@+>@@H+">*@+ GF+ $FQ(*@G@+ G%@)#+ (F#G)FH?+ Fa+ G%@+ @*)U)>)*)GB+ "HA+ "((*)$"G)FH+ (#F$@??I+ SFc@#?+ \"G?FH+ ?")A+ G%@B+ >@@H+ #@"AB+ "HA+ ">*@+ GF+ %@*(+ @H#F**+ ("#G)$)("HG?6+ R=#)HU+ G%@)#+ #"Q(+ =(I+ G%@+ #@?=*G?+ G%@)#+ %@"*G%+ )H?=#"H$@+ "AT)?F#?+ %"T@+ ?@@H+ c)G%+ $FH?=Q@#?+ %"T@+>@@H+T@#B+@H$F=#"U)HU+GF+"**+)HTF*T@A6 l1H@+ (F?)G)T@+ ?)A@+ @aa@$G+ Fa+ G%)?+ ("?G+ a"**g?+ %@"A*)H@?+)?+G%"G+@L$%"HU@?+"#@+FH+G%@)#+c"B+GF+ >@$FQ)HU+ "+ %F=?@%F*A+ G@#Q6+ '+ B@"#+ "UFI+ QF?G+ $FHT@#?"G)FH?+">F=G+@L$%"HU@?+?G"#G@A+c)G%+G%@+ QF?G+ >"?)$+ @L(*"H"G)FH?+ Fa+ c%"G+ "H+ @L$%"HU@+ ;@%i%#;B"%0G"%3D@0%279@%<C%?"<?#"%5L9;AP%7%?#7A"% G)$]@G+FH*)H@Im+\)**)"Q?+?")A6+ lX=G+HFc+$FHT@#?"G)FH?+FaG@H+?G"#G+"G+"+QF#@+ "AT"H$@A+ *@T@*+ aF#+ $FH?=Q@#?+ "HA+ @Q(*FB@#?+ "*)]@+j+"HA+G%@+QF#@+@A=$"G@A+>FG%+U#F=(?+"#@+ ">F=G+ @L$%"HU@?I+ G%@+ >@GG@#+ )G+ )?+ aF#+ G%@+ %@"*G%+ $"#@+"HA+)H?=#"H$@+)HA=?G#)@?+"*)]@6m++

THE POWER OF CHOICE:

The Game-Changing Combination of Private Exchanges and Health Savings Accounts

BY JONATHAN FIELD » MANAGING EDITOR » THE INSTITUTE FOR HEALTHCARE CONSUMERISM WITH JOHN YOUNG » CEO » CONSUMERDRIVEN, LLC

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POWER OF CHOICE: Game-Changing Combination of Private Exchanges and Health Savings Accounts Theme One: Employer Interest in Private Exchanges is Real and Growing N#U4#$5##)/-$+025$0&$)/2#4#52$)/$A4)H*2#$#L("*/-#5$B)2"$ #7A+0C#45$(+*)7)/-$2"*2U5$2"#$<)4#(2)0/$2"#C$B)++$=#$2*T)/-$500/$ V$=62$+025$0&$"#5)2*2)0/$*5$B#++@$W40B2"$#52)7*2#5$&407$76+2)A+#$ 5064(#5$*4#$-#/#4*++C$(0/5)52#/2F$2")/T)/-$XY$7)++)0/$A#0A+#$ B)++$=#$5#4H#<$)/$A4)H*2#$#L("*/-#5$=C$PYOZ@

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Plan’s Next Move

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HealthCare Exchange Solutions™ I www.TheIHCC.com I March/April 2014

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POWER OF CHOICE: Game-Changing Combination of Private Exchanges and Health Savings Accounts 1H@+Fa+G%@+QF?G+HFG">*@+"HHF=H$@Q@HG?+)H+G%@+@L$%"HU@+"#@"+?F+a"#+ 0<%7%2"3A"2%8<A0D;5L0;<A%CLA2;AP%6<2"#(%N@%0G"@"%8<6?7A;"@%8<A0;AL"%0<% G%)?+B@"#+c"?+G%@+C@>#="#B+/+"HHF=H$@Q@HG+G%"G+U*F>"*+%@"*G%+)H?=#"H$@+ 6<T"%0<%2"3A"2%8<A0D;5L0;<AM%;0%;@%@7C"%0<%0G70%;0%5<2"@%Q"##%C<D%0G"%CL0LD"% $FQ("HB+9)UH"+cF=*A+>@+*"=H$%)HU+)G?+FcH+(#)T"G@+@L$%"HU@+)H+aF=#+)H)G)"*+ "AF(G)FH+Fa+%@"*G%+?"T)HU?+"$$F=HG?+"?+c@**6 Q"#]@G?M+'G*"HG"I+R"**"?I+E"H+C#"H$)?$F+"HA+\"?%)HUGFHI+R696 S%@#@+ %"A+ *FHU+ >@@H+ f=@?G)FH?+ "HA+ #=QF#?+ >F=H$)HU+ "#F=HA+ Conclusion: The Next Generation of 0G"% ;A2L@0D9% <A% QG"0G"D% 0G"% 67=<D% G"7#0G% ?#7A@% Q<L#2% #7LA8G% 0G";D% Improving Health and Lowering Costs <QA% "/8G7AP"@M% 7A2% ^;PA7g@% 7AA<LA8"6"A0% @""6@% 0<% 8<A3D6% ;A2L@0D9% ?(@$=*"G)FH6+ kG;#"%;0g@%8#"7D%0G70%"/8G7AP"@%7D"%<A%7%D7?;2%PD<Q0G%0D7="80<D9%7A2% <H+G%@+"HHF=H$@Q@HGI+9)UH"+"*?F+HFG@A+G%"G+)?+)?+l"$G)T@*B+("#G)$)("G)HU+ G%"G+G%@B+c)**+$FHG)H=@+GF+?%)aG+@Q(*FB@#k?(FH?F#@A+%@"*G%+$"#@+GFc"#A+"+ ;A%7%AL65"D%<C%?D;T70"%"/8G7AP"@%726;A;@0"D"2%59%5"A"30%8<A@L#07A0@%7A2% QF#@+ $FH?=Q@#kA#)T@H+ QFA@*I+ )G+ )?+ HFG+ $*@"#+ c%@G%@#+ $=##@HG+ @L$%"HU@+ 5D<B"D7P"%3D6@%0G70%07DP"0%780;T"%"6?#<9""@%l;A8#L2;AP%CL##9%;A@LD"2%7A2% F(@#"GF#?+ G#=*B+ =HA@#?G"HA+ G%@+ $FH?=Q@#)?Q+ (FG@HG)"*+ "#F=HA+ %@"*G%+ ?@*ak)H?=#@A+QFA@*?i+"HA+#@G)#@@?6m+ ?"T)HU?+"$$F=HG?6+ !@"Hc%)*@I+ G%@+ X*=@+ 9#F??+ X*=@+ E%)@*A+ >#"HA+ %"?+ "*?F+ >@@H+ "+ +l4L$%"HU@?+(#FT)A@+G%@+>@?G+F((F#G=H)GB+aF#+:E'+"AF(G)FHI+>=G+HFG+ T@#B+ "$G)T@+ )H+ G%@+ (#)T"G@+ @L$%"HU@+ "#@H"6+ :@"*G%+ 9"#@+ E@#T)$@?I+ "+ "**+@L$%"HU@?+"#@+aF$=?@A+FH+(#FT)A)HU+G%@+>@?G+:E'+$=?GFQ@#+@L(@#)@H$@Im+ *)$@H?@@+ Fa+ G%@+ X9XE+ >#"HA+ ?")A+ SFAA+ X@#]*@B6+ + l<H+ a"$GI+ ;A% 3T"% @070"@J% k"##R<;A0M% YA8(M% Q"HB+@L$%"HU@?+"#@+HFG+"c"#@+ Ultimately, however, whether health G%@+ *"#U@?G+ $FQ("HB+ )H+ G%@+ Fa+ :E'+ #@TF*=G)FH+ %"((@H)HU+ X9XE+ '??F$)"G)FHY+ "HA+ X*=@+ )H?)A@+ G%@)#+ Faa@#)HU6+ + S%@#@+ )?+ savings accounts continue their strong 9#F??+ X*=@+ E%)@*A+ Fa+ !)$%)U"H+ #FFQ+aF#+)Q(#FT@Q@HG+%@#@6m 7D"% =<;A0#9% 0G"% 67=<D;09% SFA"Bg?+ ]@B+ @L$%"HU@+ growth throughout this decade and FcH@#?+ )H+ X*FFQ+ :@"*G%+ "HA+ G@$%HF*FUB+ (*"B@#?+ $FQ@+ a#FQ+ into the next will rely on all exchange $=##@HG*B+ ?)G+ FH+ )G?+ >F"#A+ Fa+ "+A)T@#?@+>"$]U#F=HAM+G@$%HF*k A)#@$GF#?6+ 3G)*)b)HU+ X*FFQ+ <P9M% 3A7A8"M% 5"A"30@% 726;Ak vendors — not only those that come :@"*G%+ G@$%HF*FUBI+ G%@B+ %"T@+ ;@0D70;<AM% 5"A"30@% 8<A@L#0;APM% ?=$$@??a=**B+ F(@#"G@A+ %@"*G%+ @G$6+ 5FG+ "**+ c@#@+ )HTF*T@A+ )H+ from a CDHC background. Exchange (*"H+ @L$%"HU@?+ )H+ Q"HB+ 36E6+ G%@+ )HA=?G#B+ #@TF*=G)FH+ G%"G+ ?G"G@?6 c"?+ $FH?=Q@#kA#)T@H+ %@"*G%+ vendors should see health savings 'G+ G%)?+ (F)HGI+ )G+ )?+ *"#U@*B+ $"#@+ G%#F=U%F=G+ G%@+ @"#*B+ GF+ =H$*@"#+ c%"G+ QFT@?+ 3H)G@A+ Q)Ak,---?Y+ "HA+ )G+ )?+ (F??)>*@+ accounts as a way to further the :@"*G%$"#@I+ :=Q"H"I+ '@GH"+ j+"G+G%)?+(F)HG+j+G%"G+G%)?+Q"B+ "HA+ FG%@#+ *"#U@+ %@"*G%+ (*"H?+ >@+ c%@#@+ "+ *)H@+ )?+ A#"cH+ )H+ consumerism principles that drive their c)**+Q"]@+)H+G%)?+?("$@6+hSF+>@+ G%@+?"HA6 models in the first place. $*@"#I+'@GH"+%"?+>@@H+)HTF*T@A+ CF#+ @L"Q(*@I+ '*@U@=?+ ;A% D"0;D""% 5"A"30% "/8G7AP"@% S@$%HF*FU)@?+j+"H+F#U"H)b"G)FH+ G%#F=U%+)G?+#@*"G)FH?%)(+c)G%+G%@+:8+;F*)$B+'??F$)"G)FH6+<G?+QFT@+)HGF+G%@+ 0G70% G7@% ;0@% D<<0@% ;A% EIY% I"A"30@M% <A"% <C% 0G"% "7D#;"@0% 8<A@L6"DV2D;T"A% "$G)T@+@L$%"HU@+?("$@+)?+c%"G+)?+?G)**+)H+f=@?G)FH6i %@"*G%+ $"#@+ $FQ("H)@?I+ "HA+ G%@+ 9FH?=Q@#+ R#)T@H+ :@"*G%$"#@+ EF*=G)FH?+ A)T)?)FH+ Fa+ C<E+ j+ )?+ $=##@HG*B+ >FG%+ "+ Q"#]@G+ *@"A@#+ )H+ %@"*G%+ ?"T)HU?+ Theme Five: The Added Bonus of Utilizing a "$$F=HG?+"HA+(#)T"G@+@L$%"HU@+G@$%HF*FUB6+S%@)#+"$f=)?)G)FH+Fa+\F#]">*@+ EF*=G)FH?+*"?G+B@"#+)H+Q"HB+c"B?+"HG)$)("G@A+G%@+(Fc@#a=*+$FQ>)H"G)FH+Fa+ Defined Contribution Strategy %@"*G%+"$$F=HG?+"HA+@L$%"HU@?6 1G%@#+$FQ("H)@?I+?=$%+"?+X*FFQ+:@"*G%I+2)"bFH+"HA+9)@*FEG"#I+"*?F+ ;4)H*2#$#L("*/-#5$2"*2$&*H04$<#'/#<$(0/24)=62)0/$*4#$5##)/-$*$ %"T@+ >"$]U#F=HA?+ )H+ $FH?=Q@#kA#)T@H+ %@"*G%+ $"#@I+ "HA+ )G+ )?+ $@#G")H*B+ "6-#F$#H#/$-4#*2#4$*<0A2)0/$0&$"#*+2"$5*H)/-5$*((06/25@ *FU)$"*+ G%"G+ G%@?@+ (*"B@#?+ Q"B+ %"T@+ "+ *@U+ =(+ FH+ $FQ("H)@?+ a#FQ+ FG%@#+ CF#+G%F?@+G%"G+$FQ@+a#FQ+"+>"$]U#F=HA+Fa+$FH?=Q@#kA#)T@H+%@"*G%+ >"$]U#F=HA?+c%@H+)G+$FQ@?+GF+(#FT)A)HU+@Q(*FB@#?+c)G%+"AA)G)FH"*+$F?G+ 87D"M%2"3A"2%8<A0D;5L0;<A%CLA2;AP%@0D70"P;"@%7D"%7A%"@?"8;7##9%;A0"D"@0;AP% ?"T)HU?+>B+@H#F**)HU+"+%)U%+H=Q>@#+Fa+Q@Q>@#?+)H+%@"*G%+?"T)HU?+"$$F=HG?6 3*G)Q"G@*BI+%Fc@T@#I+c%@G%@#+%@"*G%+?"T)HU?+"$$F=HG?+$FHG)H=@+G%@)#+ A"/0% @0"?(% NA2% <T"D7##M% "/8G7AP"@% 0G70% L0;#;e"% 2"3A"2% 8<A0D;5L0;<A% 7D"% ?G#FHU+ U#FcG%+ G%#F=U%F=G+ G%)?+ A@$"A@+ "HA+ )HGF+ G%@+ H@LG+ c)**+ #@*B+ FH+ "**+ ?@@)HU+"+Q=$%+%)U%@#+#"G@+Fa+%@"*G%+?"T)HU?+"$$F=HG+"AF(G)FH6+ <H+ a"$GI+ G%@+ !)HH@"(F*)?k>"?@A+ X*FFQ+ :@"*G%I+ "+ Q"#]@G+ *@"A@#+ "HA+ @L$%"HU@+T@HAF#?+j+HFG+FH*B+G%F?@+G%"G+$FQ@+a#FQ+"+9R:9+>"$]U#F=HA6+ (#)T"G@+@L$%"HU@+()FH@@#+A"G)HU+>"$]+GF+,--DI+%"?+%"A+/n+(@#$@HG+Fa+)G?+ 4L$%"HU@+T@HAF#?+?%F=*A+?@@+%@"*G%+?"T)HU?+"$$F=HG?+"?+"+c"B+GF+a=#G%@#+ Q@Q>@#?+@H#F**+)H+:E'k@*)U)>*@+(*"H?6+X*FFQ+%"?+)Q(*@Q@HG@A+@L$%"HU@?+ 0G"%8<A@L6"D;@6%?D;A8;?#"@%0G70%2D;T"%0G";D%6<2"#@%;A%0G"%3D@0%?#78"( C<D% 5<0G% G"7#0G% ?#7A@% 7A2% "6?#<9"D@% 7A2% C7T<D@% 7% 2"3A"2% 8<A0D;5L0;<A% ?G#"G@UB+"?+)HG@U#"*+h>=G+HFG+H@$@??"#Bi+GF+)G?+(*"GaF#Q6 E02207$+)/#8$)&$*/$#7A+0C#4U5$-0*+$)5$(052$4#<6(2)0/$*/<$ S%@+ ]0426/#+ J*F>"*+ e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a+ h/N+ (@#$@HGi+ Fa+ @Q(*FB@#?+ #@(F#G@A+ G%@B+ "#@+ QFT)HU+ F#+ %"T@+ QFT@A+

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March/April 2014 I www.TheIHCC.com I HealthCare Exchange Solutions™

EXCHANGE SOLUTION PROVIDER MEMBER PROFILES

G((#55$2"#5#$A40'+#5$0/+)/#$*2$BBB@!"#I133@(07@ HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

TSYS HEALTHCARE TSYS Healthcare® provides end-toend strategic payment solutions for 706.649.5080 consumer directed healthcare. We www.tsys.com/healthcare partner with benefits administrators, healthcare@tsys.com financial institutions, health plans, and software providers to navigate all aspects of HSAs, HRAs, FSAs, transportation accounts, cash reimbursements, and lines of credit. TSYS Healthcare cards offer participants the security they expect along with the ability to conveniently access funds from multiple accounts and manage their benefits payments with simplified single-card access. Clients and partners benefit from simplified processes, reduced paperwork and cost savings that can contribute to improved return on investment.

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— Trey Jinks, Group Executive, TSYS Healthcare HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

A PRIVATE EXCHANGE THAT SIMPLIFIES HEALTH INSURANCE

INSUREXSOLUTIONS

10275 W. Higgins Road, Suite 500 Rosemont, IL 60018 855-563-6993 info@insurexsolutions.com www.insurexsolutions.com

The InsureXSolutions® private exchange offers employers a simplified role in the new health insurance marketplace. Employers with part-time workers or retirees, as well as small businesses can utilize this exchange to empower their employees to choose the health and dental insurance that best fits their personal and family needs. Employers can reduce costs and administrative tasks, while employees receive interactive support tools and personal guidance from our licensed insurance professionals. Available in select markets, InsureXSolutions is exclusively offered and operated

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BENEFIT ADMINISTRATION/PRIVATE EXCHANGES

Since 1988, CieloStar (formerly OutsourceOne) CIELOSTAR has helped brokers, employers and employees 530 U.S. Trust Building navigate the ever-changing world of benefits.

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With a team of industry thought leaders, CieloStar 612.436.2706 makes navigating healthand benefits choices john.reynolds@cielostar.com easy for employers and employees by offering comprehensive benefits administration solutions with a high-touch, high technology model—most recently launching a proprietary private health insurance exchange.

“Fueled by the far-reaching impact and complexities of health care reform taking effect in 2013 and 2014, employers and employees increasingly find themselves in a ‘farmer’s market’ of benefits choices. Cielostar is uniquely positioned with enabling technology that helps purchasers and consumers make the best possible decisions and create a best-in-class benefits administration process. Our unique comprehensive approach to benefits offers everything from back room technology for enrollment, data, billing and call centers to complete solutions for COBRA, CDHP and health insurance exchanges.”

— John Reynolds, CEO, Cielostar HSA / HRA / FSA ADMINISTRATION AND FINANCE

Evolution1 and our Partners serve more EVOLUTION1, INC. than 9 million consumers, making us 952.908.9056 the nation’s largest electronic payment, www.evolution1.com on-premise and cloud computing sales@evolution1.com healthcare solution that administers reimbursement accounts, including HSAs, HRAs, FSAs, VEBAs, Wellness and Transit Plans. It is the only solution that offers a single end-to-end user experience, provides innovative auto-substantiation technologies, and automates workflow for Partners, employers, and consumers. It does all this on one technology platform comprised of 1Cloud™, 1Direct™, 1Pay™, 1View™, 1Plan™, and 1Mobile™. Evolution1 and our Partners are dedicated to delivering value, reducing costs and simplifying the business of healthcare.

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HealthCare Exchange Solutions™ I www.TheIHCC.com I March/April 2014

15

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