Three representatives from private health insurance exchanges, speaking as part of a Midwest Business Group on Health education program, asserted that exchanges are hitting the ground running, and that the model is well-equipped to help employers meet the health needs employees.

"We went live [Jan. 1] with three employers ... representing approximately 100,000 employees and 200,000 lives," Abigail Neary, senior vice president at Aon Hewitt, said during the forum. Employees, she says, are choosing their health coverage much as they've always done: "based on whether their doctor is in-network, if their prescriptions are covered, [if] have they had a good experience."

The current health care system, Neary said, is a Bermuda Triangle into which far too much money and effort gets lost. Between the three points of that triangle (employers, employees and providers), there are holes a private exchange can help fill.

"Today, if you look at this triangle, there's a disproportionate share of the risk, the volatility and the sustainability of health care being put on the employers and employees," Neary said. "So we set out to actually design a model that would reduce trend."

John Vlajkovic, of the Bloom Health Private Exchange, said his organization's platform currently has more than 150 companies on it.

"Employers have finite resources. They are making an investment in an employee and they are [currently] making the decision for the employee, saying, 'Here's how much money is going into your health care benefit.' The employee has no say in that process," Vlajkovic said.

But Sherri Bockhorst, a principal at Buck Consultants Health Insurance Exchange, warns against letting private exchanges become too overwhelming. Workers can find satisfaction in the new system, she says, if it strikes the same, precise blend of simple and accommodating.

"We believe that the health of your business depends on the health of your employees, and we didn't feel that just putting a DC amount in and shifting your employees to some other kind of product ... and giving them a lot of choice, wasn't necessarily the best thing for employees," she said. "We have employees who don't understand the difference between 'copay' and 'coinsurance,' so offering five different plans from six different carriers, we don't think actually helps meet the needs of employees."

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