Private exchange enrollment numbers depend on how one defines a private exchange. For some, a private exchange is simply tech-enabled choice — which most employers are embracing — while others define it as more than technology. Despite the definition, most consultancies  agree by 2018, the numbers will be huge.

To date, private exchange adoption has been modest, with some progress expected for 2016. A survey by health tech company bswift, in conjunction with Employee Benefit News, found that 5% of large employers self-reported they are participating in a private exchange as of 2015. Of those not currently in an exchange, 6% said they are “considering” a private exchange for 2016 and future years, the survey found.

However, overall interest is very high in private exchanges, says Barbara Gniewek, principal at PricewaterhouseCoopers. “It really is over the next four-to-five years that they expect to capture 20%-30% market share of employers,” she says.  An April 2015 study by Accenture estimated 6 million people were receiving employer health benefits through a private exchange for the 2015 plan year. The consultancy predicts that by 2018, 40 million will purchase their insurance from private exchanges.

Also see: How transparent are private exchange fees?

The thought, Gniewek explains, is similar to a hockey stick approach, where once a lot of companies switch to a private exchange, everybody else will go.

A recent PwC study found 40% of employers are considering a private exchange. For large employers, private exchanges represent “a different way to offer benefits,” Gniewek says. “They can truly transform the way employees offer benefits.”

Jeff Yaniga, chief revenue officer of Chicago-based Maestro Health, predicts that tipping point will come in mid-2016, “when those thinking about it are finally going to go,” he says.

Private HIX definition

Part of the confusion over enrollment numbers depends on the definition of a private exchange, says bswift’s CEO Rich Gallun.

“Everybody is asking the question of how many people will be enrolled in private health care exchanges in 2018,” Gallun says. “My response is maybe we are asking the wrong question. What is a private exchange or what components will drive value?”'

Also see: Business benefits of private exchanges come into focus

“When people [use our platform], some call it a private health care exchange, some call it online enrollment, some call it ben admin,” he adds, defining a private exchange as “tech-enabled choice; more choices for the employee and more use of technology.”

However, Gniewek says it’s about more than just choice of technology. While exchanges enable consumers to purchase benefits, and have ben admin and managed enrollment and technology, they also contain a consulting component with a prepopulated storefront and relationship with carriers, she says. “It really is not just a ben admin or online enrollment,” she explains. “But has relationships and products built into it. That’s what an exchange is.”

Story updated June 25, 2015

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