Most large employers are not considering moving their employees to a private exchange in 2014 and not yet thinking about public exchanges, either, with so many variables in play, officials with The National Business Group on Health said Wednesday in Washington.

The group’s new survey of 108 respondents, all members of the NBGH, and nearly evenly distributed by employer size, found that just 1% were moving active employees to the private exchanges. However, 30% would consider it for 2015 and beyond.

“Private exchanges are an option that some employers are considering for … sometime in the future,” said NBGH President and CEO Helen Darling. “They are thinking ahead.”

Yet, Darling pointed out that ‘ahead’ in health care is in actuality only a few months from now. Open enrollment planning for 2014 was already underway and employers are already starting work on 2015 plan design.  And in just six-to-seven months from now, they will start planning for 2016 open enrollment, she said.

However, while employers are not moving their active employees to the exchanges, they are moving retirees. Ten percent did so in 2013, 7% plan to for 2014, and 40% are considering it for the future, the survey found. That, Darling said, is a key piece of the puzzle.

“Private exchanges are new. The number of people in a private exchange is still quite modest so if you are a large employer, you think about it for retirees. But [private exchanges] have to be up and running and serving a lot of people,” she said. “[They need to] give evidence of a good solution. Right now the track record with retirees, that’s a very comfortable step.”

Public exchanges

Meanwhile, survey respondents said they expect 12% of current full-time employees to choose public exchanges when they become available in 2014. Darling said that is very specialized by industry, with that 12% largely composed of lower wage employees, such as retail and hospitality, where even in the best of circumstances, those employees may not be taking benefits in the past because they couldn’t afford them.

While the public exchanges will not open to large employers until 2017 the earliest, the big question, Darling said, is that there are so many variables to consider including when, if ever, public exchanges will be available for larger employee sizes.

“The other moving target is regulatory decisions,” she added. “It isn’t clear what could happen between now and then in terms of people making decisions about what exchanges can do and what penalties would be paid if an employer decides to” go rouge and drop health care.

In the end, there are many factors to consider, she said. “Most of our members are very pragmatic and prepare for the future but with so many factors in play, it’s virtually impossible to think it through.”


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