Health insurance exchanges, both public and private, are the topic of much discussion these days. Many national and regional brokers alike have communicated their exchange strategies, and private exchanges are swinging into operation. Not a day goes by that I don't hear about an exchange opportunity from brokers and general agents. Much of the discussion has been focused on the technology and mechanics of exchanges. What will they look like? How will they operate? What about the user experience? Next generation decision support, UX 2014, defined contributions. Group benefits, community rating, voluntary products. Each exchange offering slightly different approaches and capabilities. Competition at its best.
However, when all is said and done, the success or failure of any given exchange hinges on one single component: customer service. Service has been written about and proven to be the only sustainable competitive advantage in virtually any business. And HIXs are no exception. Exchange technology will continue to evolve and improve; vendors leapfrogging each other with new capabilities and the latest advances in usability and social networking. First movers will have an initial advantage, but only service will differentiate a HIX over time.
For employers, HIXs represent the first stages of a potential paradigm shift away from employer-sponsored group benefits. The transition will be difficult, because employees still look to their employers for information on their benefits, and many employers believe that benefits are essential in attracting and retaining the best employees. But the financial drivers of HIXs may outweigh the traditional benefits approach.
One thing employers will want to know is how will their employees be serviced in a HIX - who they gonna call? Servicing a HIX means providing support before, during and after the purchase decision. Employees, now consumers in the HIX model, will still have questions about their benefits. They are used to calling, emailing or even meeting with HR. After the purchase, the consumer, now a member, will have questions about their benefits, claims, copay amounts, co-insurance, billing, etc. And throughout the complete spectrum of their online experience they will have technical questions and problems - browsers, mobile devices, Macs and PCs. Again, who they gonna call?
One-on-one support
And the best self-service portal will not win the day. Yes, self-service is an important part of the overall service model, but HIX members will want and need one-on-one support. And because members will cover a wide-ranging demographic - baby boomers, Gens X and Y, men, women, blue- and white-collar workers - they will have varying expectations on how the service dialog should work. Online chat, email and the telephone will all need to be provided. Some users will want responses to their inquiries via texts to their mobile devices. Furthermore, these different communication modalities will need to be intertwined. An online chat, for example, may lead to a follow up email or call-back. It is even conceivable that support might be provided face-to-face at "retail" outlets.
HIXs are online marketplaces by definition. But even the best online services are connected to the real world via their service model. As you analyze and consider various HIX solutions, make sure you understand the service model and ask yourself, "Who they gonna call?"
Lamb is VP and group head of the EbixBenergy business unit at insurance software company Ebix Health. Reach him at
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