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Employers want unbiased advice on private health care exchanges


As private health insurance exchanges evolve, some benefits consultants are trying to distinguish themselves as unbiased advisers in a marketplace dominated by companies offering advisory services alongside their own branded exchange products.

Months of conversations with current and prospective clients recently led Pacific Resources Benefits Advisors L.L.C. to launch a specialized consulting practice designed to provide employers with independent, third-party guidance on private exchanges, company executives say.

“A good number of employers raised the issue of consulting objectivity and bias where companies were marketing and selling an exchange platform,” said Jody Hunter, Resources Benefits' Chicago-based vice president of marketplace solutions.

Additionally, findings of the company's February employer survey about private health insurance exchanges revealed significant interest in independent advisory services.

Although its parent company, insurance brokerage Brown & Brown Inc., launched a proprietary exchange platform last year, Mr. Hunter said that product is not included in the consultant's assessments of exchange platforms.

“The marketing for the Brown & Brown product is really focused on employers with under 500 employees, and that's not a market segment that we focus on,” Mr. Hunter said. “We're focused on the segment that, on average, totals about 10,000 or more employees per client.”

Several other consultants, including PricewaterhouseCoopers L.L.P., Laurus Strategies and Sibson Consulting, also have elected to not develop in-house private exchange products and instead have launched exchange consulting practices.

“We felt that if we had our own exchange product that we had to sell, it would put us in an untenable position and prevent us from being as objective as we want to be,” said Nancy Scola Lombaer, a Chicago-based partner at Laurus Strategies.

Benefits brokers and consultants with considerable investments in their respective exchange platforms — including Towers Watson & Co. and Aon Hewitt — said they also provide clients with unbiased advice on private exchanges, at least in the initial phases of an employer's inquiry.

“At that early stage, the relationship that we've built with clients as trusted advisers still holds, and we generally haven't had any issues or questions around objectivity from clients,” said Jim Winkler, Aon Hewitt's chief innovation officer of health and benefits in Norwalk, Connecticut.

However, some private exchange providers agreed that independent assessments can be valuable to their clients, particularly when employers seek comparisons of external exchange offerings.

We've been pretty clear in making the point that any company that owns an exchange really shouldn't be in the business of evaluating which exchange makes sense for an employer, because you can't really be objective in that evaluation,” said David Ostendorf, chief health care actuary at Towers Watson in Milwaukee. “That's something that almost always needs to be done by an objective third party.”

Other benefits brokers, including Lockton Cos. L.L.C. and Crystal & Company, also have positioned themselves as independent advisers on private exchanges, taking the position that their limited engagement in the exchange marketplace affords them greater objectivity than their competitors.

“Once you start making financial investments into certain ex-changes, I think it changes the mindset of the companies providing these services to the extent that they're focusing on generating a return on their investment,” said Michael Grant, New York-based executive managing director of employee benefits services at Crystal & Company.

One reason independent consultants cite for employers' demand for unbiased advisory services is the heightened attention private exchanges have drawn from em-ployers' chief financial officers and other senior executives, particularly due to the economic and administrative complexity of switching to an exchange.

“Even if the employer's human resources or benefits manager has a long-standing relationship with their broker or consultant, because you now have the CFO or another senior executive involved in these discussions about private exchanges, there's a greater emphasis on the need for an independent view of the marketplace,” said Barbara Gniewek, a New York-based principal at PricewaterhouseCoopers L.L.P.

Independent consultants say not offering proprietary exchanges makes it easier to collect detailed product and pricing information from multiple exchange owners.

“That's one of the reasons we came out pretty aggressively to say we're not building an ex-change, because we wanted to remove that barrier,” said Christopher Calvert, New York-based senior vice president and health practice leader at Sibson Consulting, a division of Segal Group Inc. “Since we've done that, the private exchange providers have become much more willing to discuss the details of their products.”

Going forward, most benefits service providers said they expect more companies to offer independent consulting focused exclusively on private exchanges, especially given the speed with which marketplace conditions shift.

“We saw a similar dynamic unfold with the advent of benefits administration outsourcing, and I think the exchange marketplace is evolving in the exact same way,” Mr. Ostendorf said. “Over time, it will become very unusual for even large organizations to go out and make this decision without a third-party search consultant helping to guide the process.”