Trends. Private Exchange SWOT Analysis. Private Exchange SWOT Analysis March Online purchasing. Retirement and health care silos

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Private Exchange SWOT Analysis Charlie Isaacs Senior Client Consultant, Practice Leader 3 15 Trends CURRENT: TRADITIONAL MODEL Employer (wholesale) Employer hands-on Limited choices Custom benefit design Defined benefit Offline Retirement and health care silos FUTURE: EXCHANGE MODEL Individual (consumer) Employer hands-off Expanded choices Standard offerings Defined contribution Online purchasing Total rewards 1

Defined Contribution Similar to defined contribution for retirement (e.g. 401k) Employer establishes budget Determines buckets Link to total rewards philosophy Budgeted growth Performance factor Gaining Momentum 23% of employers will be considering a shift toward a defined contribution approach within the next three years. 23% Arthur J. Gallagher & Co. 2014 Benefits Strategy and Benchmarking Survey 2

Private Exchange Sponsored benefits marketplace Medical Ancillary Voluntary Other Fully or self-insured option Shopping experience Sponsor selects carrier(s) Vendor identified Budget determined Employees purchase products New Attention Employers are looking for a way to cap expenses Alternatives to public options A diverse workforce can make one-size-fits-all impractical 3

How it Works PLANS Fully insured vs self funded Range of plan options Single carrier vs. multiple Long-term rational pricing PLATFORMS Selection issues Instead of the usual one-size-fits-all approach, personalize and right-size each employee s benefits portfolio. You give employees a set amount of money to spend on benefits Employees shop in the online store and are guided to personalized benefits selections 150+ technology vendors with solutions including varying levels of decision-support features and benefits administration functionality PLAYERS CARRIERS In-house solutions, as well as partnerships with brokers and associations BROKERS Packaged solutions involving various carriers, products and delivery platforms EMPLOYERS Sponsorship of private exchange solutions Experience Typically not pooled, so your demographics and experience determine your rates Defined contribution gives employees ownership in how they spend Employee purchase decisions and revised risk profile can change experience 4

Not about Shifting Risk When done well, employees: Better understand and appreciate their benefits Choose plans that are suited to their individual needs Lower costs Manage risk Key Differences Exchange vs. benefits administration Process vs. transaction Strategic alignment Regulatory and legislative compliance Defined contribution discussion/decision Communication Meaningful choice Robust decision support Superior customer advocacy 5

Strategic Planning 90% 87 % 90% of organizations surveyed do not have a written strategic benefits plan with measurable objectives. Gallagher Benefit Services, Inc. 2014 Benefits Strategy and Benchmarking Survey Considerations Controlling the growth of benefit costs is important to you Defined contribution Trend Hire date to full productivity is relatively long and you want to continue to provide benefits as part of your acquisition/retention strategy Employees don t fully understand/ appreciate what you are spending on benefits Employees want more choices 6

Time of Change Align your total rewards philosophy with your overall organizational strategy Leader vs. follower Model impact Exchange Considerations EMPLOYER CONTRIBUTION Defined Contribution/Defined Benefit - How much? - For whom? - For what? - Funding vehicles-hra, Section 125 - Long term strategy - Communication strategy PRODUCTS & CARRIERS The Store Single v. Multi-Carrier Does multi-carrier make sense? Local/regional/national Individual v. Fully-Insured v. Self Funded Driven by market segment and employee segment Product Shelf Standard v. custom; driven by market segment Which products and how many? CONSUMER SHOPPING EXPERIENCE Driven by number of choices Decision support Recommendation engines Live support TECHNOLOGY AND ADMIN SUPPORT Eligibility and enrollment platform Spending account administration Payroll deduction calculations Billing and payment services Other 7

Private exchanges market organization Available Options Private Exchange Models Pre-65 Group Sponsored Exchanges Post-65 Group Sponsored Medicare Exchanges Pre-65 Consumer Directed Post-65 Consumer Directed Medicare Group Coverage Individual Coverage Group Coverage Individual Coverage WEB BASED ENTITIES 20 public announcements (examples: ehealth, GoHealth) Public Exchange Models Small Group SHOP Exchange (Federal to launch in 2015) Individual State/Federal Exchanges Gallagher Marketplace Recommendation Engine Sophisticated statistical modeling to predict the right combination of plans Education Accessible education about insurance with articles, videos and FAQs Plan Summaries Key components of plans simply and without insurance jargon Comparison Tools Side-by-side comparisons of options 8

Employee Communications Percentage of employees responding favorably to their benefits package: With effective benefit communication Those with above average healthcare benefits 83.6% Those with below average healthcare benefits 76.2% Without effective benefit communication 25.7% 22.1% Source: Towers Watson Employee Engagement Communications to educate and engage employees in the private exchange 9

Case Study Manufacturing company with 1,000+ employees Goal: Structure benefits to align with growth strategy Control cost and mitigate risk Our Approach Analysis of current options Similar medical plans with little variation Significant premium increases High basic life benefit Examine Total Rewards strategy 10

Results Pre-Exchange vs. Post-Exchange Spend Pre-Exchange Post-Exchange Total Spend $9.5 M $9.3 M FLEX Credit -- $6.5 M Life $268,540 $167,837 LTD $234,092 $102,048 STD $292,315 -- Employer Contribution $7.2 M (75%) $6.7 M (72%) Employee Contribution $2.3M (25%) $2.5 M (28%) Medical Plan Ratio Total Premium $7.9 M $8 M Employer Contribution $5.9 M (75%) $6.4 M (81%) Employee Contribution $1.9 M (25%) $1.5 M (19%) Questions? Charlie Isaacs Senior Client Consultant, Practice Leader Charlie_Isaacs@ajg.com 11