THE BUSINESS VALUE OF PRIVATE EXCHANGES Mercer Marketplace April 2014 Matthew Snook, Partner matthew.snook@mercer.com 813 207 6310
Driving Forces for Private Exchanges Challenge of Attraction and Retention: Employee Concerns Importance of benefits as attraction/retention factor 53% say benefits play a significant role in their decision to stay with their employer Low satisfaction with current benefits 24% think that their benefit program is very good Lack of meaningful choice Want flexibility to choose benefits that fit their needs: reduce the value of some benefits and increase the value of others 1
Driving Forces for Private Exchanges Employer Concerns Cost of providing benefits Employers costs continue to outpace earnings and inflation Resources required to manage benefit programs 79% of US employers cite one-stop shop for all administration as reason to integrate core and voluntary benefits Health care reform How to address increased costs, design, communications, and administration implications 2
How Do Private Exchanges Differ From One Another? 1 2 3 Exchange Product Suite Funding Flexibility Sponsor Medical / RX Only Comprehensive benefit portfolio including dental, vision, life, disability, critical illness and more Consultant/Broker Technology Firm Carrier Partnership Fully-Insured only Both Fully-Insured and Self-Insured 4 5 Benefits Carriers Available Administration Services Participating carriers Single Carrier Multi-Carrier Online enrollment platform Payroll / Carrier integration Decision support tools Call center support Employee communications 6 Target Market Segments Small to Mid Large to Jumbo All employer sizes 3
Mercer Marketplace Business Value Early Results - Different Reasons Drive Decisions Top 3 Reasons for Moving to Mercer Marketplace 63% Simplified administration and compliance 47% Ability to better manage future costs, defined contribution facilitation 41% Achieve immediate cost savings 4
Simplified Administration Efficient Solutions For Employers Funding DC or DB Standard Plan Designs Choice among multiple, prescreened plans Employee Communications and Education Online Call Center Print and email Administration Eligibility determination Data-driven events Election management Contribution calculation Election Data Deductions Reporting and Premium Data Carriers Payroll HR Your Options Our Responsibility 5
Simplified Administration Compliance Support Summary plan description creation COBRA qualifying event notice, participant billing COBRA participant billing Plan document creation Compliance support 5500 preparation HIPAA notices Discrim. testing PPACA Elig determination of FT/PT status 6
Empowered Employees Comprehensive Benefit Options Medical Medical HSA Health Care FSA Dependent Care FSA Supplemental Medical Accident Critical Illness Hospital Indemnity Dental and Vision Dental Vision Life Employee Term Life Spouse Term Life Child Term Life AD&D Permanent Life Disability STD LTD Transportation Transit Account Parking Account Other Group Legal Home & Auto Identity Theft Pet Insurance 7
Empowered Employees 5 Distinct Choices in Medical / RX Plan Designs Medical Plan Design Grid $0 Deductible Plan $350 Deductible Plan $800 Deductible Plan $1,500 Deductible Plan $2,500 Deductible Plan HRA or HSA Eligible? HRA HRA HRA Either HRA or HSA 3 Either HRA or HSA 3 Location of Services In- Out-of- In- Out-of- In- Out-of- In- Out-of- In- Out-of- Annual Deductible Individual None $1,500 $350 $2,000 $800 $2,400 $1,500 $3,000 $2,500 $4,500 Family None $3,000 $700 $4,000 $1,600 $4,800 $3,000 $6,000 $5,000 $9,000 OOP Max (incl. ded) 1 Individual $1,500 $3,000 $2,000 $4,000 $2,400 $4,800 $3,000 $6,000 $4,500 $9,000 Family $3,000 $6,000 $4,000 $8,000 $4,800 $9,600 $6,000 $12,000 $9,000 $18,000 General Coinsurance 100% 70% 80% 60% 80% 60% 80% 60% 70% 50% Physician Preventive 100% 70% 100% 60% 100% 60% 100% 60% 100% 50% PCP / Specialist $15 / $25 70% $15 / $30 60% 80% 60% 80% 60% 70% 50% Hospital Facility Inpatient $200 70% 80% 60% 80% 60% 80% 60% 70% 50% Outpatient $100 70% 80% 60% 80% 60% 80% 60% 70% 50% Emergency Room (waived if admitted) $100 $100 $100, 80% $100, 80% 80% 80% 80% 80% 70% 70% Retail RX 2 Generic $5 $10 70% ($10/$20) 80% 70% Formulary Brand $20 $30 70% ($25/$50) 80% 70% Non-Formulary Brand $50 $60 55% ($40/$80) 80% 70% Mail-Order RX 2 Generic $12.50 $25 70% ($25/$50) 80% 70% Formulary Brand $50 $75 70% ($62.50/$125) 80% 70% Non-Formulary Brand $125 $150 55% ($100/$200) 80% 70% Actuarial Value 92% 87% 81% 74% (HSA-eligible) 77% (HRA-eligible) 64% (HSA-eligible) 69% (HRA-eligible) NOTE: Plan designs subject to change based on forthcoming PPACA regulations; plan designs subject to state mandates (if insured) 1: All copays (office visit, ER, hospital, and Rx), coinsurance, and deductible apply to the OOP maximum. 2: Preventive Rx (as defined under HSA regulations) for the $1,500 and $2,500 deductible plans is covered at the in-network coinsurance level prior to meeting the deductible. 3: HSA-eligible designs are subject to deductible and OOP maximum requirements dictated by IRS, including true family structure, integrated pharmacy, and minimum deductible/maximum OOP maximum levels; actuarial values are based on an HSA design. 8
Reduced Costs Early Results - Employers Maximizing Choice Platinum (90%) Gold (80%) Silver (70%) Bronze (60%) $0 Deductible $350 Deductible $800 $1,500 Deductible $2,500 Deductible 37% 70% 93% 96% 89% 9
Reduced Costs Early Results - Right-Sizing 100.0% Average Value of Medical Plans 90.0% 80.0% 70.0% 60.0% $800 50.0% 40.0% 30.0% 80.4% 71.9% Per-employee cost reduction from right-sizing benefits 20.0% 10.0% 0.0% Pre-Marketplace Post-Marketplace 10
Reduced Costs Early Results - Non-Medical Savings 9.4% Average savings for life and disability benefits offered via Marketplace Active marketing of all lines of coverage Aggressive carrier bids Multi-line discounts 11
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