PRIVATE HEALTH INSURANCE EXCHANGES WHAT EMPLOYERS THINK ABOUT EXCHANGES IN 2016 EXECUTIVE SUMMARY

PRIVATE HEALTH INSURANCE EXCHANGES WHAT EMPLOYERS THINK ABOUT EXCHANGES IN 2016 EXECUTIVE SUMMARY

ABOUT THE SURVEY Pacific Resources conducted its third annual survey to capture the current perspective on private exchanges from some of the largest employers in the United States. The survey was conducted in the first quarter of 2014, 2015 and 2016. The companies surveyed over all three years represent all industries. Many are ranked in the Fortune 1000, with several listed in the top 50. In response to what we have seen in the marketplace, we invited some smaller employers (under 5,000) to participate in the survey. We also differentiated 2016, in between Non-Medicare eligible retirees and Medicare eligible retirees. Respondents were senior human resource or benefits executives with decision-making authority within their organizations. The companies surveyed represent more than 1.2 million active or retired employees and 2.8 million covered members. 2

LARGE EMPLOYER PRIVATE EXCHANGE SURVEY KEY LEARNINGS IN 2016 Most employers indicate that they have a good understanding of private exchanges. The top three attributes of a private exchange are: Multiple carriers Benefits administration Defined contribution strategy Cost is still the driving factor for considering a move to an exchange; employee choice and administrative ease are also important. Fewer employers are interested or confident in exchanges as a strategy for active employees. Exchanges are perceived as a better option for the retiree population, particularly for Medicare eligible retirees. Employers want help evaluating exchange vendors. Nearly half want independent advice A third indicated that they would engage their benefits consultant even if that consultant sponsors an exchange 3

SURVEY RESULTS 4

UNDERSTANDING OF EXCHANGES FOR THE MOST PART, EMPLOYERS UNDERSTAND EXCHANGES How would you assess your company's understanding of the opportunities, challenges and decisions required to move to a private exchange? 53.6% 47.8% 42.6% 59.2% 34.8% 31.5% 8.7% 9.3% 8.7% 1.9% 1.9% 0.0% We have a thorough understanding of how exchanges work, including the differences of each exchange vendor model. We have a basic knowledge of how exchanges work and have had only limited exposure to the various vendors in the exchange marketplace. Our knowledge of exchanges is based solely on what we have read in the trade journals. Other (please specify) * 2016 2015 2014 *Other includes answers such as We have more than a basic knowledge, but not thorough. 5

DEFINITION OF AN EXCHANGE AN EXCHANGE SHOULD OFFER MULTIPLE CARRIERS, BENEFITS ADMINISTRATION, AND A DEFINED CONTRIBUTION STRATEGY When you think about the definition of a private exchange, which of the following attributes fit your definition?* (Please select your top three attributes.) 72% 48% 44% 30% 24% 20% 14% 14% 8% 2% *New question for 2016; not asked in 2015 and 2014 **Other = All of the above 6

REASONS FOR MOVING TO AN EXCHANGE COST STILL DRIVING FACTOR; EMPLOYEE CHOICE AND ADMINISTRATIVE EASE STILL IMPORTANT Of the following reasons, which would rank as most important in your company s decision to move to an exchange? (select up to 5) Reduce company costs 64.4% 81.5% 84.9% Giving our employees more choice that may better meet their coverage needs 44.4% 40.7% 66.0% Administrative ease 24.5% 37.8% 50.0% Multiple carrier choices in multiple markets Opportunity to move to defined contribution method of funding* 11.3% 31.1% 25.9% 26.7% 29.6% Empowering employees to make informed benefit decisions* 24.4% 27.8% 2016 2015 2014 *These responses were not an option in 2014 7

INTEREST LEVEL FOR ACTIVE EMPLOYEES FOR ACTIVE EMPLOYEES, MORE THAN 70 PERCENT OF RESPONDENTS HAVE NO PLANS TO EVALUATE EXCHANGES OR HAVE EVALUATED AND DECIDED NOT TO MOVE TO AN EXCHANGE How would you describe your company s level of interest in private exchanges for ACTIVE employees? 42.2% 38.9% 37.0% 35.2% 28.9% 18.5% 20.4% We have no plans to evaluate private exchanges at this time. 13.3% 11.1% We are interested in evaluating private exchanges as a benefits strategy. 7.4% 6.7% We have begun the process of evaluating a private exchange as a potential benefits strategy. 13.0% We have conducted an evaluation of various private exchanges and have decided NOT to move forward with replacing our benefit plans with an exchange. 2016 2015 2014 1.9% 0.0% 0.0% 0.0% We have conducted an evaluation of various private exchanges and have decided to move forward with replacing our benefit plans with an exchange. 7.4% 3.7% We are considering setting up our own exchange. 8.9% 5.5% 0.0% Other (please specify) * *Other includes answers such as We will continue to monitor. 8

LACK OF CONFIDENCE FOR ACTIVE EMPLOYEES THE PERCENTAGE OF EMPLOYERS WHO LACK CONFIDENCE THAT AN EXCHANGE WILL PROVIDE A VIABLE ALTERNATIVE FOR PROVIDING HEALTH BENEFITS HAS NEARLY DOUBLED SINCE 2014. How confident are you that private exchanges will provide a viable alternative to your current methods of providing health coverage to active employees? 57.8% 44.4% 35.2% 35.2% 34.0% 26.7% 11.1% 5.7% 15.6% 9.3% 15.1% 0.0% Very confident Somewhat confident Not confident Don't know 2016 2015 2014 9

WHY NOT MOVE ACTIVE EMPLOYEES UNPROVEN COST SAVINGS IS THE MAIN REASON EMPLOYERS ARE NOT MOVING ACTIVE EMPLOYEES TO AN EXCHANGE If you conducted an evaluation of various private exchanges and decided NOT to move forward with an exchange for ACTIVE employees, please indicate the reasons why. (select all that apply) Unproven cost savings 84.6% Level of employee disruption 53.9% Minimal short-term cost savings 30.8% Minimal long-term cost savings 30.8% Cost of exchange administration 23.1% Other (please specify) 23.1% Level of network disruption 8.9% Other reasons include loss of control, employee confusion, difficult to unbundle if not working 10

MORE RETIREES THAN ACTIVES ON EXCHANGE TREND FROM PREVIOUS YEARS CONTINUES What percentage of your population is on a private exchange? (enter a whole number) Active Employees Non-Medicare Eligible Retirees Medicare Eligible Retirees 2% 2% 11% 11

INTEREST IN EXCHANGES NEARLY HALF OF RESPONDENTS HAVE NO PLANS TO EVALUATE PRIVATE EXCHANGES FOR NON-MEDICARE ELIGIBLE RETIREES How would you describe your company s level of interest in private exchanges for Non-Medicare Eligible Retirees? We have no plans to evaluate private exchanges at this time 37.0% 46.7% Other (please specify)* 20.0% 22.2% We have begun the process of evaluating a private exchange as a potential benefits strategy 11.1% 13.3% We are interested in evaluating private exchanges as a benefits strategy 8.9% 13.0% We currently have a private exchange in place for Non-Medicare Eligible Retirees 6.7% 14.8% We have conducted an evaluation of exchanges and have decided to move forward with replacing our benefit plans with an exchange We have conducted an evaluation of exchanges and have decided NOT to move forward with replacing our benefit plans with an exchange 2.2% 1.9% 2.2% 0.0% 2016 2015** *Many of the other responses indicated that respondents do not offer benefits to retirees **In 2015, we did not specifically ask about Non-Medicare eligible retirees and Medicare eligible retirees. 12

CONFIDENCE IN EXCHANGES CONFIDENCE VARIES DEPENDING ON WHETHER RETIREES ARE ELIGIBLE FOR MEDICARE How confident are you that private exchanges will provide a viable alternative to your current methods of providing health coverage to: Non-Medicare Eligible Retirees Medicare Eligible Retirees 26.7% Don't know 6.7% Very confident 33.3% Don't know 24.4% Very confident 27.8% Somewhat confident 28.9% Not confident 22.2% Not confident 20.0% Somewhat confident 13

INTEREST IN EXCHANGES NEARLY HALF OF RESPONDENTS HAVE NO PLANS TO EVALUATE PRIVATE EXCHANGES FOR MEDICARE ELIGIBLE RETIREES How would you describe your company s level of interest in private exchanges for Medicare Eligible Retirees? We have no plans to evaluate private exchanges at this time 37.0% 48.9% Other (please specify)* 22.2% 24.4% We have begun the process of evaluating a private exchange as a potential benefits strategy 0.0% 11.1% We are interested in evaluating private exchanges as a benefits strategy 8.9% 13.0% We currently have a private exchange in place for Non-Medicare Eligible Retirees 8.9% 14.8% We have conducted an evaluation of exchanges and have decided to move forward with replacing our benefit plans with an exchange 0.0% 1.9% We have conducted an evaluation of exchanges and have decided NOT to move forward with replacing our benefit plans with an exchange 0.0% 8.9% 2016 2015** *Many of the other responses indicated that respondents do not offer benefits to retirees **In 2015, we did not specifically ask about Non-Medicare eligible retirees and Medicare eligible retirees. 14

EMPLOYERS SEEK HELP EVALUATING EXCHANGES 80% OF EMPLOYERS NEED EXPERT ASSISTANCE AND NEARLY HALF INDICATE THEY WANT INDEPENDENT ADVICE Which one of the following responses best describes how your company would, or did, evaluate a private exchange vendor? 48.9% 31.1% 16.7% 13.2% 35.2% 24.5% 24.5% 20.0% 18.5% 29.6% 37.8% 0.0% We would engage our benefits consultant even if that consultant sponsors an exchange. We would engage an independent consultant whose firm does not sponsor or own an exchange. We would perform the evaluation primarily using inhouse staff including our procurement office. Other * 2016 2015 2014 *Other could be: We have not yet discussed how we would approach an evaluation We would not perform a comprehensive evaluation but would rely on our consultant to tell us which exchange would work for us 15

ABOUT PACIFIC RESOURCES Pacific Resources Pacific Resources is a leading independent employee benefits advisory firm that works with Fortune-ranked and other large companies. For over four decades, Pacific Resources evidence-based insights have shaped innovative employee benefit solutions, helping companies get the most value from their benefit plans, and positively impacting the lives of millions of employees and their families. http://www.pacresbenefits.com/ For more information on the survey, contact Pacific Resources, at info@pacresbenefits.com. 16

Pacific Resources Benefits Advisors, LLC does not provide legal, regulatory or tax guidance or advice. Questions regarding specific issues and application of federal, state and local laws should be addressed by your tax and legal advisor. The information in this document is intended to provide a general overview of the services contained herein. Pacific Resources makes no representation or warranty as to the accuracy or completeness of the document, and undertakes no obligation to update or revise the document based upon new information or future changes. All information presented is considered proprietary information (unless otherwise noted) and may not be distributed or copied in any part, form or manner. 17