Roughly 6 million people chose their employer-sponsored health benefits through a private insurance exchange for 2015, according to a report from consulting firm Accenture.
That's double the 3 million people who were enrolled in private-exchange plans in 2014. But the latest figure is still a nominal slice of the approximately 150 million nonelderly people who have employer-sponsored health coverage.
Human resources firms and health benefits consultancies such as Aon Hewitt and Towers Watson are bullish on private exchanges, which essentially act as online shopping centers for employees who enroll in health plans. Those firms also have skin in the game. Employers hire them to help set up the exchanges.
The optimistic outlook is also partly because the Affordable Care Act has encouraged more consumers to directly sign up for health insurance, experts say. Almost 12 million people have purchased health coverage through the ACA's federal and state individual exchanges. However, enrollment on the ACA's exchanges for small businesses with 50 or fewer employees has been dismal.
The CMS has not said how many employees purchased insurance on the federally operated Small Business Health Options Program exchanges in 2014. State-run SHOP exchanges had enrolled only 76,000 people as of last June, according to the Government Accountability Office (PDF).
Most of the growth in private exchanges for 2015 came from midsize employers, or those with 100 to 2,500 employees, Accenture said. The firm maintained its prediction that 40 million people will pick their employer health benefits through a private exchange by 2018.
That year is important because that's when the ACA's so-called Cadillac tax goes into effect on generous employer plans. “Private health insurance exchanges will provide an ideal alternative to simultaneously migrate away from these legacy high-cost plans, and provide employees with new options to manage their health,” Accenture said in the report.
Some health insurers, such as Aetna, have been more aggressive than others in investing in private exchanges. In October, Hartford, Conn.-based Aetna partnered with bulk shopping chain Sam's Club to build a private exchange for shoppers who are small-business owners. Aetna also spent $400 million on Bswift, a technology company that builds health insurance exchanges and manages benefits for employers.
