National Business Group on Health Surveys Corporate America

Corporations are currently reviewing the option of moving their retirees and part-time workers into health insurance marketplaces created by the Affordable Care Act (ACA), according to a survey this week by the National Business Group on Health. Along with these options, organizations also expect coverage for their full-time workers and spouses to shift to the online, state-based marketplaces known as insurance exchanges.

"They see the exchanges as logical places for them," said NBGH President Helen Darling. "These are people that public policymakers wanted to get into the pool." NBGH, an association of large employers offering what are often substantial medical benefits, polled its membership about their plans for 2014. The association has approximately 360 members, with about one third responding to the survey. The findings will provide evidence of how organizations are dealing with the Affordable Care Act, and how employer-based coverage will change in the future.

NBGH asked whether employers expected various groups "who may currently be covered by your plans will choose public exchange coverage when it becomes available in 2014." While 40 percent predicted no change, 20 percent of those responding expected part-time workers to buy exchange plans next year. The health law does not require employer coverage for those who work less than 30 hours a week. Twenty five percent of the organizations anticipated that retirees too young for Medicare and still on the company plan could choose exchange coverage in 2014.

An interesting development in the various options has been private health insurance exchanges for employees and retirees. Like the public ACA exchanges, private exchanges offer a menu of comparable policies and other benefits for consumers. At present, private exchanges are now offered only to a limited number of companies. While they lack government subsidies, they may also provide organizations the greatest flexibility and cost savings over time. Only about a third of the companies in the NBGH survey are considering moving employees into private exchanges. "At this point it's still mostly interest," Darling said. "There's a lot of talk."

Ms. Darling expects quicker adoption, however, of private exchanges for retirees. Nearly half the companies are considering shifting retirees into private exchanges next year or later, while ten percent have already done it. Since the idea is gaining momentum, it is likely that the survey will document more evidence of their use in the future.