Executives representing health plans, health maintenance organizations and disease management firms, as well as health insurance brokers and agents are uncertain about the future of health plans and health insurance exchanges, according to survey results from Munich Health North America, a subsidiary of Munich Re.

Of the 326 executives taking part in the survey about several important health care issues related to the Affordable Care Act (ACA), 55 percent do not believe health plans they work with intend to operate on the health insurance exchanges in 2014.

Also, five years from now, respondents said health exchanges will be:

  • Primary vehicles for individual and small group insurance (37 percent)
  • Nothing more than a high-risk pool (36 percent)
  • “Don’t know” (16 percent)
  • Shut down in most states (11 percent)

While 73 percent of respondents are very or somewhat confident that a strong market will develop outside of the exchanges for supplementary medical insurance products, 22 percent are not confident and 5 percent don’t know.
Marsh also concluded that as a result of the ACA, health insurance executives expect U.S. employers to increasingly self-fund their group health insurance plans, and therefore expect to see growth in their self-funded or administrative services only (ASO) portfolios. Of those surveyed, 82 percent have experienced a growing level of interest among employers in self-funding their group health insurance plans over the past 12 months, with 32 percent stating that interest has increased “significantly.” Therefore, 69 percent plan on growing their self-funding or ASO portfolios over the next year.


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