exchange 101
empowering consumers to pick the plan that's best for them

An exchange is a marketplace where insurance providers compete for your business. Consumers leverage their combined purchasing power to obtain the best insurance plans at the best prices possible to find coverage that fits their needs and budget. It’s easy to compare options and enroll online.

Why were exchanges created?

Exchanges were created to help consumers find the best plan to meet their needs and budget. Too often individuals were denied coverage and could not get insurance due to pre-existing conditions.

There are two types of exchanges — public and private.

What’s the difference between public and private exchanges?

Public exchanges are:

Our Private exchange is:

What is defined contribution?

Employers can provide their employees a defined contribution, or pre-determined amount of money, they can use in the Marketplace however they want. By setting a pre-determined amount of premium contributions, employers are able to control their costs and budget farther in advance. Employees have a greater appreciation when they can use the money the employer provides, in addition to their own pre-tax dollars, to choose the benefits they value and want the most.

Feature SmartBenefits Marketplace™ Public
Who is eligible? Individuals and Groups with 10 or more employees. Individual: U.S. Citizen & legal immigrants
Group: Businesses up to 100 employees (SHOP exchange - DELAYED)
# Participating carriers Anthem, Coventry-Aetna, United Health Care, Assurant, Guardian, MetLife, Unum MO: Anthem, Coventry
Ill: Blue Cross/ Blue Shield --ILL, Coventry
Defined contribution strategy (cafeteria) Available Not available
Non-medical product availability (L, D, V, STD, LTD,LTC, IDI, Worksite,
Retirement plans)
Available for Groups Not available
Federal tax subsidies Not available Accessible to individuals only through the American Health Benefit Exchange
Small Business tax credits Available for 2013 tax year Starting in 2014, can only access credits through the public (SHOP) exchange (small groups <50 EEs)
Pre-tax contributions for premiums Available for both Individual and Group coverage through employer Not available
Integration with payroll vendor Available Not available
Broker sales support SBM will promote/support Yes
One-on-one Call Center / Client Service / Benefit Counselors SBM provides Uncertain Federal employee