Sebelius Releases Proposals for Minimum Requirements for State-Run Health Insurance Exchanges; Extend Health CEO Bryce Williams Offers “Four Keys To Building An Effective Health Insurance Exchange”

SAN MATEO, Calif.--(BUSINESS WIRE)--As a complement to the draft proposals for minimum requirements for state-run health insurance exchanges, released today by Health and Human Services (HHS) Secretary Kathleen Sebelius, Extend Health, Inc. CEO Bryce Williams announced “Four Keys to Building An Effective Health Insurance Exchange.” As the operator of the nation’s largest private Medicare exchange, Extend Health’s four keys can serve as best practice guidelines for states as they prepare to meet the 2014 deadline for the implementation of a health care insurance exchange.

“Anything less than an efficient marketplace enabled by sophisticated technology open 24 hours a day, and licensed benefit advisors available by phone to help consumers, will not cut it. With less than 30 months to go, needless to say, time is short.”

According to statements made today by Secretary Sebelius, state-run exchanges will share three features: they will be “one-stop shops” for consumers seeking private health insurance; they will set conditions that insurers compete only on price and quality; and they will ensure a basic level of coverage.

Said Bryce Williams, CEO of Extend Health, “The evolving exchange requirements issued by the Federal government to date – including today’s – give states design and implementation flexibility, but they are complex. In seven years of operating the nation’s largest private Medicare exchange, which processes millions of health plan-related exchange transactions annually, we’ve learned that building an effective exchange takes time. We believe that many states will be hard pressed to build effective exchanges ready for enrollments by the fall of 2013, as proposed in the new regulations, in time for the beginning of the plan year 2014, which the Patient Protection and Affordable Care Act mandates.”

Added Williams, “Based on our experience, there are four keys to building an effective exchange that will meet the minimum requirements proposed by the HHS today and meet the goal of extending health insurance to all Americans.”

The four keys are:

1. A dynamic exchange architecture and flexible tools that allow for the inevitable evolution and change that state exchanges will undergo, with minimal re-engineering.

2. Standardization of processes that make data exchange and communications between all the players in a state exchange seamless and efficient, in addition to the mandated standardization of health plans which makes plan comparisons and purchase decisions easier for consumers.

3. A scalable platform that can grow to handle the millions of consumers and the tens or hundreds of millions of transactions and interactions expected of a robust exchange.

4. A great consumer experience that makes it easy for consumers to determine eligibility, make informed choices, purchase and enroll in health plans, pay premiums and manage coverage, including reimbursements.

“Health insurance exchanges are more than interactive websites and will require the participation of both consumers and health plans to meet their goals,” said Williams. “Anything less than an efficient marketplace enabled by sophisticated technology open 24 hours a day, and licensed benefit advisors available by phone to help consumers, will not cut it. With less than 30 months to go, needless to say, time is short.”

Over seven years, Extend Health has built the largest private Medicare exchange in the country. More employers have used Extend Health than any other company to transition their retirees to a private Medicare exchange. Extend Health also is the only company that has helped more than 350,000 retirees use an exchange to select from more than 3,500 private Medicare plans from 73 national and regional insurance companies.

The Extend Health exchange platform is the only one in the industry that enables end-to-end electronic transmission of enrollment information with interoperability between the exchange and insurance carriers. This interoperability promotes accurate and efficient enrollment, premium administration, claims processing and reimbursements. Extend Health’s licensed benefit advisors work in U.S. call centers where state-of-the-art routing systems direct every caller to an advisor with the appropriate licensure and insurance appointments that match the caller's geographic area and available plans. Advanced decision support tools help benefit advisors provide clear and concise guidance and support, and make it easy for retirees to select the private Medicare coverage that best suits their needs.

About Extend Health

Extend Health, Inc., founded in 2004, operates the largest private Medicare exchange in the country. For more information, visit Extend Health on the web at http://www.extendhealth.com.