Robert L. Rodriguez

Director of Sales

Expansion of Vision Plans through the private exchange

Vision care executives predict increased enrollment in vision plans through the expanding private exchange

Rapidly expanding private exchanges continue to develop as an attractive alternative to the public healthcare exchanges created by the Affordable Care Act (ACA). Specialty healthcare organizations and especially vision care executives are keeping an eye on the private exchanges, and they are seeing a trend of consumers enjoying greater access to vision insurance and purchasing more vision plans. This is great news for healthcare payers with a vision care component, not only for the remainder of 2015 but for at least the next three years if trends continue as predicted.

Celina Burns, president of Davis Vision, said, “We’re projecting significant momentum in the private exchange space in 2016 and beyond.” And according to Employee Benefit News (EBN), “Employees have their eyes set on vision insurance, as sales have increased close to 25% since 2013 and are leading the pack in worksite voluntary sales growth.”

The rise of the private exchange

As a readily-accessible online marketplace, the private exchange encompasses individual purchases in addition to small and large group exchanges. It poses a number of advantages for employers, including cost control through defined contributions, a reduction of the HR administrative burden, and tax benefits.

One of PLEXIS’ strategic partners, Accenture, estimates that enrollment in private exchanges will double for 2015, from 3 million people in 2014 to 6 million in 2015. Furthermore, Accenture predicts a continuous rise in private health exchange enrollment, with a projection of 40 million enrollments by 2018, surpassing enrollment in public exchanges.

Greater focus on the importance of eye health

Leading vision care executives report that earlier benefit packages may not have included a vision component, but as the private exchange evolves both in technology and as a business model, it is becoming easier than ever to select a vision care plan. The Kaiser Foundation reports that “employers have more control over how to allocate their benefit dollars between medical and ancillary plans, and exchange sponsors report that consumers appear to be re-allocating dollars from medical to ancillary.”

PLEXIS delivers scalable, vision-specific solutions

From a technology perspective, PLEXIS is proud to help specialty healthcare organizations leverage the tools that deliver greater administrative efficiency for vision care claims management and benefit administration. In response to the needs of vision insurance organizations, PLEXIS adapted our core platform to automatically manage complex vision-specific accumulators and highly-complex fee schedule calculation instructions. In addition, PLEXIS’ solutions for vision care payers have proven extremely scalable as payers’ operations expand along with the rising numbers of consumers choosing vision care plans. Thanks to the rapid rise of the private exchange, it will potentially be easier than ever before to add vision care to their medical package.

Upcoming events

Join PLEXIS in Las Vegas on May 4-6 at the 2015 Specialty Health Summit, “Stacking the Deck: Cashing in on Consumer Value.” This influential event is presented by the National Association of Specialty Health Organizations (NASHO) and the National Association of Vision Care Plans (NAVCP).

The National Eye Institute (NEI) kicked off Healthy Vision Month on May 1st, inspiring more Americans to focus on the importance of eye health.




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