A Primer for Millennial Mentors: Differences Between Private & Public Healthcare Marketplaces

It’s open enrollment season, and everyone’s talking about the best ways to get healthcare coverage. If you’re helping a Millennial …

It’s open enrollment season, and everyone’s talking about the best ways to get healthcare coverage. If you’re helping a Millennial or other family member choose the right plan, knowing where to look for appropriate plans is the first challenge. Options include public exchanges, private exchanges, and employer-subsidized insurance. Let’s look at the key differentiators of the first two.

The difference between public exchanges and private marketplaces is pretty straightforward:

  • A private health insurance marketplace is run by a private company.
  • A public health insurance exchange is run by a government (or government-contracted) entity.

When considering individual health care options, or coverage for  a company’s employees, it’s important to remember the two are very different and that, generally, private healthcare coverage marketplaces offer more choices for individuals and employees. To make the best possible decision, consider the differences between these two platforms.

Public Exchanges

Public exchanges are synonymous with the Affordable Care Act. Public exchanges are sponsored by the state or federal government and offer services for individuals and small companies with up to 50 employees. Public exchange coverage programs are paid for by individuals and small companies, although many public exchange plans are also covered by government subsidies.

Private Marketplaces

Private marketplaces are run by private companies and offer more health care choices for individuals, and employees of companies large and small. Unlike public exchanges, private benefits marketplaces like Candor(™) offer a variety of vision, dental and Tele-health benefits, along with other ancillary options, such as pet care all in one online place, which allows employees to tailor a plan to fit their specific needs.

Additionally, private marketplaces also offer the benefit of ‘defined contributions’ (an affordable alternative to employer-sponsored group health insurance plans). This means employers can define their annual contribution budget and offer employees more freedom in how they choose to shop for coverage.

You can purchase your own “private” policy at any time, and employers usually have defined enrollment periods set by their plan providers. If you’re using a public Obamacare exchange, though, there’s a limited time each year when you can enroll in or change your health insurance plan (unless you’ve had a “qualifying life event” like a marriage, birth, or job change that causes you to lose employer-provided insurance).

Private marketplaces create predictability. You’re buying a more budget-friendly solution that helps employers remove themselves from employees’ insurance choices, and helps individuals managing their own health plans.

In addition to the differences noted above, look at the differences between different private marketplaces. If you’re considering buying coverage on a private marketplace, ask the following questions:

  • Does the private marketplace offer additional wellness benefits?
  • Are you able to secure your coverage simply and cost effectively?
  • Are you able to comparison shop between insurance carriers?
  • Are you able to find plans your doctor accepts?
  • Are you able to get deep discounts on related services including Dental, Vision, MRI and CT Scans, Counseling, Alternative Medicine etc?

Some experts suggest looking beyond the official federal and state marketplaces. One option is to check out a private marketplace offering wellness benefits as well as appropriate health insurance plans, such as Candor. Candor has developed an app that makes it easy to find the healthcare coverage you need. The app and its associated software platform incorporate tools and support for partner insurance agencies health insurance carriers, wellness providers and healthcare providers.

Download the app today to see if private marketplace healthcare coverage is right for you, and visit https://candor.insurance for additional information.