US Exchanges: A Marketplace Overview

by Tom Scales,  Mohammed Mahfuz, July 14, 2015
Vendor Reviews
North America

Abstract

The sale of insurance in the United States has followed a traditional agent model for generations. Recent advancements in technology, coupled with legislative and regulatory changes, are reshaping the marketplace. These outside forces, combined with a changing demographic of technologically literate consumers, are pushing insurers out of their comfort zone into new channels and new approaches to sales.

Never has this been more apparent than the introduction of insurance exchanges as defined by the Patient Protection and Affordable Care Act of 2010 (ACA). Health insurers have been forced to change their sales model, for both individual health insurance and insurance available as an employee benefit. These changes are beginning to affect life insurance companies as well.

To support the changing market, insurers must implement new technology in a timeframe that virtually requires them to use software available from vendors. The purpose of this report is to provide a market overview of key vendor participants as well as Celent’s observations on the market and direction as a whole.

“The market is changing at a pace never before seen, and exchanges are a huge part of the changing dynamic,” says Tom Scales, a research director with Celent’s Insurance practice and coauthor of the report. “Exchanges go well beyond just health insurance companies and are a component of transformation of the entire industry.”

Celent profiles seven vendors that cover a cross-section of the industry. The report is not intended to be an all-inclusive review of the industry, but a solid foundation for companies that are reviewing technology and considering their strategy.

This 56-page report contains 10 figures and 28 tables.

Celent is a research and advisory firm dedicated to helping financial institutions formulate comprehensive business and technology strategies. Celent publishes reports identifying trends and best practices in financial services technology and conducts consulting engagements for financial institutions looking to use technology to enhance existing business processes or launch new business strategies. With a team of internationally based analysts, Celent is uniquely positioned to offer strategic advice and market insights on a global basis. Celent is a member of the Oliver Wyman Group, which is a wholly-owned operating unit of Marsh & McLennan Companies [NYSE: MMC].

Media Contacts

North America
Michele Pace
mpace@celent.com
Tel: +1 212 345 1366

Europe (London)
Chris Williams
cwilliams@celent.com
Tel: +44 (0)782 448 3336

Asia (Tokyo)
Yumi Nagaoka
ynagaoka@celent.com
Tel.: +81 3 3500 3023

Table of Contents

Executive Summary

1

 

Key Research Questions

1

Introduction

2

 

Key Research Questions

2

Report Method

5

 

Approach

5

 

Categorizing the Vendors

5

 

About the Profiles

5

 

Limitations

5

Vendor Preview

7

Solution Profiles

10

Benefitfocus, Inc.: Benefitfocus Marketplace

11

Bloom Health Corporation: Bloom Health Private Exchange Platform Solution

15

ConnectedHealth, LLC: SmartChoices Marketplace

21

Connecture, Inc.: On Ramp

26

Ebix, Inc.: EbixEnterprise

30

Vimo, Inc. (dba GetInsured): The GetInsured Individual Exchange Solution

35

hCentive, Inc.: WebInsure Suite

41

Vendor Observations

46

Insurer Next Steps

47

Conclusion

48

Exchange Glossary

49

Leveraging Celent’s Expertise

51

 

Support for Financial Institutions

51

 

Support for Vendors

51

Related Celent Research

52

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