For now, large employers are eying HIX for their retirees, former employees on COBRA, and their part-time employees who are not eligible for company benefits. HIX rules prevent them from shifting full-time employees to the exchanges. That policy will change in 2017, and Wojcik expects employers to at least take a look then to see if a public HIX might fit in their benefit strategy.
Mondy says Cigna is looking beyond the initial enrollment period to member retention, which has always been a challenge in the individual market. It is expected that HIX will provide a similar type of competitive marketplace for individuals that is now enjoyed by groups. He is concerned, however, that loss leaders may disrupt the market, as individuals focus on the low monthly premiums rather than the full package, which may include high deductibles, copays, and small provider networks.
Extensive membership turnovers within HIX could affect market stability and make it more difficult for health plans to profitably manage members..
The first miles of the marathon
"This is a very heavy lift for everybody. It is much more than just putting a product out there," says Mondy. "That's why we're concentrating on markets we know and have the capabilities to serve. We'll have the opportunity to analyze things as we go along and as the health insurance exchanges mature."