Wal-Mart Offers Shoppers Retail Health Coverage

Adding health insurance plans to customers' shopping lists

By Stephen Miller, CEBS Oct 10, 2014

As the Affordable Care Act makes it easier for employers to drop health care coverage for part-time employees who can purchase subsidized insurance through a public health exchange, or for employers to eliminate health benefits altogether—penalty free—if they have fewer than 50 full-time employees, retail services are springing up to help consumers lacking employer-provided coverage to navigate the health care market.

Consider that Wal-Mart Stores Inc., the nation's largest private employer, recently announced it is eliminating health coverage for its part-time U.S. employees who work less than an average of 30 hours a week, in a move aimed at controlling rising health care costs. The announcement affects 30,000 Wal-Mart workers and follows similar decisions by other employers.

These moves are creating a new market for retail health insurance, so it may not be surprising that Wal-Mart also recently announced it has inked a deal with DirectHealth.com to launch Healthcare Begins Here, an in-store program designed to educate American consumers on their health insurance options and to help them purchase insurance offered by multiple carriers.

An in-store program to market health plans

for those who have lacked, or recently lost,

employer-provided health coverage.

DirectHealth, an online health insurance comparison site, will set up counters in 2,700 of Wal-Mart’s more than 4,000 stores starting Oct. 10. The counters will be staffed with independent, licensed agents to provide customers with education and guidance about purchasing health insurance. Customers also will have the ability to enroll in policies by phone, online or onsite at Wal-Mart.

According to recent research by the Kaiser Family Foundation, more than 60 percent of people have difficulty understanding their health insurance plan options and nearly 40 percent feel they picked the wrong plan after enrollment.

“For years, our customers have told us that there is too much complexity when it comes to understanding their health insurance options,” said Labeed Diab, Wal-Mart senior vice president and head of the firm’s health and wellness division, in a statement accompanying the retailer’s Oct. 6 announcement. The new program “addresses that complexity by bringing clarity and increased choice to the insurance enrollment process,” he noted.

“Many consumers have an extremely difficult time navigating the health care landscape, including understanding plan types, coverage levels and health care terminology,” commented Abby Rosenberger, marketing content manager at Zane Benefits, a consultancy. “Wal-Mart’s hope,” she added, is “to drive traffic to the store by offering face-to-face time with an agent to answer any questions consumers may have on their options.”

The new service will:

  • Provide those under age 65 with access to thousands of health exchange plans from more than 300 leading carriers. The open enrollment period for the Affordable Care Act’s Health Insurance Marketplace (the public exchanges) takes place from Nov. 15, 2014, to Feb. 15, 2015.
  • Provide those over 65 with access to more than 1,700 plans from 12 leading Medicare Advantage or supplemental “medigap” insurance carriers. Enrollment takes place during the Medicare open enrollment period from Oct. 15, 2014, through Dec. 7, 2014.

Retailers Make Their Move

Drugstore giant CVS Health Corp. is another example of a retailer moving into the health care delivery space. CVS Health is doing so through a growing number of in-store walk-in clinics, a Pharmacy Advisor prescription management program to encourage proper use of medications, and community health promotion efforts. The drugstore chain recently announced it would stop selling tobacco products as part of its health initiative, which includes a comprehensive smoking cessation campaign.

At a Sept. 19 briefing at the National Press Club in Washington, D.C., CVS Health President and CEO Larry J. Merlo said the company also will focus on providing care coordination services for people with chronic illness, to deliver better patient outcomes at lower costs.

Sam’s Club Launches Private Health Insurance Exchange

Sam’s Club, a division of Wal-Mart Stores Inc., announced in October 2014 it is launching a private health insurance exchange for its members, "a move that is aimed at providing the small-business owners that are its core customers with a way to offer affordable insurance coverage to their employees," the Washington Post reported.

The exchange, known as The Aetna Marketplace for Sam’s Club, will be available in 18 states to members, their employees and their families. Employers can choose whether to offer a defined contribution plan or one that gives workers a flat, pre-tax contribution to apply toward a plan of their choice.

"One of Sam’s Club’s chief rivals, Costco, already offers a private insurance marketplace that is geared at individual shoppers," the Post story noted, adding, "The Sam’s Club marketplace is different in that it was designed specifically to appeal to small-business owners, although individual members could potentially sign up for it."

Stephen Miller, CEBS, is an online editor/manager for SHRM. Follow him on Twitter @SHRMsmiller.


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