5 HIX Challenges for Health Insurers

States will have the flexibility to decide what model they want to implement so insurers will face variations in exchange designs across the country. The differences could make some exchanges profitable for some insurers but not for others the report shows, and insurers will need to decide which ones they will enter.

4. Health insurance will shift from a wholesale to a retail business. Some 37% of healthcare insurance executives who said they plan to participate in exchanges said their companies aren't active in the individual market today and 20% don't offer small group policies. Gitlin says insurers will need to learn a new business and compete in ways they never have before to earn consumers' business and loyalty. That means understanding who the consumers are, what motivates them and how they behave so insurers can tailor communications, products, and services to this new market.

5. Business will be brand neutral. According to the report, the four most important considerations in selecting a health plan are price, benefits, provider network and coverage area. A company being well known is the least influential attribute. Gitlin says that means insurers will need to be prepared to compete for exchange business on the basis of value for the consumer.

Gitlin cautions that health insurers will also face a huge consumer education challenge to help individuals understand the benefits of purchasing health insurance through an exchange. In the PwC survey some 56% of consumers didn't even know what health insurance exchange was.