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Exact(8)
Alternatives include replacing current exchanges with one or more private marketplaces, eliminating the non-exchange market, allowing state exchanges to function as an active purchaser in rate setting and allowing subsidy-eligible consumers to purchase coverage directly from an agent or broker.
The United States became an active purchaser, arming anti-Soviet fighters in Afghanistan in the 1980s and indigenous Afghan and Iraqi forces in recent years.
In the Massachusetts exchange, known as the Connector, the state serves as an active purchaser, soliciting bids from insurance companies and negotiating prices and benefits in an effort to secure the best value for state residents.
Boesky was an active purchaser of both Guinness and Distillers shares during the takeover battle.
Covered California's strategy of serving as an "active purchaser" may also provide an advantage.
But for that tool to work, consumers need the support of an active purchaser that can go toe-to-toe with the insurers.
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The company claims over 130 million annual active purchasers, and it has a presence in more than 1,100 cities across China.
Iraqi records, for example, show that Glencore, a Swiss-based trading company that was one of the most active purchasers of Iraqi crude, paid $3,222,780.70 in surcharges.
The company created tiers to motivate customers with differentiated experiential privileges and rewards for trackable activity, resulting in 20% increase in member spend and 40% of members being new active purchasers.
Only 18 states and D.C. have chosen to implement their own insurance exchanges, and only seven are planning exchanges that are active purchasers, the more aggressive kind of exchange that liberals and consumer advocates would like because they weed out plans with high premiums.
Lawmakers have a host of important decisions to make when creating an exchange, such as whether it should be an active or passive purchaser, what role brokers should play and whether the exchange should cater to individuals and small businesses jointly or separately.
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