The 3 Main Differences Between Public and Private Health Exchanges

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When it comes to healthcare benefits, the difference between private and public exchanges has never been more relevant. Private benefits exchanges have been around for quite some time and are often used as a solution for employers looking to keep their healthcare spending more predictable and offer more options for their employees. The public exchange is a more recent health insurance offering due to the Affordable Care Act (ACA), a ruling to make sure every U.S. citizen has affordable health coverage. While both offer individual healthcare benefits, there are three primary differences between a public and a private health exchange.

  1. Who Runs the Exchange. Public exchanges are run by the federal government through or your state may have its own marketplace. Private exchanges are run and operated by insurance or benefits brokerages, employee consultants, and private and public companies. Through a private exchange, consultants and brokers, like Wolf Point Advisors, offer education, assistance and the best service guarantee to ensure that the websites are user friendly and operating properly.
  2. Eligibility Requirements. Employers utilize private exchanges to offer health coverage to their employees, and we’re seeing more communities, clubs, and incubators, start to put together private exchange offerings for their members. Public exchanges are present for those who do not have an employer-sponsored healthcare plan. Individuals and families who do not receive health insurance offerings through their employers are required to purchase on the public exchange. If employer offerings are unaffordable, individuals may also opt to purchase healthcare through the public exchange; however, if they fail to purchase coverage there will be a penalty.
  3. Assistance in Coverage. The only service available through the public exchange is health coverage, so if you want other types of coverage you will have to go elsewhere. With a private exchange, on the other hand, the packages are fully customizable, and can offer a one-stop-shop for individuals and employees of small businesses. The exchange can house a variety of products like dental and vision, identity theft coverage, pet insurance, gym memberships, and more as the list continues to innovate and grow. Plus, private exchanges can offer specially priced supplemental benefits, giving member groups access to special group pricing to some of the best and well known plan providers in the United States.


The advisors and human resources experts at Wolf Point Advisors are available to provide advice and assistance when looking for the best programs to fit each individual’s needs and price point. When looking to participate in a public or private exchange, consider these three main differentiators, and contact us  for more information. We’re happy to sit down and walk you through the value we can provide to your member group or business.