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The employer's contribution to coverage purchased on these exchanges may cover a greater or smaller portion of the insurance bill than the worker is accustomed. It depends on the plan selected. The process is more complex than making trip plans on a travel website, said Ken Sperling, Aon Hewitt's national health exchange strategy leader. "It's a little bit more involved than buying a plane ticket, but I don't think it's more involved than buying a TV," he said. Workers who use these exchanges can wind up paying a bigger share of the insurance bill for their coverage over time if the contribution from their company doesn't climb to keep up with insurance costs or the worker doesn't chose a cheaper plan. Sondergeld, the Walgreen executive, said his company will consider adjusting its contribution in the future if needed. Employer-sponsored coverage is the most common form of health insurance in the United States, covering more than 149 million non-elderly people. Benefits experts say defined contribution plans make up a relatively small slice of that total, but the trend is expected to grow, especially with big companies. A total of 29 percent of firms with 5,000 or more employees surveyed earlier this year by the nonprofit Kaiser Family Foundation said they are considering offering benefits through a private exchange. In contrast, only 7 percent of companies with 200 to 999 workers are considering it. Private exchanges are being considered more in the retail and manufacturing industries, according to Kaiser, which studies health care issues and does not run an exchange. How fast defined contribution coverage grows remains to be seen. Health benefits trends tend to grow slowly. Many companies prefer to wait to see how other companies fare after making a big switch before they try it on their own employees. But benefits experts say more companies are starting to appreciate the stability defined contribution plans offer. The approach means a company isn't on the hook for an unexpected expense if a wave of big medical claims hits during the year. "It's something they can budget for as opposed to something they are surprised with," Sperling said.
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