Eric Kasen, Executive Vice President, Brown & Brown Insurance Services, waited nearly 30 years for health insurance in America to catch up with his vision of a private exchange for employees. "There's never been a true solution to lower the cost of health care from an employer's perspective that could actually work," he says. "It's just cost-shifting and marketing that's designed to increase profits for carriers."

That changed with the introduction of Individual Coverage Health Reimbursement Arrangements (ICHRAs) in 2020. The model lets employers contribute pre-tax funds toward the health insurance premiums their employees purchase on the individual market.

"The minute the Health and Human Services said employers could use the defined contribution model through an HRA, I thought, finally," remembers Eric. "I never understood why they didn't allow it when the Affordable Care Act was introduced 10 years earlier."