The Affordable Care Act (ACA) has created a lot of buzz about healthcare exchanges. Most recently the enrollment period opened for individuals to purchase insurance on public exchanges. Some of these people, if they have low-income, may be eligible for government assistance to help pay for their coverage on the public exchanges. ACA has also created an interest in private exchanges for both active employees and retirees. Although private exchanges that offer individual plans to Medicare-eligible retirees have been available for several years, there has been a renewed interest in these exchanges as an alternative means of providing retiree healthcare coverage. The increased attention due to these recent developments, coupled with a continued focus by employers on ways to mitigate rapidly rising retiree healthcare costs, has accelerated changes in the design of retiree healthcare benefit plans. This Insight focuses on the accounting implications of such changes.