(AP file Photo)

Many U.S. employers may already be using public or private health insurance exchanges.

Aflac Inc. polled U.S. employers with three or more employees about exchange use.

Seven percent of the employers with health plans said they are getting their health coverage through a private exchange or the new Patient Protection and Affordable Care Act small-group exchange system.

Six percent said they have given employees cash that the employees can use to buy coverage through the PPACA individual exchange program.

About 47 percent of the employer benefits decision makers surveyed said they believe they understand PPACA very or extremely well, but only 27 percent of the benefits decision makers at employers with fewer than 25 employees are confident that they understand PPACA.

Forty-five percent of the employers said they will rely on insurers or brokers to recommend any benefits package changes needed as a result of the changing health care environment.

In related news, about one-third of the employers said they had delayed or eliminated pay raises to hold down costs, but only 22 percent said they had cut back on benefits.

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