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Improved Efficiency and Better Member Experiences

For health plans, we automate operations so you can grow bigger and faster in government and commercial markets. For government agencies, we make your processes more efficient so you can focus on your core mission, without needing to overhaul legacy systems. For enrollment partners, we simplify the healthcare shopping experience.

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Softheon by the Numbers




Licensed Carriers


Premiums Processed

Scale in Government and Commercial Markets without the Growing Pains

Automate mission-critical healthcare processes, so you can focus on what matters: member experience, ROI, and strategic goals. Softheon’s off-the-shelf solutions for health plans let you consolidate many vendors into a single platform that includes: 


Grow membership by over 2,000% while reducing the proportion of HICS cases.

Shopping & Enrollment

Offer Phase III Enhanced Direct Enrollment, accounting for 17% of all ACA enrollments.

Premium Billing

Consolidate vendors for a smoother handoff from enrollment to billing.


Identify delinquent members every 24 hours, not every 30 days.


Keep more members with an effectuation rate of over 95%, on average.


Secure more subsidy dollars and improve retention with a 99%+ subsidy reconciliation rate, on average.

Member Communication

Reduce churn by creating a personalized experience.

Leading Carriers Use Softheon to Get and Keep More Members

Why Health Plan Leaders
Trust Softheon

“Softheon’s expert knowledge of the ACA marketplace coupled with their leading enrollment and billing technology has made them the perfect partner during Hometown Health’s first open enrollment period on the exchange.”

David Hansen | CEO, Hometown Health

“[Softheon has] a fantastic solution and its performance has been great… the strength of the vendor relationship isn’t whether you have problems or not, it’s how you go about solving them and those issues.”

Paul Wingle | CVS/Aetna

See the difference Softheon can make to the health of your health plan

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