Skip to main content

Smarter Automation,
Smoother Operations

Using AI-powered automation for better outcomes. For health plans, we simplify operations so you can grow bigger and faster in government and commercial markets. For government health agencies, we make your processes more efficient so you can focus on your core mission, without needing to overhaul legacy systems.

Read our latest blog to learn how healthcare leaders are using AI for better day-to-day operations.

Get Started
Home
SOFTHEON BY THE NUMBERS

30M+

Enrollments

100+

Licensed Carriers

$20B+

Premiums Processed

10

State Agencies

Grow Without The Growing Pains

Automate the boring parts of healthcare so you can focus on what matters. Softheon’s off-the-shelf solutions let you consolidate many vendors into a comprehensive platform that includes:

Home
Compliance

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

Home
Shopping & Enrollment

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

Home
Premium Billing

Consolidate vendors for a smoother handoff from enrollment to billing.

Home
Reporting

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

Home
Payments

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

Home
Reconciliation

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

Home
Member Communication

Reduce churn by creating a personalized experience.

Many see 2x+ ROI within a year

From anonymous shopping to automated reconciliation, Softheon provides a comprehensive user journey designed to reduce costs and improve effectuation rates. Clients who use Softheon have seen over 2x ROI in a year.

View Solutions for Health Plans
Home
RESOURCES

Membership growth rate 300% above industry average.

Learn how a national carrier consistently outperformed in the ACA market in Softheon’s latest use case.

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 or government agency.

Get Started