Utilizing Marketplace technology to improve health plan enrollment in Wisconsin
STONY BROOK, N.Y., Dec. 15, 2022 /PRNewswire/ — HealthPartners is demonstrating its commitment to simplicity and affordability by providing an improved shopping experience for Wisconsin residents in the health insurance marketplace. Through its partnership with Softheon, a leading cloud-based health insurance exchange technology provider, HealthPartners will utilize Enhanced Direct Enrollment (EDE), allowing Wisconsin consumers to shop for and enroll in individual marketplace plans directly from the HealthPartners website.
“I’m pleased to announce Softheon’s partnership with HealthPartners in support of our shared mission,” said Eugene Sayan, CEO and founder of Softheon. “As one of the first CMS approved, Phase 3 Enhanced Direct Enrollment vendors, Softheon understands how the automation of Marketplace processes can help speed access to healthcare,” Sayan concluded.
Softheon supports Phase 3 EDE, the highest level of capability and functionality with Centers for Medicare and Medicaid Services (CMS). Investing in a Phase 3 EDE solution allows HealthPartners to confirm eligibility and apply subsidies for 100% of enrollees without redirecting to healthcare.gov.
A trend of increasing Affordable Care Act (ACA) enrollments coupled with the expansion of subsidy enhancements through 2025 with the Inflation Reduction Act, presents a growing market that health plans are capitalizing on. HealthPartners recognized members’ need for easier access to more affordable health plans.
Health plan enrollees have been increasingly leveraging the EDE pathway. During 2021 open enrollment, 17% of members enrolled through EDE, a dramatic increase compared to 8% in 2020. Softheon predicts that the general shift towards a consumer-centric approach to selling and retaining coverage will cause a continued increase in EDE enrollments.
Along with being one of the few Phase 3 EDE vendors, Softheon’s close relationship with CMS will help HealthPartners rapidly respond to changing regulatory and operational requirements.
Softheon strives to use its industry expertise and upstream relationships to help health plans like HealthPartners better serve new and old members alike. This collaboration will allow HealthPartners to provide a simpler enrollment experience and remain a leader in a dynamic marketplace.
For more information about Softheon, please visit https://www.softheon.com/
Founded in 2000, Softheon’s Software-as-a-Service (SaaS) and Business Process-as-a-Service (BPaaS) solutions solve complex challenges for health plans and government health agencies. Currently, Softheon’s solutions serve 8 State agencies and over 90 health plans. Issuers and consumers utilizing Medicaid, Medicare, and the ACA (Affordable Care Act) Marketplace benefit from Softheon’s innovative technology that reduces administrative overhead and enhances user-experiences. Softheon is an Agent, Broker, and Merchant of Record that facilitates health insurance enrollment, administration, and renewal.
Founded in 1957, HealthPartners is the largest consumer-governed, non-profit health care organization in the nation. The organization is dedicated to improving health and well-being in partnership with members, patients and the community, and provides a full range of health care delivery and health plan services including insurance, administration and health and well-being programs. HealthPartners serves more than 1.8 million medical and dental health plan members nationwide. The care system includes more than 1,900 physicians, nine hospitals, 53 primary care clinics, 19 urgent care locations, 23 dental clinics and numerous specialty practices in Minnesota and western Wisconsin. HealthPartners also provides medical education and conducts research through HealthPartners Institute. For more information, visit healthpartners.com.
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