Thought leadership
HIX 3.0 – Sustainable Information Technology and Operations Solutions for State-Based Marketplaces
January 29, 2019
In the early days of the Patient Protection and Affordable Care Act (ACA), there was an expectation that most (if not all) states would establish a State-Based Marketplace (SBM). However, for several well-documented reasons, most states deferred to or relied on the Federally Facilitated Marketplace (FFM) for most – or all – of their Marketplace operations and information technology (IT).
Infographic: Get smart on 1332 Waivers
August 16, 2018
The infographic gives an overview into the guardrails, application requirements, and state alterations the 1332 Waiver allows. Some details discussed include: state adoption and implementation, how the ACA’s basic protections will be retained, and the standards health insurance marketplaces must live up to.
Infographic: Quick facts: Section 1115 Medicaid Waivers
August 7, 2018
The infographic discusses what reforms states can implement, what constraints states are under for changing Medicaid rules, and which states have approved or pending 1115 Waivers.
Infographic: For robust data verification, get Verify
August 2, 2018
Softheon’s Asset Verification System, Verify, is the ‘first of its kind’ to certify both Health and Human Services (HHS) programs. Designed exclusively to detect fraud, waste, and abuse of enrollees and applicants while providing real-time identity confirmation, Softheon Verify™ combines robust data certification and a simple workflow to access and manage complex, varied Health & Human Services (HHS) eligibility and asset verification data. Download our solution overview to learn more.
Infographic: Get the scoop on HSAs
July 26, 2018
Download our infographic and get the scoop on health savings accounts (HSAs). This infographic offers quick facts HSAs and offers insight into why Health Plans should begin viewing HSAs for members the same way employers view 401ks for employees; make contributions on their behalf.
Consumer Premium Bill Presentment Bill Payment Index (CPBP2)
May 4, 2018
Softheon’s Consumer Premium Bill Presentment, Bill Payment Index (CPBP2) report includes data from more than 60 commercial health and dental plans across 29 states, and measures bill presentment and transaction types including, but not limited to, print and mail fulfillment, electronic delivery, online (card and ACH), IVR (Card and ACH), Walk-in, and lockbox payments. The analysis represents over 3.2 million covered lives, or nearly 37% of the commercially insured U.S. population, under the Affordable Care Act, and more than $4 billion-member premium transactions in 2017.
Enhanced Direct Enrollment: the Evolution of the Consumer Experience
Apr. 18, 2018
In our new whitepaper written by Jane Good, Founder, JGood Advisors, we will be discussing Enhanced Direct Enrollment (EDE). EDE is a unified enrollment experience that contains an updated, easy-to-use, portal for Marketplace members. EDE will eliminate the current “double redirect” to HealthCare.gov, using a series of CMS-based APIs to process eligibility and changes behind the scenes. This new portal will allow issuers and agent/brokers to establish and maintain relationships with members from initial enrollment, through mid-year changes, and into renewal. The goal of EDE is to provide consumers and health insurance brokers with alternatives to shop for and enroll in coverage, providing the data and tools needed to effectuate and maintain policies.
A Formula for Success: the Future of Technology Maturity Improvement
Feb. 1, 2018
Small group enrollment & billing: solutions & challenges
Feb. 1, 2018
Connecting the Medicaid & ACA world
Jan. 16, 2018
2018 Industry predictions
Jan. 16, 2018