CMS approves GuideWell Connect for ACA direct enrollment

The Centers for Medicare and Medicaid Services has approved GuideWell Connect as an Affordable Care Act direct enrollment platform.

The Centers for Medicare and Medicaid Services has approved GuideWell Connect as an Affordable Care Act direct enrollment platform.

The action by CMS now gives health plans three private options for enrolling members on the ACA marketplace besides the federally run

GuideWell Connect says its solution “empowers health plans to better interact with their members.” GuideWell Connect, the consumer engagement business of GuideWell Mutual Holding, provides integrated consumer engagement solutions to help health plans attract, engage and retain members, the company says. It also provides technology-enabled services across the member lifecycle to advance health plans' financial performance, grow membership and drive better health outcomes for members.

"Ultimately, we want to make it easier for people to obtain medical coverage that meets their needs, and we believe this is a game changer for consumer health solutions," says Scott Paddock, president and CEO of GuideWell Connect.

Jacksonville, Fla.-based GuideWell Connect will join only two other CMS-approved direct enrollment platform providers—the other two include HealthSherpa and Stride Health, both based in San Francisco.

In 2017 CMS announced plans to make ACA enrollment easier by allowing CMS-approved private-sector web brokers. In a blog on the subject, CMS called its decision to allow private brokers on the ACA exchange a “win-win” for not only Americans looking for an easier way to register, but to help stabilize the ACA marketplace.

GuideWell Connect’s direct enrollment platform will first be available on SalesConnect, a white-labeled shop-and-apply platform for health plans and their members, the company said. In 2020, GuideWell Connect will offer an "EDE-as-a-service" option. GuideWell Connect’s EDE has already been successfully implemented by the largest health plan in Florida, one of the leading ACA plans in the country, GuideWell Connect said.

Through SalesConnect, health plans will be able to provide a seamless experience to their enrollees and see improved conversion rates, GuideWell Connect said.

To qualify for the CMS approval, GuideWell Connect spent the past year developing the integration and “undergoing extensive business and security auditing to ensure compliance with CMS' nearly 300 security and privacy standards,” the company said. In addition, GuideWell Connect tested the integration to ensure it would work with the ACA Exchange.

This new CMS announcement follows GuideWell Connect’s February acquisition of a technology-enabled health and wellness company, Onlife Health, from Blue Cross Blue Shield of Tennessee and Cambia Health Solutions. The addition of Onlife brought GuideWell’s health plan and employer clients to 19 states.

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