Softheon, a health insurance exchange integrator, is partnering with America's Health Insurance Plans, the national trade association, to help insurers offer health plans on the new state, federal and private health insurance exchanges. Under the terms of the deal, Softheon's Health Insurance Marketplace platform for enrollment, premium billing and plan management will be available to America's Health Insurance Plans members.
Offered as a cloud-based service, the Softheon platform will provide the on-boarding services required by The Centers of Medicare and Medicaid Services for America's Health Insurance Plans members offering approved Qualified Health Plans, as defined by the Affordable Care Act.
"One of the biggest problems of the transition to a health insurance marketplace model is that it involves many IT applications, architectures and related activities, said Eugene Sayan, Softheons founder and CEO. "Recently, over 35 health plans have chosen Softheons SaaS platform and [outsourcing] services to virtually eliminate all risks associated with [the federally facilitated and state-based marketplace] integration."
These on-boarding processes for the public exchanges would require extensive technology investment and business resources by health plans. We are pleased to provide our members with access to Softheon's cloud-based SaaS [software-as-a-service] platform and BPO [business-process outsourcing] services to help them succeed in the new marketplace," added Brendan Miller, vice president of business development at AHIP.
Softheon recently completed initial Centers of Medicare and Medicaid Services connectivity and carrier wave testing on behalf of its customers.
"Cloud computing offers healthcare payers an alternative for implementing cost prohibitive applications due to high resource demand or expensive hardware investment. While cloud computing will require new skills and training, it offers an opportunity to experiment with new products and more quickly capitalize on new market opportunities," said Christina Lucero, a principal research analyst at Gartner, an IT research and advisory firm.
AHIP members provide health and supplemental benefits to more than 200 million Americans through employer-sponsored coverage, the individual insurance market and public programs such as Medicare and Medicaid. The association advocates for public policies that expand access to affordable health care coverage to all Americans through a competitive marketplace that fosters choice, quality and innovation.
Based in Stony Brook, N.Y., Softheon provides solutions for interacting with private, federal and state insurance exchanges, measurably reducing administrative costs, improving member and provider satisfaction, and addressing regulatory compliance challenges. The companys Marketplace Connector Cloud (MC2) is offered as a SaaS solution, where insurers pay a one-time activation and ongoing per member per month fees for the service. MC2 is used by over 35 health plans and eliminates many of the risks associated with ACA compliance.
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