Softheon Offers Contingency to Qualified Health Plans for Healthcare.gov Transitions

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May 26, 2015, 04:21 ET

STONY BROOK, N.Y., May 26, 2015 /PRNewswire/ -- Softheon, Inc., a proven leader in marketplace integration and business process operations, announced today that it will offer Softheon Select, an incentivized program, to Carriers offering plans through State-based or Federally Facilitated Marketplaces. Through this program, Softheon will assist Qualified Health Plans transition to or from healthcare.gov, in light of challenges related to the upcoming Supreme Court's decision on King V. Burwell and/or States' approaches to achieve Exchange sustainability.

Softheon recognizes the uncertainty which accompanies Health Plans struggling to clinch their IT strategy. For a modest payment plan, Softheon Select will provide carriers with a competitive advantage that will be paramount to their capability to provide services in the event of a radical change in the healthcare industry. By reserving Softheon Marketplace Connector Cloud (MC2), a configurable integration platform designed to handle all marketplace IT and business processes, Carriers can seamlessly transition to new State or existing Federal processes before the start of Open Enrollment in November. Softheon MC2 offers a ready-to-deploy Marketplace solution with complete functionality for State & Federal Marketplace Integration, Direct Enrollment, Premium Billing, Edge Server, and Private Exchanges. All Softheon solutions maintain full regulatory compliance and are integrated with carrier core systems, including TriZetto Facets, QNXT, DST Amisys, HealthEdge, ikaSystems, and EPIC Tapestry.

Retaining in-depth knowledge inclusive of 834 intake and payment reconciliation, Softheon looks forward to the opportunity of working with health plans, Co-Ops, and ACOs in tackling future PPACA challenges and optimizing new healthcare opportunities. In 2014, Softheon successfully transitioned several of its Nevada and Oregon-based clients to healthcare.gov, after Cover Oregon and Nevada Health Links' decided to convert to the Federal enrollment platform. This process delivered all marketplace infrastructure and processes in less than 30 days, while minimizing all associated risk.

Softheon's Marketplace Connector Cloud (MC2) has been trusted by health plans, in all 50 states, as an accelerated federal, state, and private exchange integration platform. Nearly 10% of all Americans who enrolled in Federal and State Based Marketplaces in 2015 coverage use Softheon MC2 platform for enrollment, premium billing, and member services.

Softheon works with health plans, brokers, and employers to facilitate multi-channel enrollments, streamline administration, and provide continuous customer support. Softheon MC2 Plan Management, Enrollment, and Premium Billing platforms have effectively enrolled and effectuated over 1 million lives and has recently announced its Web Broker Entity (WBE) agreement with the Centers for Medicare Medicaid Services (CMS), in which it will establish an enrollment platform to facilitate and assist eligible consumers with selecting qualified health insurance plans offered on the federal marketplace.

About Softheon

Empowering the nation's first state health benefit exchange since 2008, Softheon's vision and strategic direction address healthcare payer, provider, and government agencies' goal of meeting Affordable Care Act (ACA) milestones.

Softheon provides HIX Integration, Direct Enrollment, Premium Billing, and Edge Server solutions for insurance carriers of all sizes participating in Federal and State Health Insurance Exchange (HIX) Marketplaces.

MC2 is a Software-as-a-Service (SaaS) solution provided by Softheon where insurers pay a one-time activation fee and ongoing PMPM fees for exchange members while eliminating most, if not all, risks associated with ACA enrollment compliance and other mandates.

Softheon is an authorized Web Broker Entity (WBE) and approved by the federal government to offer subsidized health insurance to Americans.

To find out more about Softheon, visit www.softheon.com

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