Softheon to Provide Health Insurance Exchange Integration Solution for WINhealth

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Sep 12, 2014, 05:06 ET

STONY BROOK, N.Y., Sept. 12, 2014 /PRNewswire/ -- Softheon, Inc., a proven leader in health insurance marketplace integration and business operation, announced today that WINhealth has chosen the Marketplace Connector Cloud (MC2) as their software platform that will integrate its comprehensive plan offerings for individuals, families, and groups both on and off the Federally Facilitated Marketplace (FFM). WINhealth is a not-for-profit managed care organization that serves members in the State of Wyoming.

Softheon MC2 will be utilized to integrate WINhealth's Plan Catalog Management, Eligibility & Enrollment (including electronic Direct Enrollment Consumer portal), SHOP, Premium Billing, Edge Server, and other consumer service solutions through leveraging its core administrative system, without the need to "rip and replace" existing IT investments. This partnership will focus on enhancing WINhealth's multi-channel distribution and outreach channels, while aiming at enhancing the user experience of its members and brokers.

"We're confident that our members and partners will significantly benefit from our partnership with Softheon. It is a comprehensive solution that will improve our efficiencies and overall service. We are pleased to have Softheon as an esteemed partner and we are encouraged to have such a great resource in them throughout this transition," said WINhealth president and CEO, Stephen Goldstone.

Softheon MC2 is a Software-as-a-Service (SaaS) solution that serves as the integration platform between carriers' existing business processes and IT systems for both Public and Private Exchanges. Softheon MC2 platform offers Plan Catalog Management, Eligibility & Enrollment, SHOP, Premium Billing, Customer Service, and Edge Server solutions. Softheon MC2 is compatible with multiple carrier core systems, including TriZetto Facets, QNXT, DST Amisys, HealthEdge, ikaSystems, and EPIC.

Eugene Sayan, Founder & CEO of Softheon, concludes "We are delighted to be serving WINhealth's on & off exchange integration needs. Adding WINhealth to our successful and innovative health plan client base not only brings much joy, but exemplifies the hard work and commitment Softheon delivers."

As of May 12, 2014, Health Insurers have enrolled and effectuated over 400,000 lives through ACA Federal and State Based Marketplaces using the Softheon MC2 platform. Softheon MC2 is fully integrated with Federal and State Based Marketplaces, including California, Washington, Massachusetts, New York, and others. This innovative integration platform provides Insurers the ability to have marketplace infrastructure and processes up and running in less than 30 days, with minimal risk and full PPACA regulatory compliance.

Softheon is uniquely qualified as the technology platform used by the nation's first full-service state health benefit exchange, since 2008. During the initial testing and implementation of marketplaces, Softheon participated in pilot federal and state programs, including the successful completion of CMS Direct Enrollment connectivity and carrier wave testing, effectuating marketplace members with multiple carrier core systems. Softheon was also chosen, as the sole vendor, to participate in the CMS Data Baseline Beta Test Program where all Softheon MC2 clients successfully established an enrollment baseline with CMS. Softheon recently announced their recognition as the "leading Cloud Platform for Public & Private Exchanges," by iMERGE Consulting, an independent research and consulting firm assisting States and Health Insurers with ACA challenges.

About WINhealth
Since its creation in 1996, WINhealth has been dedicated to improving healthcare options for Wyoming residents and providing a personal touch in helping businesses, individuals and families find the right option. WINhealth offers healthcare plans for individuals and groups both on and off the Federally Facilitated Marketplace. WINhealth offers a wide variety of affordable plans, many of which include free preventive healthcare services through an ever-expanding network of providers that covers all of Wyoming and extends into Utah, Idaho, Montana, Colorado, and South Dakota. Learn more about WINhealth plans and access the Marketplace at WINhealthplans.com.

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 solutions for interacting with Federal and State Health Insurance Exchange (HIX) Marketplaces, while measurably reducing administrative costs, improving member and provider satisfaction, as well as addressing regulatory compliance challenges in all managed care administrative processes.

Softheon's Marketplace Connector Cloud (MC2) has been trusted by over 40 health plans as an accelerated federal, state, and private exchange integration platform. Softheon MC2 is a Software-as-a-Service (SaaS) solution where insurers pay a one-time activation and ongoing PMPM fees for exchange members only, while eliminating most, if not all, risks associated with ACA compliance of 2014 enrollment and other mandates.

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

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