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Platform makes accessing the insurance exchange easier for consumers while eliminating risks for health insurers associated with integration
STONY BROOK, N.Y., Feb. 27, 2014 /PRNewswire/ -- Softheon Inc., a leader of health insurance marketplace integration and business operation, announced FirstCare Health Plans uses Softheon Marketplace Connector Cloud (MC2) to acquire Federally Facilitated Marketplace (FFM) members with CMS. This new technology allows consumers to easily access the insurance marketplace while also making it simpler to apply for subsidies.
Softheon MC2 is working with FirstCare Health Plans to integrate its plan management, eligibility & enrollment, SHOP, premium billing and customer service solutions along with HealthEdge's HealthRules core administrative platform. Softheon MC2 is an integration platform between the FFM and FirstCare's existing business processes and IT systems. Softheon MC2 operates with minimal risk and is in full compliance with the Affordable Care Act (ACA). The integration is complete and has enrolled exchange members since Oct. 1, 2013 as required by the ACA.
"We are very excited to be working with FirstCare Health Plans," says Eugene Sayan, founder and CEO of Softheon. "We are grateful for all the guidance and support we have received from the FirstCare leadership team. It is extremely gratifying to see our collective achievements now that we are enrolling and adding exchange members."
"FirstCare's goal is always to make insurance accessible and affordable to all Texans," says Tim Lauer, FirstCare's CIO. "Softheon represents a level of IT expertise and dealing with the ACA that we could not achieve on our own. The Softheon team has exceeded our expectations and we are looking forward to continuing to innovate with them."
Since 2008, Softheon Inc. has been the trusted technology platform used by the nation's first full-service state health benefit exchange. Recently, Softheon was selected to participate in pilot program for CMS Direct Enrollment connectivity and carrier wave testing and successfully added marketplace members with multiple carrier core systems, including TriZetto QNXT, DST Amisys, HealthEdge, ikaSystems and EPIC.
"One of the biggest problems of the transition to a Health Insurance Marketplace model is that it requires significant investment since involves many IT applications, system integrations, and related activities. It can be even more complex and disruptive on the business side of the enterprise," stated Eugene Sayan, founder and CEO of Softheon. "Being trusted by over 48 health plans, we are pleased to offer an advanced yet proven technology platform and services to virtually eliminate all risks associated with health insurance exchange integration."
About FirstCare Health Plans
At FirstCare Health Plans, we believe that Texans and our communities should be healthy. As a result, we work with premier doctors and hospitals to provide Texans access to affordable, high-quality care.
Since 1985, we've been serving the health care needs of members across North, West, and Central Texas. FirstCare offers a wide range of HMO, PPO, HSA and ASO products through a variety of programs, including: small and large employer plans; state, federal and teacher plans; government programs; and the Health Insurance Marketplace.
With the support of our owners - Covenant Health in Lubbock and Hendrick Health System in Abilene - we now serve approximately 165,000 members. Our corporate headquarters are located in Austin, Texas. We also have offices in Abilene, Amarillo, Lubbock and Waco. For information, please visit www.firstcare.com.
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 35 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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