STONY BROOK, N.Y. June 5, 2015 - , a proven leader in health insurance marketplace integration and business operation, announced today that , Texas' ninth largest, serving over 300,000 lives, has fully implemented its Marketplace Connector Cloud (MC2) as its software platform to integrate its comprehensive plan offerings to the Federally-Facilitated Marketplace. Community Health Choice is a not-for-profit managed care plan and a member of the Association of Community Affiliated Plans (ACAP)
Following this implementation, Softheon MC2 Plan Catalog Management, Eligibility & Enrollment, Electronic Direct Enrollment Consumer Portal, and Premium Billing solutions have been utilized by Community Health Choice - leveraging its core administrative system. The focus of this partnership will enhance Community Health Choice's multi-channel distribution and outreach channels, while cultivating the user experience of its members and brokers.
"We were thrilled with our enrollment of nearly 40,000 members in the Marketplace this year, and Softheon has become an essential part of our administration of this line of business," says Ken Janda, President and CEO of Community Health Choice.
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, and are continuously updating its solutions to adapt them to address regulatory requirements, as federal and State guidance continues to shift.
"We are delighted at the opportunity to work with Community Health Choice. With our reduced integration times, this implementation holds testament to our guaranteed delivery and our commitment to our health plan clients," stated Eugene Sayan, Chairman, President, & CEO of Softheon.
Currently in use by health plans in all 50 states, as an accelerated federal, state, and private exchange integration platform, Softheon MC2 has had a substantial and direct impact on its clients' membership, processes for populating data, sales approaches, and customer service strategies. 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, nd Premium Billing platforms have effectively enrolled and effectuated over 1 million lives and has recently announced both and its agreement with the Centers for Medicare Medicaid Services (CMS). Through Softheon Select, a healthcare.gov transition program, Softheon will assist Qualified Health Plans, as reprieve against the possibilities associated with technical and financial issues experienced by Exchanges and the coming Supreme Court decision on King V. Burwell. Serving as a WBE, Softheon will establish an enrollment platform to facilitate and assist eligible consumers with selecting qualified health insurance plans offered on the federal marketplace.
Community Health Choice is a local, non-profit health plan. They offer Children's Medicaid (STAR) and CHIP programs. CHC also offer plans through the Health Insurance Marketplace. Community has a network of 9,000 doctors and 70 hospitals and is accredited by URAC for its health plan operations.
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. 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. 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 enrollment compliance and other mandates.