Softheon is committed to adhering to the latest regulations set forth by the Centers for Medicare and Medicaid Services (CMS). In alignment with the new guidelines effective July 19, 2024, all Enhanced Direct Enrollment (EDE) partners, including Softheon, must ensure that changes to a consumer’s Federally Facilitated Marketplace (FFM) enrollment are conducted by authorized agents or brokers. Unassociated agents or brokers will need to engage in a three-way call with the consumer and the Marketplace Call Center or guide the consumer to make the changes themselves through HealthCare.gov or an approved partner website.
Softheon was notified of these changes along with other EDE partners through standard CMS communication channels. We immediately confirmed that we were in compliance with this new guideline. In addition, we made updates to our systems to support the new requirements, which includes implementing user experience changes and additional safeguards, such as a weekly CMS-run process to identify and cancel unauthorized National Producer Number (NPN) switches, ensuring that all broker activities are conducted with proper authorization and consumer consent.
Consumers can continue to use our platform to manage their applications, and authorized brokers will maintain their ability to assist them. Softheon remains dedicated to helping our partners navigate these changes, ensuring seamless and secure interactions for both consumers and brokers. We will continue to monitor and implement any further CMS requirements, providing our clients with the tools and support they need to stay compliant and deliver exceptional service. Softheon aims for a future in which health care is accessible, affordable, and plentiful for every American. In that pursuit, we are proud to be a Phase III EDE CMS partner, staying in close contact and remaining ahead of new regulations that might affect consumer access to healthcare.
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About Softheon:
Founded in 2000, Softheon’s healthcare Software-as-a-Service (SaaS) and Business Process-as-a-Service (BPaaS) solutions solve complex challenges for health plans and government health agencies. Currently, Softheon’s solutions serve over 100 health plans. Issuers and consumers in Small Group, Medicare, and Affordable Care Act (ACA) markets benefit from Softheon’s innovative technology that reduces administrative overhead and enhances user-experiences. Softheon is an Agent, Broker, and Merchant of Record that facilitates health insurance enrollment, administration, and renewal. For more information on Softheon’s solutions, visit www.Softheon.com.
