GetInsured, a leading innovator in health insurance exchange platforms, unveiled the GetInsured Shared HIX Platform as an alternative to existing state-based marketplaces that have self-sustainability concerns.
With the Shared HIX Platform, states will have access to a full-featured, ACA-compliant individual and small business health options (SHOP) marketplace.
The GetInsured Shared HIX Platform offers states a pathway for continuing marketplace innovation while advancing self-sustainability through a solution that carries no upfront cost and offers a predictable per-member-per-month (PMPM) cost structure. This helps states in two ways:
States that have an existing state-based marketplace (SBM) can dramatically reduce their maintenance and operations (M&O) costs by plugging into a platform that shares hosting, software code, content, testing, compliance, security, audits, training and other services across customers that have similar requirements.
States that are considering a build-out of an SBM can stand up a robust, ACA-compliant marketplace more quickly and cost effectively than using a customized approach that requires the engagement of separate vendors for project management, security, implementation, training, etc.
Recently, GetInsured announced the availability of a Lean SBM solution for states that want to build a health insurance marketplace (the Lean SBM white paper is available here). The differences between the Lean SBM Solution and the Shared HIX Platform include:
The Lean SBM uses federal eligibility and enrollment services in order to be launched quickly (within 60 days), and it is intended to be used by states that do not have a state-based marketplace and may need one quickly. The Shared HIX Platform integrates with state-based eligibility determination systems and takes approximately six months to implement.
The Lean SBM uses federal enrollment systems on the back-end as the system of record. The Shared HIX Platform provides states with a full state-based marketplace, where they control their own eligibility, carrier integration, plan management, enrollment and financial management systems.
Both models do not support extensive customizations, but with the Shared HIX Platform, GetInsured intends to accommodate particular state variants of general needs through configuration, where appropriate.
In both cases, GetInsured provides a world-class, state-branded and state-configured solution that delights consumers, employers, employees, agents/brokers, carriers and state administrators. In both cases, states will have access to a full-featured Individual and SHOP Marketplace, and both models support direct enrollment for carriers and brokers.