Health Insurance Exchange Platform

Health Insurance Exchange Platform

Health insurance exchange platform is something that everybody related or concerned about healthcare industry is on fire about. How it is proposition to be created; how it is bustle to function; how it would be effective in bringing down the costs; how it would come true to the promises it holds; how it would ease the purchase of affordable health insurance—all these questions make an arousing disparateness in the minds of consumers, healthcare companies, state authorities and, of course, the companies who would simplify the creation of these marketplaces.
The obligation lies on every state to create a bazaar that could open doors purchase of health insurance plans at an affordable price. The mart itself holds multiple objectives that intend to operate in the favor of consumers. Overall, healthcare companies have to reduce their administrative costs significantly and repossess for the loss in premium of health insurance plans.
What hangs on the Health Insurance Exchange Platform?
Every state must launch health insurance exchange to okay with the requirements of the Patient Protection and Affordable Care Act. This exchange should own eligible state residents to search for, choose and buy health insurance, and small businesses to pool together to reduce their insurance costs.
There are two deadlines that need to be met by the states responsible by the Department of Health and Human Services:
1. “Readiness determination” prong of January 1, 2013
2. Exchange “Go live” pole of January 1, 2014
Surely, these deadlines lob a heavy burden on the state authorities who might feel the pressure due to want of resources, proper infrastructure to bring out the plans, maybe the need of scholarship / understanding as how to execute what is required.
Let’s talk about some features that a health insurance exchange needs and state authorities should focus on to create:
1. The health insurance exchange should help state residents find an affordable health plan that meets their specific needs with ease. This should be the core functionality for the exchange eliminating or significantly decreasing the need of face - to - face interaction with agents or brokers.
2. The health insurance exchange should help small businesses find affordable health plans that meet the needs of their employees in unanimity with the Small Business Health Options Program ( SHOP ). Without doubt, this aspect adds tremendous monetary worth to the functionality of health insurance exchange platform as the number of small businesses in the country is significantly immense.
3. The health insurance exchange should offer or smooth a simple, easy - to - fathom experience designed for individuals who hold little or no scholarship of health insurance. This is where software or automation understanding will come into play. Software companies will have to develop changing senses for creating conforming automation.
4. Ideally, the health insurance exchange should be able to operates cost - effectively and stop administrative complexity. In every department, administrative complexity and bottlenecks are terminus to ensue. However, the exchanges should work insoluble to axe them ab initio.
5. At the end, the health insurance exchange should recognize and meet all Federal and State regulations and timetables without dial out.
With these features in mind, states can outline on special and non - boon compensation for the development of health insurance exchanges. The online setup of this market should be able to give some real - time control at the back - end and further ease at the front - end. Some obligatory features could interject:
1. Admin control panel allowing addition and editing of health plans, rates, etc.
2. Eligibility check for the plans and consumers.
3. Quoting engine with broker - consistent intelligence.
4. Enrolment facility for consumers, health plans, etc.
5. Integrated agent portal for agent management and functionality.
6. Payment options through credit cards, debit cards, and HRA and manager collection facilities.
7. Reports of metrics for agents and consumers.
8. E - apps uniform e - sign, printing of application forms, etc.
Without doubt, health insurance exchanges are not a one - day task that states could complete. There is whole lot of planning and thinking that needs to be put in to create a diagram for the creation of health exchanges. State authorities will have to put in the best efforts to create these health insurance exchange platforms.