Health Insurance Exchange Platform

Health Insurance Exchange Platform

Health insurance exchange platform is something that everybody related or concerned about healthcare industry is overwrought about. How it is stunt to be created; how it is life 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 far out combo in the minds of consumers, healthcare companies, state authorities and, of course, the companies who would open doors the creation of these marketplaces.
The obligation lies on every state to create a bazaar that could facilitate purchase of health insurance plans at an affordable price. The bazaar 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 clinch 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 exposed by the Department of Health and Human Services:
1. “Readiness determination” point of January 1, 2013
2. Exchange “Go live” stub of January 1, 2014
Surely, these deadlines lob a hefty burden on the state authorities who might feel the pressure due to privation of resources, proper infrastructure to bear out the plans, conceivably the scarcity of knowledge / 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 accord with the Small Business Health Options Program ( SHOP ). Without doubt, this aspect adds tremendous amount to the functionality of health insurance exchange platform as the number of small businesses in the country is significantly mammoth.
3. The health insurance exchange should offer or ease a simple, easy - to - catch experience designed for individuals who grab little or no enlightenment of health insurance. This is where software or automation skill will come into play. Software companies will have to develop activating moderation for creating identical automation.
4. Ideally, the health insurance exchange should be able to operates cost - effectively and destroy administrative complexity. In every department, administrative complexity and bottlenecks are extreme to transpire. However, the exchanges should work insolvable to abolish them ab initio.
5. At the end, the health insurance exchange should yes and meet all Federal and State regulations and timetables without avoid.
With these features in mind, states can image on representative and non - blessing boost 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 speed up ease at the front - end. Some vital 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 - commensurate 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 supervisor collection facilities.
7. Reports of metrics for agents and consumers.
8. E - apps related 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 comp for the creation of health exchanges. State authorities will have to put in the best efforts to create these health insurance exchange platforms.