Softheon

Blog

Category: Brokers (page 1 of 2)

What’s new for SHOP in 2018

Yvonne Villante
Follow Me

Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
Follow Me

The Small Business Health Options Program (SHOP) will remain open for small businesses with 1-50 employees in 2018, and will boast new features that’ll impact how small employers and their employees enroll in and manage their coverage for SHOP plans starting on or after January 1, 2018.

Continue reading

President Trump Signs Executive Order on Health Care

Matt Cummings

Solutions Architect at Softheon
Matthew is a Solutions Architect at Softheon. He works closely with Product and Development teams to design products and solutions to help Health Plans and other entities to excel in the marketplace. He received his bachelor's degree in Applied Psychology and Business Management from Stony Brook University in Stony Brook, New York.
What Happened?

President Trump on Thursday, signed an executive order directing the Departments of Treasury, Labor and HHS to consider loosening rules controlling the issuance of health coverage by groups and businesses as well as the duration of short-term that don’t currently meet ACA rules[1].

“With these actions, we are moving toward lower costs and more options in the health-care market…”, Trump said during the signing ceremony in the Roosevelt Room in the White House.

Supporters of the executive order say that it will help to improve access, increase choices and lower costs for healthcare. Sen. Rand Paul (R-KY), who worked closely with the President on the order called it, “The biggest free market reform of healthcare in a decade”.

Continue reading

CMS to Boost 2018 Enrollment with Proxy Direct Enrollment Pathway 

Yvonne Villante
Follow Me

Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
Follow Me

CMS will allow some to skip HealthCare.gov during the 2018 Open Enrollment Period (OEP).

On May 17, 2017, the Department of Health and Human Services and the Centers for Medicare and Medicaid Services announced a new “Proxy Direct Enrollment (DE) Pathway” for the 2018 Open Enrollment Period (OEP).

Initially this process will be available for simple enrollments only, rather than special enrollments, terminations, or such as multi-tax filer households or applications with non-United States-born citizens. Consumers will also need to create their own HealthCare.gov account to engage in the process [1]. For the 2018 open enrollment period, DE Proxy will be available for the Federally Facilitated Marketplace (FFM) and State-based Marketplaces (SBMs) utilizing the Federal HealthCare.gov platform. Applicants and enrollees using the process will be able to complete their eligibility determinations – including eligibility determination of marketplace coverage, premium tax credit, and cost-sharing reduction payment – and enroll in qualified health plans (QHP) on the direct enrollment entity’s website [1].

Continue reading

1332 ACA Waiver Could Be a ‘Game Changer’

Yvonne Villante
Follow Me

Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
Follow Me

With the future state of health care uncertain, States are displaying their continued interest in healthcare reform to address their states’ health care needs with Section 1332 State Innovation Waivers.

Perhaps less well known than Section 1115 Waivers, Section 1332 Waivers allows states to pursue innovative strategies for providing residents with access to quality, affordable insurance while retaining basic protections of the Affordable Care Act (ACA).  Section 1332 Waivers became available through the ACA on January 1, 2017, as a way to permit states to pursue new strategies to provide quality health insurance, while preserving basic protections of the ACA.

Continue reading

CMS’ New Special Enrollment Period Rules Debut Today

Yvonne Villante
Follow Me

Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
Follow Me

The Centers for Medicare and Medicaid Services (CMS) will begin enacting its new Special Enrollment Period (SEP) rules for Marketplace coverage, a measure intended to reduce SEP misuse. Beginning today, these rules will modify the criteria for enrollees who are permitted to use special enrollment windows for coverage.

The pre-enrollment verification (SEPV) program will apply to all Affordable Care Act Marketplaces to ensure individuals seeking to enroll during a SEP prove their eligibility, with documentation, before enrolling into coverage. Starting this summer, new enrollees who attest 1 of 4 SEP events will be subject to the SEPV program for pre-enrollment verification. It will require consumers to submit documentation to confirm their SEP before they can enroll. This program will apply exclusively to new enrollees with the following qualifying events: Loss of qualifying coverage or minimum essential coverage (MEC); Permanent move; Gaining a dependent (marriage, birth, adoption); or Medicaid or Children’s Health Insurance Program (CHIP) denial.

Continue reading

May Round-up: CMS Announces Plan to End FF-SHOP; Expand Direct Enrollment; 90-day Stay for Cost-sharing Reduction Payments

Yvonne Villante
Follow Me

Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
Follow Me
CMS Announces Plan to End FF-SHOP

On May 15, Officials from the Centers for Medicare and Medicaid Services (CMS) announced that the agency would implement a FF-SHOP overhaul. Under the proposal, 33 Federally-Facilitated Small Business Health Options (FF-SHOP) Exchanges would effectively shut down on January 1, 2018. After November 15, 2017, employees of small businesses could check their eligibility on HealthCare.gov but would need to enroll in a plan directly from an insurance company, an agent or a broker.

According to CMS, the proposal would “reduce [the] budern on insurance companies, consumers, and American taxpayers, and make SHOP plans more readily available to those small businesses that need affordable health insurance options.” [1]

Continue reading

Here Is What’s in The House-Approved AHCA Bill

Yvonne Villante
Follow Me

Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
Follow Me

In a 217 -213 vote, Members of the House passed the American Health Care Act (H.R. 1628).  If passed in the Senate, the bill would replace the Affordable Care Act (ACA) and establish a system designed along conservative lines. This is anticipated to reduce the cost of healthcare for Americans and provide greater choice and flexibility, as well as reduce Federal spending, and lower taxes for Americans.

(Related: AHIP Illustrates the Big Picture on AHCA, our Evolving Health Care System)

Here are the highlights of the key provisions in the health care bill:

Continue reading

Will Private Exchange Enrollment Really Quadruple by 2020?

Yvonne Villante
Follow Me

Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
Follow Me

Private exchanges are evolving to become an end-to-end solution for healthcare benefits administration. Although there has been a slower than expected uptake in private exchange enrollment among active employees, enrollment is anticipated to more than quadruple between 2015 and 2020.

The private exchange experience

Unlike the public exchanges, where the states or federal government (healthcare.gov) own the experience, private exchanges are often owned by health insurance companies or brokers, and provide an ecommerce portal for shopping, enrolling, and purchasing insurance or ancillary products.

For consumers, using private exchanges often feels like a personal shopping experience. It’s consistent and is often very similar to making an online purchase or booking a trip through a tool like Expedia. In a matter of a few clicks, consumers can locate the amount of money that their employer is contributing toward their cost of insurance, search through plans with differing premium accounts, and enroll or renew in insurance coverage.

Continue reading

Five Things to Watch this Open Enrollment

Yvonne Villante
Follow Me

Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
Follow Me

5 Things to Watch This Open EnrollmentPerhaps one of the most stressful times of the year for issuers and brokers is Open Enrollment. During this critical time of year consumers around the country can renew their current coverage or enroll in new coverage.

On October 19, Secretary Burwell offered the Department of Health and Human Services’ (HHS) projections. Based on HHS’ forecasts and recent news developments, here are five things to watch this open enrollment:

Continue reading

Older posts

© 2018 Softheon

Theme by Anders NorenUp ↑