Health Insurance Exchange Platform
Health insurance exchange platform is something that everybody related or concerned about healthcare industry is hysterical about. How it is animation to be created; how it is response 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 agitative divergency in the minds of consumers, healthcare companies, state authorities and, of course, the companies who would speed up the creation of these marketplaces.
The obligation lies on every state to create a bazaar that could expedite 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 recover 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 play ball with the requirements of the Patient Protection and Affordable Care Act. This exchange should concede 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 pledged by the Department of Health and Human Services:
1. “Readiness determination” edge of January 1, 2013
2. Exchange “Go live” tip of January 1, 2014
Surely, these deadlines hurl a heavy burden on the state authorities who might perceive the pressure due to deprivation of resources, proper infrastructure to manage out the plans, feasibly the need 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 cooperation 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 sizeable.
3. The health insurance exchange should offer or smooth a simple, easy - to - appreciate experience designed for individuals who take over little or no education of health insurance. This is where software or automation faculty will come into play. Software companies will have to develop enterprising generalization for creating coextensive automation.
4. Ideally, the health insurance exchange should be able to operates cost - effectively and axe administrative complexity. In every department, administrative complexity and bottlenecks are heel to arise. However, the exchanges should work hard to annihilate them ab initio.
5. At the end, the health insurance exchange should sign and meet all Federal and State regulations and timetables without wink at.
With these features in mind, states can draw on innate 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 aid ease at the front - end. Some needful features could append:
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 - comparable 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 according to 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 plan for the creation of health exchanges. State authorities will have to put in the best efforts to create these health insurance exchange platforms.
