MOUNTAIN VIEW, CA--(Marketwired - Apr 13, 2015) - GetInsured, a leading innovator in consumer health insurance marketplace technology, today unveiled the GetInsured Lean State-Based Marketplace (SBM) Model as an alternative to traditional State-based Marketplace procurement and implementation approaches.
The Lean SBM Model enables states to leverage GetInsured's proven IT architecture and assets to launch a complete individual health insurance marketplace, including call center services, in 60 days or less. GetInsured has successfully launched four State-based Marketplaces (California, Idaho, New Mexico and Mississippi) and spent a decade operating a consumer health insurance marketplace that is fully compliant with the Affordable Care Act (ACA). The Lean Model leverages GetInsured's existing eligibility and enrollment application programming interfaces (APIs) with Healthcare.gov, as well as re-use of its proven exchange technology, to keep implementation and operational costs low. The solution requires no federal grants or additional cost to taxpayers.
"We're seeing increasing interest from states wanting to build their own exchanges versus using the Federally Facilitated Marketplace (FFM)," said Chini Krishnan, GetInsured co-founder and CEO. "State regulators recognize the benefit of being fully in control of one of the most important services they provide their citizens. With the IT investments in health insurance marketplaces over the past few years, building new SBMs no longer needs to be expensive or complicated. And states get a far better user experience for all stakeholders -- consumers, carriers, brokers, administrators -- which translates into more enrollments."
"Your Health Idaho enjoyed a successful launch in November 2014, and GetInsured's exchange platform played a critical part in making it happen," said Pat Kelly, executive director of Idaho Health Insurance Exchange. "They have invaluable experience building health insurance marketplaces that delight consumers and drive enrollments. Their team has been easy to work with and responsive to our needs. As a result, Your Health Idaho enjoyed strong enrollment throughout the 2015 enrollment period. We're delighted to see GetInsured's technology evolve as a result of Idaho's experience, and we look forward to seeing a next generation of exchanges."
Benefits of the Lean SBM Model:
Rapid Stand up for Fast Deployment
GetInsured can launch its fully functional Lean SBM within 60 days, allowing states to meet their open enrollment deadlines. Thereafter, GetInsured can quickly iterate to meet a state's requirements.
Robust Functionality Out of the Box
The Lean SBM provides states with advanced functionality out of the box, including eligibility determination, plan shopping and comparison, enrollment, financial management, call center services, plan management, consumer noticing, analytics and reporting.
Low Cost to Deploy and Maintain
A Lean SBM can be implemented without the use of federal grants (section 1311 grants) and can be maintained through ongoing per-member-per-month (PMPM) assessments. Common in the private marketplace, PMPM pricing models align technology vendors with their customers, share project risk and ensure both parties are motivated to work together to achieve marketplace enrollment goals. A state's cost for the Lean SBM has four possible components: (i) any fees charged by Centers for Medicare & Medicaid Services (CMS) to provide eligibility services to the SBM; (ii) license, maintenance and operation fees charged by GetInsured for the SBM platform; (iii) any consumer assistance costs incurred by the state; and (iv) any administrative and governance costs incurred in the exchange set-up. Collectively, GetInsured expects these amounts to be meaningfully lower than the 3.5 percent user fee the FFM charges states today.
The Best User Experience Available
States can control the user experience and benefit from GetInsured's award-winning private sector consumer features, including the ability to find plans that cover preferred doctors and prescriptions, the ability to view each plan's provider network density on a map, and the ability to compare plans by estimated out-of-pocket expenses.
Because GetInsured's Lean SBM platform shares assets among states -- four to date and growing -- and across public and private sector clients, customers benefit from an IT platform built for sustainability and scalability.
Turnkey Customer Service from Licensed Brokers
If a state prefers not to use its own call center, GetInsured can provide customer assistance via its call centers in Phoenix, Ariz. and Atlanta, Ga., which are staffed with highly trained customer service representatives who can enroll customers by phone on behalf of the state.
Full Visibility into Market Behavior to Improve Customer Enrollment
GetInsured's solution gives states complete visibility into enrollment statistics, including detailed user demographics and engagement with the website and call center. This enables continuous improvement in messaging and user experience to improve enrollment rates, and can inform education and outreach efforts.
Support for CHIP and Medicaid Enrollment
States can extend the Lean SBM Model to implement integrated enrollment experiences for qualified health and dental plans, Medicaid and CHIP (Children's Health Insurance Program), thereby providing a friendly and cohesive user experience for all state customers.
Minimal State Resources Required for Implementation
The Lean SBM can be launched out of the box, requiring minimal state resources for design, configuration or implementation. Typically, a state will only need to provide one or two full-time resources to make policy decisions and assist GetInsured with website branding, telephony configurations, customer service training and health plan configurations.
GetInsured is a cloud-based health insurance exchange platform that combines modern technology and customer service capabilities to make health insurance shopping easy and efficient. Since its founding in 2005, GetInsured has helped millions of consumers find the right health plan for their needs and budgets. GetInsured is approved by the federal government to enroll Americans in subsidized health insurance plans, and also provides state governments and employers with SaaS-based technology solutions for public and private health insurance exchanges. For more information, please visit www.GetInsured.com.