State-Based Marketplaces

• One end-to-end vendor: We offer an “all-in-one” solution, meeting your state’s needs for an operationally efficient migration from a Federally Facilitated Marketplace (FFM) to a State-Based Marketplace (SBM) and for user-friendly tools and solutions to meet the needs of the consumer, agent, customer service representative, and administrative users.
• A technology platform with a rich base configuration and continuing momentum: Our technology is mature and is being used in whole or in part by five state-based marketplaces successfully.
• A consumer support center that is built out and in operation today: We have been running call centers for our public and private sector customers for more than ten years now. Thus, we are able to provide our existing, proven, fully built-out operational call center with additional dedicated resources.
• Small implementation footprint: Our implementation approach leverages best practices from marketplace implementations in these, and other, states and does not require extensive customization or a ground-up system build. GetInsured is the only team in the market that has successfully transitioned a state from the FFM to an SBM.
• Qualified Health Plan eligibility and integration with Medicaid: The coordination of integrated eligibility between state exchanges and Medicaid has traditionally been one of the most significant challenges for SBMs. We leverage our experience and past successes integrating with other Medicaid eligibility systems, such as at YHI in Idaho.
• Ongoing enhancements: Due to the ever-changing market, our platform will continue to evolve in the future. We customarily make usability, security, effectiveness, and efficiency updates across all our state and private customers. This unique feature of our offering helps provide states with a predictable budget.
• Marketplace Platform Advisory Council: In addition to having access to generally available enhancements, we also provide our customers access to our Platform Advisory Council comprised of our current customers. The council’s purpose is to help all of our customers align their interpretations of ongoing feature requirements and coordinate improvements for greater efficiency.

If your state currently leverages the Federally Facilitated Marketplace (FFM), a state exchange can give you more control over rising premiums, as evidenced in research from The Commonwealth Fund suggesting SBMs have up to 20% lower premiums than States on FFM/healthcare.gov. Plus, the move from FFM to SBM is much easier due to new policies that encourage states to leverage section 1332 waivers.

With a state-based marketplace, you are likely to reduce your costs dramatically, increase usability and operational efficiency, and support your state’s specific policy desires. The economics of state-based marketplaces have been proven to be more sustainable for many states than operating on the FFM. Contact us for more information and state-by-state savings opportunities.

• Eliminate auto-renewal risk present with Healthcare.gov;
• Support shopping and enrollment for the Medicaid buy-in (like Minnesota is planning);
• Support the unique churn needs between Medicaid, Medicaid buy-in and QHPs;
• Provide administrators the data they need to target outreach efforts in particular counties, cities, towns;
• Support multilingual language support where appropriate;
• Support workflow that gets users their insurance cards (an issue many states have seen in the past); and
• Enable advocacy with optimal use of the health plan wellness services.