GetInsured Unveils New Shared HIX Platform to Address State-Based Exchange Sustainability Concerns

MOUNTAIN VIEW, CA--(Marketwired - May 11, 2015) - GetInsured, a leading innovator in health insurance exchange platforms, today unveiled the GetInsured Shared HIX Platform as an alternative to existing state-based marketplaces that have self-sustainability concerns. With the Shared HIX Platform, states will have access to a full-featured, ACA-compliant Individual and Small Business Health Options (SHOP) Marketplace. A full white paper discussing the platform can be found here.

The GetInsured Shared HIX Platform offers states a pathway for continuing marketplace innovation while advancing self-sustainability through a solution that carries no upfront cost and offers a predictable per-member-per-month (PMPM) cost structure. This helps states in two ways:

1. States that have an existing state-based marketplace (SBM) can dramatically reduce their maintenance and operations (M&O) costs by plugging into a platform that shares hosting, software code, content, testing, compliance, security, audits, training and other services across customers that have similar requirements.

2. States that are considering a build-out of an SBM can stand up a robust, ACA-compliant marketplace more quickly and cost effectively than using a customized approach that requires the engagement of separate vendors for project management, security, implementation, training, etc.

"States are not in competition with each other for health insurance solutions, so they shouldn't need to build and maintain completely separate and costly health insurance exchanges. There are many economies of scale available to states that adopt a common software platform, versus controlling and needing to pay for all maintenance and enhancements -- not to mention bear the entire burden if something goes wrong with the technology or compliance of the exchange. The potential cost reductions can be dramatic. States also benefit from the many modern e-commerce features and consumer tools available in our platform, which we improve upon frequently for our direct-to-consumer marketplace," said Chini Krishnan, GetInsured co-founder and CEO.

How It Works:

• A state that wishes to adopt the Shared HIX Platform essentially retires its existing Exchange platform (if it has already built one) and replaces it with the GetInsured HIX platform in the cloud.
• GetInsured will need to integrate with a state's existing state eligibility system in order to fully operationalize the solution. This integration can be achieved with no upfront cost to states or with Medicaid 90/10 grant funding.
• GetInsured shares its platform across all its state customers, therefore a state that adopts the Shared HIX Platform implicitly agrees to cooperate with other state customers to evolve the platform. In doing so, such a state minimizes many of its custom requirements (or such requirements that do not make sense to other states). The GetInsured platform is fully ACA-compliant; offers the best eligibility, shopping and enrollment tools in the industry; and currently serves more than 2 million consumers.

Cost efficiency and reuse with the shared platform extend beyond system development and hosting to other activities such as program management, testing, training, security audits, and many other governance functions. For example, three states on the Shared HIX Platform can choose to share in the cost of one common security audit and common training for agents, versus needing to budget and pay for these costs separately.

How Is the Shared HIX Platform Different from the Lean SBM?

Recently, GetInsured announced the availability of a Lean SBM solution for states that want to build a health insurance marketplace (the Lean SBM white paper is available here). The differences between the Lean SBM Solution and the Shared HIX Platform include:

1. The Lean SBM uses federal eligibility and enrollment services in order to be launched quickly (within 60 days), and it is intended to be used by states that do not have a state-based marketplace and may need one quickly. The Shared HIX Platform integrates with state-based eligibility determination systems and takes approximately six months to implement.

2. The Lean SBM uses federal enrollment systems on the back-end as the system of record. The Shared HIX Platform provides states with a full state-based marketplace, where they control their own eligibility, carrier integration, plan management, enrollment and financial management systems.

3. Both models do not support extensive customizations, but with the Shared HIX Platform, GetInsured intends to accommodate particular state variants of general needs through configuration, where appropriate.

In both cases, GetInsured provides a world-class, state-branded and state-configured solution that delights consumers, employers, employees, agents/brokers, carriers and state administrators. In both cases, states will have access to a full-featured Individual and SHOP Marketplace, and both models support direct enrollment for carriers and brokers.

To Learn More:

If you're interested in understanding more about the GetInsured Shared HIX Platform, or in helping to model the solution, please contact Andrea Riggs at andrea.riggs@getinsured.com.

About GetInsured

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. The company has successfully launched four state-based Marketplaces -- California, Idaho, New Mexico (SHOP) and Mississippi (SHOP) -- and spent a decade operating a consumer health insurance marketplace that is fully compliant with the Affordable Care Act (ACA). 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.