An Integrated Eligibility Platform That Implements All The Features Required By An ACA Compliant HIX Marketplace

Plan Shopping

  • Individual prescreening (APTC, CSR, Medicaid, CHIP)
  • Family screening (APTC, CSR, Medicaid, CHIP)
  • Plan shopping, selection and details

Enrollment – Initial Application

  • Initial Application - Unsubsidized Application (QHP only)
  • Initial Application - Subsidized Application (QHP/APTC/CSR)
  • QHP/APTC/CSR Enrollment

Enrollment – Change Reporting

  • Change reporting for existing applications
  • Life events and Special enrollment

Account

  • Messages
  • Notices
  • Upload verification documents (camera and library)
  • Household enrollment information
  • Push notifications for direct marketing and reminders

Information

  • Marketplace information including contact details, privacy policy, terms of use
  • Social media links (facebook, twitter, youtube)

Broker Connect

  • Find assisters/brokers (Location based search)
  • Broker/assister profiles

More Features, But In Significantly Less Time, Less Cost And With Less Risk

An integrated web and mobile platform that provides the most advanced and user friendly Health Insurance Exchange interface that can be implemented and maintained in a fraction of the time and cost compared to current/previous implementations

The Digital Advance


    Rapidly Configurable

  • Rapidly configurable look and feel
  • Rapidly configurable functionality

    Enhanced Consumer Experience

  • Integrated web and mobile platform
  • Apply, enroll, verify, and receive messages and notices on Web and Mobile

    Highly Interoperable

  • Standardized HIX API built for interoperability
  • Easy integration with FDSH, State systems and other enterprise systems

    Cloud Based

  • Fast, flexible plug and play setup
  • Elastically scalable with the ability to expand and contract based on user load

Full Compliance for Security & Privacy

Meets and exceeds State and Federal security and privacy standards with single and multi-factor authentication, role based authorization control (RBAC), and protection of data in all aspects of the system

Application & Change Reporting

Self service application intake and change reporting for customers via a web based and mobile interface. Provides customers an optimized application flow based on their household details for QHP, APTC/CSR and Medicaid

Integrated Eligibility Determination

Integrated eligibility determination for QHP, APTC/CSR, Medicaid and CHIP powered by a business rules engine. Provides a foundation for implementing additional programs and business rules in the future


Full FDSH & State Integration

Ready built integration with the Federal Data Services Hub for all required services such as ID Proofing, SSA Composite, Verification of Annual Household Income, Verification of Lawful Presence, Max APTC calculation, and more. Digital APIs to enable rapid integration with State systems

Notice Generation & Verifications

Full-fledged notice generation system that implements templates for all required notices and provides the ability to create additional notice templates. Verification system that can accept electronic and paper verifications and a full featured document repository

Plan Display & Shopping

User-friendly plan display and comparison shopping available via both Web and Mobile. Customers are able to screen themselves for benefits and comparison shop for health plans from multiple carriers


Health Plan and Benefits Enrollment

Customer enrollments are automatically communicated to Health Insurance Carriers and CMS via EDI transactions and the State Medicaid Agency via system interfaces that can be rapidly configured and customized for the State

Plan Management & Carrier Integration

Full-featured plan management system supporting automated integration with SERFF, and plan review, processing, approval and publishing features for Health Insurance Carriers and the Exchange Plan Management department

Worker Productivity & Process Management

Worker portal to support efficient back office operations providing features for searching, viewing and processing applications and verifications, such as a power user application interface for workers, worker oriented process flows, user roles and hierarchies, and much more

The only full-featured Health Insurance Exchange Mobile Platform

    Screen and Shop for Benefits

  • Screen for benefits including APTC, CSR, Medicaid and CHIP
  • Eligibility screening, plan rates and tax credits for SHOP
  • Provide financial quotes for APTC and health plan premiums
  • Mobile optimized list of plans with APTC slider and plan filters
  • Detailed plan information, including Plan PDF from Carriers

    Enroll in Benefits

  • Secure customer account creation
  • Mobile optimized capture of full benefits application information
  • Eligibility determination and enrollment for QHP, APTC, CSR, Medicaid and CHIP
  • Full, real-time synchronization with the web portal

    Mobile Inbox and Verifications

  • Access to a Mobile Inbox with messages and PDF notices
  • Ability to upload verification documents using the mobile camera or gallery
  • Access to documents uploaded via both Web and Mobile
  • Full, real-time synchronization with the web portal

    Additional Information and Services

  • Privacy policy and terms of use
  • Contact information and social media links
  • Assister/Navigator and Broker information and search

A full implementation of the Web and Mobile System within 6 months

Designed specifically for rapid implementation

  • Packaged the solution as a platform to make it ready for immediate transfer

  • Implemented modularity and Cloud technology to make the platform highly robust and scalable

  • Implemented digital technologies to make the system highly interoperable via XML and RESTful APIs

  • Made the platform highly configurable to allow rapid configuration and customization to meet specific State Based Marketplace requirements

  • Implemented accelerators to enable extremely rapid setup and optimized, iterative development

Iterative implementation progressively customizes a fully functional reference implementation for the State Based Marketplace within 6 months

The NovoInvent Digital HIX platform provides several advantages

More features, a faster implementation time and a better level of service while significantly reducing cost and risk


Solution Advantage
Area NovoInvent Market Highlights
System Features
  • The only integrated web and mobile platform (we include a full featured mobile solution that is not provided by any other vendor)
  • Enhanced with Digital APIs for ease of integration with external interfaces
  • Fully Cloud enabled, every tier can scale elastically
  • Packaged for rapid implementation - fully functional environment can be configured within one week
Approach
  • Functional system available from "day 1 of the project"
  • Fully implementation ready, packaged system with accelerators for enabling effective agile/iterative development
  • All Joint Application Design (JAD) sessions conducted with a fully functional system
  • Regular demonstration of customizations with every iteration (4-6 weeks)
  • Automated setup of individual developer environments saving weeks of effort for each developer
Implementation Time
  • Market leading implementation timeframe with a full Individual HIX ready for production in 6 months
  • A working system is provided from “day 1 of the project” enabling early familiarization and training
Implementation Risk
  • Size of the team, implementation cost and time are reduced, thereby reducing risk
  • System demonstration of updated, customized features is provided every 4-6 weeks in a system that is "always running“
  • Advanced technology that takes advantage of Cloud features for scalability
  • Rapid implementation of environments with early load and performance testing

Contact Us for a system demo today! In fact, we can set up an independent, fully functional, full-featured Web and Mobile environment for you within 1 week!