Redefine accuracy and efficiency of Individual and Small Group ACA compliant benefit plans

Get accurate and consistent documents, reduce benefit build timelines, decrease operational costs, and improve speed to market.

Industry Challenge 

  • Dependency on disparate legacy systems 
  • Labor-intensive, manual, and error-prone processes 
  • Lack of a single source of truth for ACA QHP benefit data 

Impact 

  • Errors in Qualified Health Plan builds 
  • Inconsistencies in data across departments 

Our Solution 

  • Creates a single source of truth  
  • Brings accuracy and timeliness in QHP product development 
  • Ensures that plans comply with the ACA 

Industry Challenge 

  • Lack of standardization and integration in IT systems 
  • Workflows spanning multiple disconnected systems 
  • Duplicative manual data entry 
  • Work assigned in spreadsheets 

Impact 

  • Process inefficiencies across business functions 
  • Delayed product development 

Our Solution 

  • Out-of-the-box workflow automation solution 
  • Eliminates departmental silos 
  • Improve communication among stakeholders 
  • Streamlines processes by automating work assignments 
  • Eliminates the need for manually filling spreadsheets and clubbing them at the end of the day 

Industry Challenge 

  • Manual generation of PBT templates and member communication documents 
  • Manual exchange of data and documents 
  • Lengthy review and approval cycle 

Impact 

  • Process inefficiencies 
  • Increased chances of errors 
  • Risk of non-compliance 
  • Member frustration and decreased Star ratings 

Our Solution 

  • Delivers compliant SBCs and standard SOBs 
  • Enables QHP PBTs, Booklets, and Handbooks generation
  • Ensures accurate state filings and ACA compliance 

Industry Challenge 

  • Lack of scalable technology 
  • Dependency on point solutions 
  • Evolving business needs and market dynamics 
  • Constantly changing compliance requirements 

Impact 

  • Stunted business growth 
  • High cost of IT system upgrades 
  • Business opportunity loss 

Our Solution 

  • Modular and scalable solution 
  • Quick and easy implementation 
  • End-to-end solution 

Why eACASync ?

Boost your ACA benefit build processes, stay up to date with regulatory changes, fast-track benefit plan design, improve speed to market, and reduce costs — all with an automated solution, hassle-free.
Accuracy and Timeliness
100%
Operational Efficiency
75%
Errors
90%
Efforts
75%

Choose an end-to-end solution or select modules to solve specific pain points

Our Qualified Health Plan (QHP) benefit plan management solution can be molded according to your business. Select from our integrated modules that suit your business to address pain points and maximize investments.

Integration of other solutions in eACASync™ ecosystem

eClaimsEngine™ – Our claims configuration solution, integrates as a component of eACASync™ to configure your Individual and Small Group benefit data at one place with intelligent decision support, eliminate repetitive data entry into Core-Admin and other systems, keep your claims system up-to-date, and automate the maintenance of your benefit configuration.

Listen to Our Customers

''I wish we had started with eACASync™ sooner. We have been manually creating our QHP submissions, which is a huge effort, with several opportunities for data quality issues. Simplify Healthcare has automated creation of the QHP requirements that not only reduces our efforts but more importantly, also reduces our risk of errors.''
— VP Commercial Plans, Mid-Sized Health Plan

Frequently Asked Questions (FAQs)

Here are the answers to the most frequently asked questions about implementing end-to-end QHP benefit plan management solution and partnering with Simplify Healthcare.

1. What is a Qualified Health Plan benefit management?



Qualified Health Plan benefit management is an end-to-end ACA compliant benefit plan management and document generation process for submitting the Qualified Health Plans to the government for approval within specific deadlines. Most health plans meet the affordable care requirements manually and with outdated methods such as spreadsheets, PDFs, and email for plan configurations. Qualified Health Plan benefit management solution streamlines the QHP benefit requirements with intelligent decision support for product development and document generation to boost operational efficiencies by up to 75%.

2. What are the challenges with traditional ACA benefit plan build processes?



Traditional ACA benefit plan build processes lead to last-minute rush, manual efforts to manage and audit plans, and inaccuracies in data. Manual and outdated methods such as spreadsheets, documents, and emails to configuring your plans often create errors and reduce overall operational efficiency. The traditional processes can lead to various challenges, such as:

 

  • Managing version control issues.
  • Core-Admin systems may require manual keying of the data, which may lead to costly errors.
  • Due to version control issues and other factors, critical downstream applications get different versions of benefits information.
  • Manual processes make the ACA benefit plan build processes slow, labor-intensive, expensive, and creates downstream errors.
  • Benefit teams often lose the opportunity to perform productive tasks such as analyzing the market and consumer trends to offer improved products.

3. Why use an ACA compliant benefit plan management solution?



eACASync™ is an automated ACA compliant QHP benefit plan management solution for Individual and Small groups. It enables health plans to automate and streamline ACA benefit plan build, benefit requirements, manage CMS updates, and auto-generate QHP plans, Summary of Benefits (SOBs), Summary of Benefits Coverage (SBCs), and Benefit Templates. Health plans can now focus on building the right products v/s, ensuring that all the Excel grids and Word documents are consistent.

4. How can you automate Individual and Small group ACA compliant benefit plan management?



eACASync™ is the only solution in the market built with a full understanding of ACA compliant Qualified Health Plans benefit requirements. With eACASync™, health plans can do the following:

 

  • Create a single source of truth for all benefits information.
  • Smoothly configure plans to comply with guardrails for regulations and business policies via centralized business rules.
  • Implement any or all modules in the order of the most critical pain points and priorities.

With pre-configured QHP plans, SBCs, SOBs, and benefits template health plans can increase operational efficiency by up to 75% and decrease manual errors by up to 90%.

5. What kind of documents can be generated with ACA compliant Qualified Health Plans benefit management solution?



With eACASync™, health plans can auto-generate QHP plans, SBCs, SOBs, and benefits template. They can seamlessly manage CMS changes without any last-minute hassle. Annotate and track changes for regulatory and business communication content from a single source.