Accelerate Speed to Market for ACA Qualified Health Plans

A configuration of the Benefits1™ Platform for end-to-end management of Small Groups and Individual Qualified Health Plans (QHPs)
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qhp management automated solution, solution for qhp management, sbc compliance, end to end aca solution, qualified health plan management, Benefits1™.ACA (formerly eACASync™)

Enable a connected benefits journey for the ACA Health Plan market

Gain Small Group and Individual plan market share

Manage ACA Products in One Place

Manage a single source of truth platform to improve data accuracy and reusability across all products

Simplify ACA Filings

Accelerate QHP Plans and Benefits Templates (PBTs) development and simplify ACA filings for multiple states

Robust Collaboration

Enable cross-functional teams and business processes by activating an out-of-the-box workflow engine across unlimited users

Errata-Free Compliance

Achieve 100% compliance with any ACA plan materials, including SBCs, SOBs, handbooks, and booklets, by leveraging a 508-compliant document automation engine

Power your connected benefits journey with integrations

Extend the capabilities of Benefits1™.ACA with a host of integrations to achieve end-to-end lifecycle management of your Qualified Health Plans
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.Actuary

Accelerate actuarial inputs to design changes and portfolio ideation

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.IntegrationHub

Use API and events to communicate data in a model that is easily consumable by target systems

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.Sales

Enable sales and sales ops to customize benefits for small groups via seamless integration with a sales CRM system

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.SuperUser.Studios

Empower superusers to maintain design, rules, and workflow configurations while also establishing governance

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.DataServices

Use a relational database to drive reports and analytics on the source of truth data or communicate it in a model that is easily consumable by target systems

.AI

Leverage the power of Generative AI to incorporate periodic code set changes published by the CMS into Benefits1™ and provide context-aware help from the product assistant

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Service1™

Deliver accurate and complete answers to members, providers, employer groups, and brokers/agents for benefit inquiries

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Claims1™

Enable automated claims configuration, code set level configuration of benefits, and testing to support claims adjudication

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Experience1™

Automate dynamic content generation and stream accurate, compliant, and consistent benefits data across the enterprise

Simplify Healthcare is positioned in the Leaders Category in the 2023 IDC MarketScape for U.S. health plan product/plan benefit configuration solutions.

What Our Customers Say

Frequently Asked Questions (FAQs)

Here is what our customers usually ask us

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

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 configure your benefit plans 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

Why use an ACA-compliant benefit plan management solution?

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

How can you automate Qualified Health Plan management?

Benefits1™.ACA is the only solution in the market built with a full understanding of ACA-compliant Qualified Health Plans benefit requirements. With Benefits1™.ACA, health plans can:

  • 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 Rules and Workflows, health plans can increase operational efficiency by up to 75% and decrease manual errors by up to 90%

What kind of documents can be generated with Benefits1™.ACA?

With Benefits1™.ACA, health plans can auto-generate SBCs, SOBs, Handbooks, and Booklets. They can seamlessly manage CMS changes without any last-minute hassle, and annotate and track changes for regulatory and business communication content from a single source