Simplify Qualified Health Plan benefit requirements

Simplify Qualified Health Plan (QHP) benefit management

Market leader in Qualified Health Plan (QHP) benefit needs, the QHP – ACA compliant solution is specifically designed to automate varied needs of Individual and Small Group ACA compliant benefit plans. It helps health plans seamlessly comply with the Affordable Care Act (ACA) and make the benefit build processes simple, efficient, and error-free.

  • Incrementally build benefit plans with inputs across teams using integrated workflows.
  • Auto-generate documents, including QHP, SBCs, SOBs, Benefit templates, and Booklets from a single source of truth.
  • Get pre-configured SBCs and SOBs, stay up-to-date with regulatory changes, and improve accuracy, consistency, and speed-to-market.

eACASync™ enables health plans to re-engineer Individual and Small Group ACA compliant benefit plans with business rule-driven end-to-end single source of truth.

Make your QHP benefit plan management process more intelligent with our robust and automated enterprise solution hosted in the cloud.

Streamline ACA benefit plan build hassle-free

A fully automated and pre-configured QHP benefit plan management solution designed to auto-generate QHP, SBCs, SOBs, and benefits template while ensuring all documents and materials are consistent across the enterprise.

Integrate legacy systems and improve operational efficiency

Automate processes on top of your existing systems, including spreadsheets, Excel grids, and PDFs, and improve overall operational efficiency with our highly configurable and modular solution.

Power-packed with various functionalities for a seamless experience

Enhance your automation with robust functionalities and document generation capability. With its intelligent decision support, health plans can now improve operational efficiency by up to 75%.

A modular approach to transform the QHP benefit requirements

Design-thinking combined with a modular approach and automation technology helps health plans remain agile and boost QHP benefit plan management in just a few clicks.

Why eACASync™?

Boost your business processes, stay up-to-date with regulatory changes, fast-track benefit plan design, improve speed-to-market, and cost-effectiveness, all with an automated solution hassle-free.
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Pre-Configured Documents

Accurate, on-time up to 100%

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Operational Efficiency

Increase operational efficiency by up to 75%

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Errors

Decrease errors up to 90%

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Efforts

Reduce/optimize efforts up to 75%

Discover how eACASync™ can help Individual and Small groups auto-generate QHP, stay up-to-date with regulatory changes, and improve speed-to-market

Application Modules

Our Qualified Health Plan (QHP) benefit plan management solution can be molded according to your business. Select from our integrated modules that suites your business to address your pain points and maximize investments.
Create single source of truth for your plan data

Take control of your data by managing its configuration and use

Establish a single source of truth to automate varied needs of Individual and Small Group ACA compliant benefit plans, annotate and track changes for regulatory and business communication content, eliminate Excel grids, automate workflows and routing of information between various teams using .Source
Auto-generate documents to meet regulations

Automate document generation and version management processes

Dynamically generate QHP, SBCs, SOBs, and benefit templates from a single source of truth. Enable omni-channel re-use of the language and dynamically generate print-ready documents to meet regulations or share your information on web portals or through print with .Docs
Improve claims management accuracy

Simplify configuration of benefit plans and keep your claims system up-to-date

Configure your benefit plans 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 product configuration with .Claims
Seamlessly share information across the enterprise

Automate the integration of key benefits data and documents into essential systems

Ensure your single source of truth is integrated everywhere across the enterprise. Seamlessly manage mandated changes without any last-minute hassle and engage all stakeholders via integrated use-case specific workflows vs. emails using .Integrate

Expose your user-configurable data to standard reporting tools

Ensure your dynamic pristine data is integrated with your Master Data Management investments and is available in real-time to your reporting and business intelligence tools using the relational database format and flexibly capture all types of types of QHP benefit needs for Individual and Small Groups using .DataMart
Improve speed-to-market with seamless CRM integration

Sell and quote while customizing your benefit plans

Simplify configuration of QHP benefit plans with the intelligent decision support for product development and document generation and allow for customization, within your CRM to create a seamless user experience that increases speed-to-market with .Sales

Frequently Asked Questions (FAQ's)

Here are the most common, 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.

What our customers say.

''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

Ready to get started with eACASync™?

Are you interested in learning more about eACASync™? Our team is ready to answer all your questions. Let’s make smarter health ecosystems together! Schedule a 1:1 demo with us today!
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