Infographic - ACA Enrollment


Automate Coverage Updates

  • Automate the processing of multiple transactions received for the same member and void canceled initial enrollments, up front
  • Merge multiple updates/changes into a single transaction
  • Convert CIC Term/CIC Adds into change transactions

Identify and resolve enrollment file issues on arrival, in real-time.

Enable Lifecycle Visibility

  • Deliver out-of-the box business-level view of processing and operational performance
  • Enable data element and transaction-level visibility
  • Ensure greater operational awareness through alerts and notification, across all lines of business

Deliver end-to-end enrollment processing visibility to enhance member satisfaction while reducing costs.

Improve Financial Reconciliation

  • Process payment remittances in any format
  • Reconcile to current and historical enrollment records and periods
  • Quickly identify missing payments or discrepancies in premiums or subsidy payments
  • Track expected, projected, and actual payments
  • Export and import financial details for offline review

Safeguard revenue with discrepancy identification and complete reconciliation.

Marketplace Regulatory Compliance

  • Out of the box integration and file processing for the FFM
  • Pre-configure state-specific guidelines, maps and validations rules
  • Enable support for baseline RCNI and RCNO, and pre-audit file formats
  • Transition smoothly from the FFM to any SBE

Ensure compliance with a best-in-class member enrollment solution.

Streamline Discrepancy Resolution

  • Automate reconciliation against monthly enrollment audit files
  • Employ intelligent workflows to identify, assign and resolve complex discrepancies

More efficient exception handling for full-file transmissions. Avoid processing delays and customer dissatisfaction.