State Healthcare Exchanges

BAS and its MyEnroll.com software is the perfect teaming solution for States and integrators who will be developing health care exchanges.

Signed into law by President Obama on March 23, 2010, the ACA requires States to begin operating a Health Insurance Exchange by January 1, 2014 or to allow the federal government to operate an Exchange on their behalf. In legislation adopted April 12, 2011, the State of Maryland established its own Exchange. The Exchange will provide Maryland’s residents and small businesses with the opportunity to compare rates, benefits, and quality among insurance plans and enroll in products that best suit their needs. It also will be the entity that evaluates eligibility for Medicaid, advance premium tax credits and other affordability programs designed to make coverage more affordable for individuals below 400 percent of the federal poverty level (FPL).

To comply with federal requirements, states must successfully develop and test their  new eligibility and enrollment systems by no later than the Spring of 2013. While Exchange coverage will not be effective until January 1, 2014, the Exchange must be prepared to begin pre-enrolling people by October 1, 2013. In light of this aggressive timeline and the expansive scope of the work required, states will need to select vendors, like BAS, with specific insurance eligibility, enrollment, administration and technology experience.

BAS has the experience, through more than 20 years of insurance eligibility, enrollment and administration software development and business process outsourcing, and more than 10 years of government contracting, to participate in complex teaming arrangements within government contracts. Presently, BAS’ clients include, but are not limited to, federal Multiple Employer Trusts and VEBA Trusts that operate in similar fashion to the proposed healthcare exchanges in that they provide unrelated employers to offer a multitude of benefit plan options all within the confines of Section 125 regulations, insurance carrier underwriting rules, and employer eligibility ruels.

Perfectly Suited

MyEnroll.com is perfectly suited for States’ individual and SHOP Health Care Exchanges. MyEnroll.com can provide, in whole or part, decision making trees for benefit plan selection, employer and individual account enrollment within the confines of table driven rules supporting special health care reform regulations, Section 125 regulations and other special underwriting requirements.

Self-Service Enrollment

MyEnroll.com can provide self-service for the entire employee benefits enrollment life cycle including new enrollment, mid-year life enrollment, annual open enrollment, and COBRA. 

EDI

Presently, MyEnroll.com connects with hundreds of insurers for the electronic exchange of data to assure fast and accurate enrollment across heterogeneous systems. MyEnroll.com’s EDI engine allows for quick builds of new and revised EDIs to meet any specification. MyEnroll.com does support ANSI 834 and the new HIPAA 5010 formats.

Billing & Collection

MyEnroll.com MyEnroll.com can provide billing that includes paper and email billings, ACH collections, A/R collection management. 

Regulatory Compliance

MyEnroll.com reporting can provide individuals, employers and State/Federal  regulators the summary and deep-dive reporting needed to assure compliance and accurate enrollment.

Best-in-Breed Technology

MyEnroll.com is remarkably flexible. It is built on Oracle Database technology and is comprised of more than 3,200 data tables that track very granular information about employers, employees, individuals, underwriting, rates, insurer EDI specifications, and much more.