ACA Marketplace
Infrastructures and Processes
In Production, Less than 90
days – Guaranteed.
It is our contractual commitment to keep implementation
under 90 days with minimal risk and full PPACA regulatory
compliance - assuming all QHPs have undergone the CMS
certification process.
2014 Softheon, Inc. and/or its affiliates. All rights reserved. Softheon is a registered trademark of Softheon, Inc. or its affiliates. This
publication may not be reproduced or distributed in any form without Softheon’s prior written permission. The information contained in
this publication has been obtained from sources believed to be reliable. Softheon disclaims all warranties as to the accuracy,
completeness or adequacy of such information and shall have no liability for errors omissions, or inadequacies in such information. This
publication consist of the opinions of Softheon’s research organization and should not be constructed as statements of fact. The
opinions expressed herein are subject to change without notice. Although Softheon may include a discussion of related legal issues.
Softheon does not provide legal advice or services and its research should not be constructed or used as such.
Softheon Stands Behind Its 90 days
or less Deployment Guarantee
It is our contractual
commitment to keep
implementation under
90 days with minimal
risk and full PPACA
regulatory complianceassuming all QHPs have
undergone the QHP
certification process.
Softheon Marketplace Connector Cloud (MC2) offers an innovative,
proven, and highly scalable platform system that offers rapid
deployment, of 90 days or less, without the use of any in-house
staff or software management - assuming all QHPs have
undergone the QHP certification process.
Softheon MC2, recognized for accelerated Exchange Integration
deployment for both Public and Private Exchanges, is the Exchange
platform of choice for over 40 health plans, in 42 states. The
Softheon MC2 platform offers Plan Management, Eligibility &
Enrollment including Direct Enrollment, SHOP, Premium Billing,
Customer Service, and Edge Server cloud-based solutions.
Eliminating the Need to “Rip and
Replace”
Softheon’s Founder &
CEO, Eugene Sayan best
describes the Softheon
Marketplace Connector
Cloud platform as “an
information highway
system connecting issuers
to all marketplaces”.
Onboarding new health
insurers is as simple as,
“adding more
automobiles to the
Softheon highway.”
Softheon MC2 is a Software-as-a-Service (SaaS) solution that serves
as an integration platform between the health plan and both public
and private Marketplaces by leveraging all existing business
processes and IT systems for over 40 health plans without a need to
“Rip and Replace”.
Softheon MC2 provides healthcare issuers a cost-efficient
alternative to costly core administrative system overhauls. In
essence, it is a “plug-in”, cloud-based solution that does not require
software, hardware, or maintenance expenses.
Rather than replacing outdated technology investments, Softheon
prides itself on having the ability to modernize existing IT
investments and core administrative systems including, but not
limited to, TriZetto QNXT, DST Amisys, HealthEdge, ikaSystems and
EPIC. Through this approach, Softheon provides health insurance
marketplace integration for private, state-based, and federallyfacilitated marketplace exchanges.
Copyright 2014. Confidential and proprietary information.
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Proven Technology. Client Success.
Service-oriented architecture (SOA) is recognized for accelerating
deployment of new applications and capabilities, streamlining
business-critical processes, reducing costs, and enabling
organizations to increase their return on investment from an
accumulation of diverse systems and communication technologies.
As health payers are forced to work with multiple content and
business process management systems resulting from
departmental investments or inherited through mergers and
acquisitions, SOA based enterprise messaging and business process
integration frameworks have emerged as the preferred solution for
breaking through these silos and unlocking the value of content
across the enterprise.
Softheon MC2 presently empowers over 40 regional health plans
with the ability to leverage their existing IT investments and core
administrative systems including TriZetto QNXT, DST Amisys,
HealthEdge, ikaSystems and EPIC, to provide health insurance
marketplace integration for private, state-based, and federallyfacilitated marketplace exchanges.
d
Softheon Marketplace Connector
Cloud – the Leading SOA Platform
for HealthCare Payers
The Softheon Marketplace Connector Cloud (MC2) is a SOA
compliant business process management and enterprise messaging
integration platform that is fully WSE 3.0 compliant, and is based on
three layers of service: integration, federation and developer.
The Softheon MC2 offers many benefits to the healthcare insurers.
•
Copyright 2014. Confidential and proprietary information.
It enables organizations to federate multiple, disparate
content repositories and workflow systems unifying these
isolated silos to improve access, as well as reuse and
control distributed content assets. It provides bidirectional
access to underlying content, workflows and functionality
that delivers a rich set of additive functions that span
multiple repositories.
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Softheon offers a large
library of pre-built
connectors to many
commercial systems,
such as Trizetto FACET,
QNXT, Amisys DST,
HealthEdge, ikaSystems,
MC400, EPIC and
provide real-time,
bidirectional access to
the native member and
claims data stored in
these systems.
•
By aggregating content into 360-degree content views, it
allows organizations to create a single logical view of
content related to a specific process or topic—regardless
of where the content is stored and managed. These
content views remove barriers imposed by disparate
content sources and make content appear as if it were
organized in a virtual repository.
•
Metadata mapping services normalize index values across
multiple systems. This intuitive mapping tool makes it easy
to define a common data model for working with content
stored in multiple disparate repositories.
•
Federated search capabilities enable property-based and
full-text queries against multiple repositories, returning an
aggregated result set. This feature also allows users to
create saved searches for enhanced productivity.
•
Single sign-on encrypts and stores repository credentials
and allows users to log on to multiple underlying systems
through a single authentication process. This capability can
also integrate with existing Lightweight Directory Access
Protocol (LDAP) infrastructures.
•
Subscription event services let companies create custom
event handlers and other rules-based behaviors that span
multiple content and workflow systems.
•
Automatic subscriptions allow content and workflow
queues to be monitored and to automatically trigger email notifications and/or other events when changes occur.
•
Cross-repository capabilities enable a range of eventbased functions, such as content and/or Metadata
replication between disparate repositories; declaring a
document as a record; or triggering a workflow event that
must occur.
•
View services can render Windows-based documents,
including all standard business formats and specialized
formats such as TIFF.
Softheon offers a large library of pre-built connectors to many
commercial systems, such as Trizetto FACET, QNXT, Amisys DST,
HealthEdge, ikaSystems, MC400, EPIC and provide real-time,
bidirectional access to the native member and claims data stored in
these systems.
Copyright 2014. Confidential and proprietary information.
Page 4 of 8
Softheon MC2 for IT
The Softheon MC2 development platform provides all the
necessary tools needed to build and deploy distributed content and
process-centric solutions with complete user interfaces and client
applications.
The development platform includes .NET and J2EE components
that snap into any Web-based application, portals, and Web
Services API that provides a common object model and full
programmatic access to underlying content and workflow systems.
The .NET and J2EE components deliver the core library services
required within a content-oriented application.
Why Softheon?
For Health Plan Issuers:
• Makes relevant content accessible from one production
workflow application.
• Enables companies to achieve higher levels of automation
and business process continuity.
• Create custom workflows with subscription event services.
• Integrated workflows help streamline work processes,
improve visibility and coordination, and mitigate risk.
• Convergence between structured and unstructured
information in a complete information services layer.
• Spanning all distributed information domains helps
companies accelerate time to market, improve business
intelligence and reuse IT investments.
• Seamless, real-time, bidirectional access to the native
content and Metadata stored in many vendors’ systems.
• Turn disparate content repositories into a single, virtual,
searchable system.
• Single sign-on enables you to sign on once to multiple
underlying systems.
For Developers;
• Service-oriented architecture (SOA) becomes an essential
part of long term IT strategy.
• SOAP WSE 3.0 compliant web interfaces for Microsoft .NET
and J2EE.
Copyright 2014. Confidential and proprietary information.
Page 5 of 8
•
•
Delivers superset functionality that can be utilized across
multiple disparate content sources to create a unified
experience.
Quickly content-enables business applications with
component-based interfaces and a complete API.
Leverages out-of-the-box adapters to underlying content sources
and pre-built interfaces to key business applications, which enable
health plans to avoid recurring expenses and an ongoing
maintenance burden.
Copyright 2014. Confidential and proprietary information.
Page 6 of 8
About Softheon
Empowering the nation's first state health benefit exchange since 2008, Softheon's vision and strategic
direction address healthcare payer, provider, and government agencies’ goal of meeting Affordable
Care Act (ACA) milestones. Softheon provides solutions for interacting with Federal and State Health
Insurance Exchange (HIM) Marketplaces, while measurably reducing administrative costs, improving
member and provider satisfaction, as well as addressing regulatory compliance challenges in all
managed care administrative processes.
Softheon's Marketplace Connector Cloud (MC2) has been trusted by over 40 health plans as an
accelerated federal, state, and private exchange integration platform. Softheon MC2 is a Software-asa-Service (SaaS) solution where insurers pay a one-time activation and ongoing PMPM fees for
exchange members only, while eliminating most, if not all, risks associated with ACA compliance of
2014 enrollment and other mandates.
Copyright 2014. Confidential and proprietary information.
Page 7 of 8
For more information
please contact your
Softheon representative
or call us at
1.800.236.7941
Visit our Web site at:
www.softheon.com
© Copyright Softheon, Inc. 2014
Softheon, Inc. 1500 Stony Brook Rd, Stony Brook NY 11794
Softheon, Softheon MC2, Softheon ESB, Softheon BPM, Softheon
HSM, Softheon BAM, Softheon EDW are trademarks of Softheon,
Inc. in the United States, other countries or both.
.NET and all .NET-based trademarks are trademarks of Microsoft in
the United States, other countries or both. Java and all Java-based
trademarks are trademarks of Sun Microsystems in the United
States, other countries or both. Other company, product or service
names may be trademarks or service marks of others.
Copyright 2014. Confidential and proprietary information.
Page 8 of 8