When considering setting up an individual exchange, you want a competitive feature set, industrial strength security and unparalleled UX—all for a cost that will help grow your bottom line. Historically, this has been a challenge for everyone from states to carriers. With a few years of the Affordable Care Act under its belt, the market is re-evaluating its technology spends and is searching for a better, less costly solution.
I’ve had countless conversations about what makes an exchange solution viable and competitive. Here are 11 features that are always top of mind for the success of any exchange:
- Security. Your exchange needs to meet state and federal standards and regulations to ensure sensitive data is protected. As an example, at GetInsured, our applications adhere to the “defense-in-depth” principle and are architected to secure information at the data-element level, where security is the strongest possible. Since our founding a decade ago, GetInsured has never suffered a security breach or HIPAA violation. These are the security qualities you want to look for in an exchange provider. You also want to ensure that you’re in compliance with the information security standards and controls of the National Institute of Standards and Technology (NIST).
- Flexible architecture. If we’ve learned nothing else over the last few years, we’ve learned that priorities, rules and requirements change. Not only that, the way consumers digest information is constantly evolving and you need a system that can easily respond to changing times without costing an arm and a leg.
- Integrated provider and formulary search. Simplicity is the name of the game. Integrating provider and formulary searches into the shopping flow allows consumers to look up information all in one place and see how their preferences apply to the plans they are considering, instead of having to search in separate directories.
- Connectivity. If you’re looking to offer on-exchange plans, your system will need to seamlessly integrate with healthcare.gov—something that not everyone has mastered. You also want to ensure that your partner can easily interoperate with other systems that carriers, like you, rely on.
- Configurability. Completely custom exchanges have priced their way out of the market, but there’s still room to create a unique and branded exchange through configuration. If you select a highly configurable platform, you can tailor the exchange to your brand and business needs.
- Plan Management. Your system needs to be able to move large amounts of data quickly and reliably. You should be able to upload plans and turn them on and off which allows you to cater to the season and your business’s changing needs – all without touching a line of code.
- Intuitive, comprehensive UX. Fantastic back-end features are great, but being able to walk your consumer through the shopping process in an easy-to-understand way is critical. Market research has consistently shown that most people do not understand insurance terms, so they don’t always understand what they are shopping for and what the plans actually include. Having an interface that guides your shoppers through the process and adequately explains insurance terminology will lead them to make better decisions, and ultimately greater satisfaction with the plans they purchase.
- Bundled ancillary shopping and enrollment. Add-ons like vision, dental and accident medical plans can improve lifetime value of customers and increase your retention rates year after year.
- Flexible electronic application options. This allows you to configure your applications to produce the output you desire, such as PDFs or XML files.
- Agent/Broker portals. Your producers are a huge part of what keeps your business going. Having portals tailored to their needs will help to enhance and streamline their sales processes.
- APIs. Build your own user interface with APIs that work with federal tax credit calculations in addition to your plan, formulary and provider data.
Given what we’ve learned over the years, including the above, we’ve built the GetInsured Marketplace for Carriers to not only meet essential market demands—but exceed them. Our award-winning user interface will delight your customers, and our pricing with delight your accounting team. If you’re ready to start or revamp your individual exchange, let’s talk.