TLC Required for Private Exchange Success

Jay Mclauchlin

Jay Mclauchlin

With a successful—albeit rocky—inaugural open enrollment under its belt, the industry’s sights are now set on improving the 2015 experience and finding new ways to serve the flood of prospects entering the market.

Eight million enrolled in health insurance via the state and federal marketplaces during the 2014 open enrollment cycle. That number is expected to double during the next enrollment period, which opens Nov. 15. By 2020, the Congressional Budget Office projects that 25 million will purchase coverage through insurance marketplaces.

In fact, the Affordable Care Act (ACA) has created the largest expansion of healthcare coverage in half a century. This includes an estimated 20 million who will be driven to individual plans when their small business employers drop group coverage.

This represents a huge business opportunity for brokers and associations willing to roll out private exchanges to leverage the expanded prospect pool and greater cross-selling opportunities. Other benefits include higher revenues and revenue per customer and less time and effort per sale.

However, as we saw with the last enrollment period, success requires more than a website, a few plans and shopping cart. A profitable marketplace must deliver on consumer expectations for more benefit and carrier options, immediate pricing and product information and a simple enrollment process.

Live customer support is one of the most important features any private exchange can offer, something 72 percent of online consumers identified as a major influencer of their online shopping satisfaction. Real-time access to knowledgeable assistance is even more significant when it comes to individual insurance coverage, a complex process for even experienced shoppers.

Also important is a seamless, user-friendly experience. The easier an exchange is to navigate, the greater the likelihood customers will return and refer others. A private exchange with limited options or that requires an aggregator to compare multiple quotes in several locations will struggle with customer satisfaction and retention rates.

Technology-only private exchange offerings simply cannot deliver on these expectations. A strategic partnership with an industry leader can by providing access to the top carrier and product offerings, technical support, sales and marketing services, revenue models and flexibility required for success.

One such solution is MyConsumerLinkSM, an adaptable, reform-compliant e-shopping platform from HealthPlan ServicesSM (HPS) that makes it easy to cross sell a variety of benefit options from the nation’s top providers, 365 days a year. It offers everything one expects from HPS, including plans from multiple carriers, real-time access to a licensed sales support team, federal public exchange support and a highly-competitive revenue sharing structure.

It also offers automated trigger/lead nurturing emails. This is important. In the absence of nurturing, a whopping 79 percent of marketing leads fail to convert. According to MarketingSherpa, organizations that nurture leads experience a 45 percent lift in lead generation ROI. The Annuitas Group also notes that nurtured leads make 47 percent larger purchases than non-nurtured leads.

Private exchanges can be a lucrative venture for associations and brokers, or the risk can far outweigh the reward. The difference is the strategic partner entrusted to provide agile technology, varied and quality plan options and expert customer support from initial contact through the life of the policy—and beyond.

Click here or call 877-506-2164 for more information on MyConsumerLink.

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Posted in healthcare reform, insurance exchange, ObamaCare, Private Exchange | Leave a comment

Health Marketplaces for Associations—the Value Proposition

David Holton - Vice President Consumer Sales

David Holton – Vice President Consumer Sales and Health Marketplace Development

“The attraction to any Association—whether professional, social or political in nature—is directly proportional to shared interests and the value members are able to glean from their association.” That’s why the mission of these organizations is to deliver programs, services and resources that benefit members in a tangible way to build loyalty and increase Association visibility.

As the healthcare landscape continues to evolve into a more consumer-driven model, the ability for Associations to provide access to individual healthcare as a value-added benefit to their members will become increasingly difficult, but advantageous. Many carriers are stepping away from the Association Group option leaving Associations scrambling for a solution for their members.  The result: navigating this current and future healthcare landscape can be overwhelming for the members seeking Medical or Medicare options and other insurance products.

To address this need, many Associations are moving to a consumer-driven tailored Health Marketplace model, where members can quickly and easily access a specific menu of insurance products to shop, compare and ultimately purchase benefits. Health Marketplaces have been introduced into the industry as a flexible alternative to traditional health plan models, allowing offerings to be customized to fit the needs of a particular group.

The value proposition of Health Marketplaces for Associations is high; member groups are able to offer alternative health insurance options to its members while, at the same time, increasing value and loyalty to the group. Provided through a private link on an Association’s website, social media site or from target marketing these custom-branded Health Marketplaces can be set up where the members can simply research and purchase from a menu of offerings on their own time and at their own price they choose. And while the choice for a Health Marketplace offering should be an easy one, many Associations will not be able to dedicate the resources needed get this kind of initiative off the ground and maintain it for the long haul.

Associations will need to leverage the know-how of an experienced partner in this process. Recognizing this need, HealthPlan Services℠ has developed, MyConsumerLink℠, a comprehensive turn-key offering to address the complexities involved in setting up customized Health Marketplaces. From front-end licensed sales professionals and call center support to the technological platform required for back-end processes, the heavy lifting is already done.

Our experts simply work with Associations to design an offering that makes sense for their membership by allowing them access to a platform of fully-vetted Quality Health Plans, as well as dental, vision, life, Medicare and other supplemental products. As members access the Health Marketplace through a private link on the group’s website, skilled sales professionals take it from there. As partners in this process, the MyConsumerLink business model also allows avenues for Associations to generate additional revenue from advertising and marketing arrangements.

Click here for more information on MyConsumerLink or call 877-506-2164.

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Posted in health insurance, healthcare reform, insurance, insurance exchange, Private Exchange | Tagged | Leave a comment

Go-To-Exchange Completes Federal, State Marketplace Transaction Testing

Dennis Prysner – Senior Vice President, Healthcare Reform

HealthPlan Services™ (HPS) is maintaining its lead as the race to open Insurance Marketplaces nears the home stretch. In July, we successfully completed point-to-point transaction testing of our Go-To-Exchange™ platform with the Federally Facilitated Marketplace and several State-Based Marketplaces—a milestone few others have achieved.

As one of just five companies (and the only non-health plan) selected by CMS to participate in its “Early Adopter” program, HPS was among the first Marketplace participants allowed to test with the federal government. Thus, while some health plans are still gearing up, we have already completed initial connectivity testing between our Go-To-Exchange Platform and CMS, including transactions specific to our carrier partners.

A precursor to user tests with real data, point-to-point tests demonstrate that the Go-To-Exchange platform’s technical connections and file formats are compatible with state and federal insurance Marketplaces. In addition to the Federally Facilitated Marketplace, Go-To-Exchange has successfully tested enrollment transactions with Covered California, Connect for Health Colorado and Maryland Health Connection.

Testing is now underway with actual enrollment data, which will be the first transactions that take place beginning Oct. 1 when Marketplaces officially opens for business. Completion will mark another significant milestone, as it demonstrates our ability to exchange data from the Marketplace Shop, Compare, and enroll process, into HPS, and back to the Marketplace.

Being among the first to successfully complete transaction testing is an important demonstration of the technical capabilities of our Go-To-Exchange Platform and provides our carrier clients with an edge in their Marketplace readiness strategy.

For those carriers that are lagging behind on readiness, achieving these significant milestones also validates that Go-To-Exchange is the proven solution that can keep them off the Marketplace sidelines. Through Go-To-Exchange, we resolve the issues around configuring products and operational processes. Our reform-ready ServiceLink℠ platform handles core administration, while ExchangeLink℠ establishes connections with the government entities and our carrier partners to carry out critical member and financial management functions.

These early successes validate HPS’ focus on delivering proven yet flexible processes and solutions that overcome the challenges of participating in multiple Marketplaces—success our carrier client can leverage for rapid deployment and ongoing management of their own effective Marketplace strategy.

Contact us today to leverage the expertise of HealthPlan Services’ Go-To-Exchange solution, or to find out more about how we can help ramp up and administer a profitable exchange for your business.

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Posted in health insurance, Healthcare, healthcare reform, insurance, insurance exchange, Private Exchange | Leave a comment

Private Exchanges and Affinity Groups—the Value Proposition

David Holton - Vice President Consumer Sales

David Holton – Vice President Consumer Sales

The attraction to any affinity group—whether professional, social or political in nature—is directly proportional to shared interests and the value members are able to glean from their association. That’s why the mission of these organizations is to deliver programs, services and resources that benefit members in a tangible way to build loyalty and increase brand visibility.

As the healthcare landscape continues to evolve into a more consumer-driven model, the ability of affinity groups to provide access to healthcare as a value-added benefit will become increasingly advantageous. Navigating the current and future healthcare landscape can be overwhelming for the average consumer seeking Medicare options, private health plans and other insurance products.

To address this need, many groups are moving to a consumer-driven private exchange model, where members can quickly and easily access a tailored menu of insurance products to shop, compare and ultimately purchase their insurance benefits. Private exchanges have been introduced into the marketplace as a flexible alternative to traditional health plan models, allowing offerings to be customized to fit the needs of a particular group.

The value proposition of private exchange/marketplaces for affinity groups is high; member groups are able to offer alternative health insurance options to its members while, at the same time, increasing value and loyalty to the group. Provided through a private link on an organization’s website, these custom-branded private exchange/marketplaces can be set up where the members can simply research and purchase from a menu of offerings on their own time and at their own price they choose. And while the choice for a private exchange/marketplace offering should be an easy one, many affinity groups will not be able to dedicate the resources needed get this kind of initiative off the ground and maintain it for the long haul.

Affinity groups will need to leverage the know-how of an experienced partner in this process. Recognizing this need, HealthPlan Services℠ has developed, MyConsumerLink℠, a comprehensive turn-key offering to address the complexities involved in setting up customized private exchange/ marketplaces. From front-end licensed sales professionals and call center support to the technological infrastructure required for back-end processes, the heavy lifting is already done.

Our experts simply work with affinity groups to design an offering that makes sense for their membership by allowing them access to a platform of fully-vetted Quality Health Plans, as well as dental, vision, life, Medicare advantage, PDP, Medicare supplement and other supplemental products. As members access the exchange through a private link on the group’s website, skilled sales professionals take it from there. As partners in this process, the MyConsumerLink business model also allows avenues for affinity groups to generate additional revenue.

Click here for more information on MyConsumerLink or call 877-506-2164.

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Posted in health insurance, healthcare reform, insurance, insurance exchange, Private Exchange | Leave a comment

Taking a Seat at the Private Exchange Table

Jay Mclauchlin

Jay Mclauchlin

The introduction of private exchanges as a new alternative in the marketplace offers a unique opportunity for agents to position themselves competitively for the future. In the wake of uncertainties and fears over how public exchanges will impact customer base and revenue streams, agents should consider how to leverage a private exchange offering to their best advantage.

Currently, employers of all shapes and sizes are looking for solutions through this new business model. It’s no wonder since industry projections suggest that by 2020, exchanges will be the main channel for purchasing health insurance for as many as 30-46 million people. As employers continue to face annual double-digit rate increases from carriers, many are moving towards offering a “defined contribution” as opposed to a “defined benefit” health plan. Under this scenario, employees would be given a set dollar amount and with a private exchange vehicle, choose health coverage that best fits their circumstance. Agents proactively working to develop private exchange capabilities should view this as a huge emerging-market opportunity.

The reality is that agents play a key consultative role in the sales process, and there is no reason why new market conditions should diminish or minimize this role. Who knows the consumer better than the agent, and who is better equipped to design and communicate the value of an exchange to employers or a particular demographic?

Agents with limited resources may be overwhelmed by the prospect of trying to establish a private exchange that can truly compete against larger players. And the reality is that most may not be equipped to offer the technological infrastructure, sales support and advanced consumer tools that will be needed to be successful.

That’s why agents will need a partner in this process. HealthPlan Services℠ has already identified the need for comprehensive turn-key offerings to address the complexities involved in setting up a private exchange. Our new MyConsumerLink℠ is a custom-branded private exchange that offers agents access to a full suite of top-name products, front-end sales and call center support as well as the technological infrastructure required to help agents successfully compete in this important market.

By leveraging a third-party private exchange infrastructure, like MyConsumerLink.com, agents are able to take advantage of HealthPlan Services’ established relationships with a variety of strong carriers and develop a flexible exchange that will display products that make the most sense for their customers. A unique web-based offering is created with the agent in mind, clearly defining the private exchange as a value-added service to clients and providing a method for establishing loyalty. As important, HealthPlan Services’ signature sales and call center support is always there as a back-up—to answer questions, provided guidance and help close the sale.

Private exchanges offer inherent advantages to agents who desire to stay competitive, and the complexities of getting one off the ground should not be a deterrent for maintaining future viability. Agents who leverage the inherent advantages of MyConsumerLink℠ offering can expect to improve their business outlook and lay a foundation for future success in the market.

Learn how MyConsumerLink can give you a competitive private medical insurance exchange solution.
Click or call 877-506-2164.

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Posted in healthcare reform, insurance exchange, ObamaCare, Private Exchange | Leave a comment

With less than 221 Days to Go, Procrastination over Exchanges Must End

Dennis Prysner

With open enrollment in state and federal insurance exchanges slated to begin Oct. 1, carriers that remained mired in the strategic planning stage are headed into dangerous territory. Unless they move quickly into the execution phase, it is highly unlikely that they will meet the timelines for Qualified Health Plan (QHP) submission and approval and interface testing for each exchange they have targeted for participation.

After two years of wrangling and uncertainty culminating in a Supreme Court decision and presidential election, the clock has run down to less than 221 days. It’s not going to stop until the exchanges open. Whether or not a carrier is ready depends entirely on how quickly they can get their technologies, plans and processes in place.

The best option now for carriers that do not want to stand by and let the first open enrollment period go by without their plans in the mix is to outsource execution of exchange readiness plans to a qualified partner—one that didn’t wait for the dust to settle before putting solutions in place that will accelerate entry into state and federal exchanges.

Going it alone means carriers have a very short window of time to build out their technical infrastructures, secure QHP approval, and deploy the processes required to connect, recruit, manage and retain customers acquired through state and federal exchanges. On the other hand, an experienced outsourcing partner can speed deployment and reduce costs by eliminating the barriers to entry with “plug-and-play” solutions that address the comprehensive administrative and technical requirements of multiple exchanges.

Carriers need a partner with a scalable, powerful platform that integrates seamlessly with state and federal exchanges. It should be an end-to-end solution that combines well-established technology and business processes with industry best practices and advanced web-based technologies. Prospective partners should also have in place relationships that ensure its services can scale appropriately in response to expected demand fluctuations in the early days of open enrollment.

The time for planning has passed. Carriers that aren’t yet executing their exchange strategies risk losing the substantial investments they’ve already, made as well as future profits from what is expected to be a very lucrative market. Teaming up with the right outsourcing partner ensures that exchange programs are done right the first time, even at this late date.

Contact us today to leverage the expertise of HealthPlan Services’ Go-To-Exchange solution, or to find out more about how we can help ramp up and administer a profitable exchange for your business.

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Posted in health insurance, healthcare reform, insurance, insurance exchange, ObamaCare, Private Exchange, state exchange, state insurance exchange | Leave a comment

Post-Election, State Insurance Exchange Planning Must Accelerate

Jeff Bak

The outcome of the 2012 presidential election eliminated many of the immediate uncertainties surrounding implementation of the Patient Protection and Affordable Care Act (ACA)– and the state health insurance exchanges that are integral to expanding access to coverage under the law. For HealthPlan Services (HPS), President Obama’s victory and the Democrat’s retention of Senate control means the gamble we took pushing forward with an exchange solution, despite nagging industry uncertainty, will ultimately pay off for our clients.

Exchange deadlines are rapidly approaching. Carriers are under enormous pressure to build the technical infrastructures and put in place the administrative processes necessary connect, recruit, manage and retain customers acquired through state exchanges.

While other organizations waited in the wings, HPS focused on eliminating barriers to entry into the potentially lucrative exchange market. We deployed our IT resources and industry expertise to create a toolset and playbook that allows carriers to quickly ramp up state exchange operations. The end result is our Go-To-Exchange™ strategy, an innovative platform that provides comprehensive management of the administrative and technical needs of health plans participating in state exchanges, speeding deployment and reducing costs.

The Go-To-Exchange technology framework provides carriers with an end-to-end solution that combines proven technology and business processes. It leverages industry best practices and advanced web-based technologies to deliver a scalable, powerful platform that integrates seamlessly with state exchanges and provides comprehensive management of health plans’ administrative and technical needs.

But we didn’t stop there. We also have established relationships with other strategic partners that, if needed, will help ensure rapid ramp-up and response to the sharp volume fluctuations many anticipate when exchanges open on October 1, 2013.

By working with a qualified partner like HPS, even those carriers that have delayed exchange planning won’t be left on the sidelines. Our Go-To-Exchange strategy lets them launch quickly, effectively and compliantly—regardless of how many states they have targeted for exchange participation.

Contact us today to learn more about our Go-To-Exchange strategy.

Posted in health insurance, Healthcare, healthcare reform, insurance exchange, ObamaCare, Reform Rebate, state exchange | Leave a comment

The Private Exchange Myth: They’re Not Just for Insurance Companies

David Holton - Vice President Consumer Sales

David Holton - Vice President Consumer Sales

It’s time to bust a myth: Insurance companies aren’t the only ones that can benefit from private insurance exchanges and the growth in consumerism.

Large firms, employers, professional associations and affinity groups can all stake a claim in the private exchange market by “private labeling” online portals to sell off-exchange health plans containing the new Essential Health Benefits (EHBs), as well as Medicare and ancillary products.

The secret to success is teaming up with a partner that offers a truly turnkey solution focused on providing an exceptional customer experience.

Designed to engage consumers in coverage decisions, private exchanges are the ideal channel for increasing loyalty as a leading-edge retention strategy. They are essentially online retail outlets that have outgrown the sterile confines of the insurance industry. Private exchanges allow shoppers to browse, seek guidance, compare costs and benefits and ultimately purchase medical, Medicare, dental and vision plans, as well as ancillary options and advanced benefits, online from organizations with which they have established trusted relationships.

The challenges have always been the high cost of establishing private exchanges, as well as the requisite carrier relationships, technical infrastructure and deep administrative capabilities to manage education, enrollment and underwriting and ongoing customer support. Today, those barriers are being eliminated by a small but growing number of existing insurance portals that can be “re-skinned” and marketed under the employer’s, association’s or firm’s brand.

One example is MyConsumerLink(SM), a turnkey private exchange solution built upon HealthPlan Services’ proven technologies, data-driven customer acquisition and retention programs and robust “e-tail” style analytics.

For example, using the MyConsumerLink Roadmap the employer, association or firm directs its employees or customers to a link on the organization’s website which takes them to the custom-branded exchange site. Here, they can access a variety of plan types and styles as well as education and research tools for personalized guidance. The experience appears seamless to the user, who is connected to a powerful technical infrastructure, licensed and highly experienced agents and always-on customer support before, during and after enrollment.

It’s a level of service that would not otherwise be financially feasible for employers and associations.

The upfront costs of a private label exchange are minimal. The typical arrangement provides a landing page explaining the site and available coverage, various pages to provide independent lines of coverage options, quote engine, results page and enrollment application. In the case of MyConsumerLink, it includes guided-selling features that provide examples of what peers have purchased and a comprehensive array of education, research and consulting tools to ensure a positive customer experience.

Partnering with MyConsumerLink lets employers, associations and firms leverage the strength of their own brand to efficiently and affordably tap into the private exchange market while increasing revenues through strengthening employee/member loyalty.

Find out more about private exchanges with MyConsumerLink!

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Reaching Seniors Aging into Medicare Coverage

Anne Maria Faria - Chief Marketing and Sales Officer

Anne Maria Faria - Chief Marketing and Sales Officer

According to the U.S. Census Bureau, 35,000 baby boomers turn 65 every month —a number that is sending daily Medicare applications skyrocketing. Indeed, baby boomers and seniors are not only part of the fastest-growing population, they are also the most affluent consumer group, controlling more than 48% of all discretionary purchases.

Carriers have a unique opportunity to reach this growing and lucrative demographic – one that spends nearly $2 trillion on goods and services each year – as they age into Medicare. However, to do so effectively, they must update their marketing strategies and product lines to better serve seniors seeking Medicare coverage.

According to a recent study conducted by LIMRA, “Advisor Perspectives on Retirement Planning,” many advisors have already begun adjusting their approach to seniors entering retirement. Among the most common changes are introducing new products or services (44%), obtaining special training (32%), adding professional staff (21%), changing platform or practice models (15%) and launching new websites or making major additions to existing web pages (15%).

For carriers intent on reaching the Medicare market, the most impactful marketing strategy will be providing seniors with a single resource dedicated to helping them make the right insurance decisions for themselves and their families.

Medicare can be a complex and confusing process, particularly for seniors sorting through multiple options for the first time. Carriers seeking to reach this lucrative market should leverage the power of the eTail model by launching a web-based, direct-to-consumer sales channel that provides aging-in seniors with convenient access to the information, research tools and personalized guidance they need to select the right plan or plan combinations for their individual needs.

A prime example of this model is benefit crossroads. Its success lies in its ability to provide seniors with an easy way to educate themselves on Medicare. They can tap into the expertise of licensed and Medicare-certified experts who can help them identify specific plans to meet their exact needs and even enroll online.

The benefit crossroads platform brings together HPS’ proven technologies, data-driven customer acquisition and retention programs and industry-leading customer support in a single online portal where consumers can self-select plans and complete enrollment online.

In addition to robust, retail-style analytics, research, education and purchasing tools, benefit crossroads is backed by a team of licensed insurance agents who are available to consult with consumers, prepare customized packages and provide ongoing member support services. Agents are specially trained and AHIP-certified in Medicare and senior marketing to ensure customers receive the support they need in the manner they are comfortable receiving it. This consultative approach has been proven to increase customer satisfaction while resulting in a higher issue rate than market average.

But benefit crossroads goes beyond the technical requirements. It also provides its sales agents with “senior-specific” training to help all generations  come together to achieve the common goal of meeting the customer’s needs.

Notes David Holton, vice president of customer sales for benefit crossroads:  “For twenty- and thirty-something agents, it’s not always easy to relate to the needs of our senior customers. Therefore, we provide specialized training to help them better connect with the customer,  understand what they are experiencing and offer them the best solutions possible.”

A unique branded-partnership opportunity, benefit crossroads is a turnkey, cost-effective solution for carriers seeking to launch a direct-to-consumer sales channel and maximize the revenue potential of the lucrative and growing senior market.

Visit benefit crossroads for further information.

 

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Supreme Court Ruling Creates New Urgency for Carrier Exchange Planning

Jeff Bak

If you hoped that the Supreme Court would send ObamaCare packing, your dreams were dashed last week with its 5-4 ruling upholding the Patient Protection and Affordable Care Act (ACA). Now, that ticking sound you hear is the clock running down to the Oct. 1, 2013 launch of the state insurance exchanges created under the ACA—and the date by which carriers must have their exchange strategies in place and be compliant with the new QHP mandate.

For carriers that waited to begin preparations, all is not lost despite the fast-approaching deadline. HealthPlan Services took a chance on the fate of the ACA and dedicated our IT resources and expertise to creating a toolset and playbook that lets carriers quickly ramp up state exchange operations—taking the guesswork out of both planning and participation.

That gives our carrier clients a considerable advantage over the competition, because while the Supreme Court ruling lay to rest any uncertainty over the future of state insurance exchanges, it did not eliminate the challenges to participation. As we’ve noted in previous posts, there are four main issues confronting carriers in terms of exchange strategies: 1) varying operational models, 2) inconsistent technical interface capabilities, 3) management of multiple data interfaces, and 4) management of multiple entities.

The clock is ticking. Much work must be done if carriers are to have the QHPs (qualified health plans) and technical infrastructures in place when open enrollment launches in a mere 16 months.

A smart strategy…one that promises to simplify processes, speed deployment and reduce upfront and ongoing costs…is partnering with an outsourced service provider capable of streamlining the interfacing and information sharing. The best partner is one that can offer a “plug and play” solution to connecting with exchanges, and provide access to systems and processes designed to ease the burden of managing and complying with multiple reporting, billing and plan management requirements.

One such turnkey solution is HealthPlan Service’s Go-To-Exchange strategy, an innovative technology platform that provides comprehensive management of the administrative and technical needs of health plans participating in state exchanges. A critical technology component is ExchangeLink, which facilitates the technical connections necessary to link carriers to exchanges.

Go-To-Exchange and ExchangeLink leverage HPS’ active ongoing engagement with industry groups and state and federal agencies to stay informed on the technology needs required for exchange connections. They reflect the firm’s thought leadership around the complexities of exchange integration and QHP administration, which have positioned HPS as a leader in reform readiness.

By outsourcing to a qualified partner like HPS, carriers can ramp up exchange activities quickly and effectively, while keeping internal resources focused on core activities to maximize profitability.

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