The Project:
In the fall of 2021, NFP Health launched a replacement SHOP exchange for the State of California (Covered California for Small Business). We provided the State with a front-end eligibility and enrollment portal and back-end premium billing to support the Exchange.
The front-end portal was designed to serve a diverse audience, allowing employers, employees, agents, general agents, and administrators to conduct new business, renewals, maintenance transactions, and general account management. The portal included several new features, including:
- Decision support for plan selection
- Options for paper or paperless notifications
- WCAG 2.1 Level AA compliance
Additionally, NFP Health built Covered California a customized financial management system to support exchange functions, including:
- Delinquency process management
- Payment processing
- Carrier payment
- Agent/general agent commissions
- Reporting
In addition to these platforms, NFP Health provides Covered California with experienced enrollment and financial operations staff to oversee all daily, weekly, and monthly jobs and an escalation team to resolve all customer-related exceptions.
The Results:
- NFP navigated and delivered a complex data migration that included three years of enrollment and financial data
- NFP integrated with the following entities:
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- Five medical carriers
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- Four dental carriers
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- California State Controller’s Office
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- Bank of America
- From its inception in 2021, NFP Health has grown CCSB’s membership by approximately 15%
Covered California
