The Project:
NFP Health launched its first public exchange Premium Billing system for the State of Rhode Island on October 1st, 2013, and was one of the few state exchanges to bill successfully. It was also one of the country’s only Financial Management systems to support the SHOP and Individual marketplace from day one.
Following a successful launch, NFP Health partnered with the State to run the Call Center & Sales team for the State’s SHOP exchange and became responsible for reconciliation between the carriers and Integrated Eligibility System.
To boost sustainability, NFP began promoting and selling ancillary benefits for the SHOP exchange in 2017.
In 2019, NFP Health replaced the State’s legacy SHOP enrollment portal and carrier interfaces, making NFP the end-to-end SHOP solution for HSRI.
The Results:
- One of the few individual exchanges to launch successfully at the start of ACA in 2013
- Replaced the State’s SHOP legacy system in less than one year
- Overhauled the reconciliation processes to reduce error count dramatically and improve overall efficiency
- Continually meet accuracy standards for billing and invoicing for SHOP and Individual markets
- Executed clean yearly SOC audits since 2014
- Sell and promote ancillary benefits to improve the sustainability of the Exchange
HealthSource RI
