Enrollment and eligibility determination will be a critical part of the entire Health Exchange setup. State agencies and insurers will be required to track and maintain enrollment records, terminations, verifications and fulfillment.

WebInsure State Eligibility and Enrollment solution makes all these tasks simple and efficient. Our solution helps insurers send and receive all enrollment related information to and from exchange. Information about all enrollments, dis-enrollments, terminations and renewals are communicated to the insurer through Exchange Manager.

The WebInsure State Eligibility & Enrollment module is a complete Eligibility & Enrollment solution for individual, families, small employers and employees that is available as a part of WebInsure State solution or as a stand-alone solution.

Salient Features – Individual & Family

• Determine their eligibility to Medicaid, CHIP, Basic health plan, Exchange plans and Federal subsidies
• Determine their eligibility to exemption from individual mandate
• Save eligibility information
• Enroll self and family through filing an electronic application with the health insurer or state agency
• Submit applicants' verification documents online
• E-sign the application
• Track application status
• Print semi-filled application& fill it in by hand to submit it offline
• Submit paper application via e-mail or fax
• Pay via credit card, bank transfer, PayPal, check, or Health Reimbursement Accounts (HRAs)
• File for life status changes
• Manage renewals

Salient Features - Employers

• Determine their eligibility to Exchange
• Determine their eligibility to federal tax credits
• Set up employee enrollments
• Manage employee eligibility
• Decide cost sharing between employee and employer
• Configure related products (dental, vision, life, etc.) a business may want to offer its employees
• Manage renewals & terminations
• Manage employee information and benefits
• Make changes to enrollments if required
• Track enrollments by employees
• Brand employee enrollment portal with employer logo, company name, contact details, etc.
• Manage bills & payments

Salient Features - Employees

• Enroll themselves and their family members in plans for which they are eligible for
• Track their enrollment status online
• Add/Remove family members upon life changing events such as marriage, child-birth, death, adoption, etc.
• Make changes to their enrollments during annual enrollment periods
• Manage terminations and renewals
• Pay via credit card, bank transfer, PayPal, check, Health Reimbursement Accounts (HRAs) or Health Savings Accounts (HSAs)