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Company: Softheon, Stony Brook, NY
Nomination Submitted by: RH Strategic Communications
Company Description: Founded in 2000, Softheon’s Software-as-a-Service (SaaS) and Business Process-as-a-Service (BPaaS) solutions solve complex challenges for health plans and government health agencies. Currently, Softheon’s solutions serve eight State agencies and over 90 health plans utilizing Medicaid, Medicare, and the ACA Marketplace.
Nomination Category: Company / Organization Categories
Nomination Sub Category: Company of the Year - Health Products & Services - Medium
 Nomination Title: Softheon
- Which will you submit for your nomination in this category, a video of up to five (5) minutes in length about the achievements of the nominated organization since January 1 2020, OR written answers to the questions for this category? (Choose one):
Written answers to the questions
- If you are submitting a video of up to five (5) minutes in length, provide the URL of the nominated video here, OR attach it to your entry via the "Add Attachments, Videos, or Links to This Entry" link above, through which you may also upload a copy of your video.
- If you are providing written answers for your submission, you must provide an answer to this first question: Briefly describe the nominated organization: its history and past performance (up to 200 words):
Total 130 words used.
Softheon is a go-to partner for organizations within the health insurance industry who are looking for an agile, innovative solution to streamline critical processes so they can better serve customers. The company is extremely profitable, generating around $100 million in annual revenue and growing at around 20 percent year-over-year, on average. Notably, Softheon has managed this growth without any outside institutional investors. The company is regularly recognized with industry awards and in the past few years has ranked on the Inc. 5000 list multiple times and was named one of the fastest-growing private companies in the New York region in 2021. With over 20 years of experience, Softheon has stood the test of time amid an ever-changing healthcare industry and continues to set the bar on driving future industry transformations.
- If you are providing written answers for your submission, you must provide an answer to this second question: Outline the organization's achievements since the beginning of 2020 that you wish to bring to the judges' attention (up to 250 words):
Total 242 words used.
The healthcare industry transformed significantly in the last two years. More insurers have entered or re-entered the Affordable Care Act (ACA) Marketplace for the third year in a row, and health plans need an innovative and responsive partner to help navigate the complex, highly regulated ACA landscape. Softheon has proven to be that partner.
Softheon continuously pioneers innovative solutions to help health plans and government agencies create seamless experiences for their members and reduce administrative burdens. In the last year alone, the company helped insurers face an influx of 14.5 million news entrants through the ACA Marketplace in the 2021-2022 Open Enrollment period, and 30 million new entrants during the extended 2021 Special Enrollment Period (SEP). Softheon pivoted its operations rapidly to support the fast-paced change driven by the SEP, reducing or eliminating significant challenges with subsidy and enrollment reconciliation faced by many ACA plans.
Softheon bolstered its strategic partnerships in 2021, including helping AARP launch a new marketplace platform for members and the general public to explore health insurance options and extending its partnership with the Association for Community Affiliated Health Plans (ACAP) into its sixth year. Softheon continues to solve complex distribution and service challenges for ACAP’s not-for-profit health plans in their work to improve the health and well-being of people with low incomes.
Softheon also expanded its leadership team in 2021 by hiring a new Chief Information Officer and Chief Financial Officer to continue supporting its growth ambitions.
- If you are providing written answers for your submission, you must provide an answer to this third question: Explain why the achievements you have highlighted are unique or significant. If possible compare the achievements to the performance of other players in your industry and/or to the organization's past performance (up to 250 words):
Total 249 words used.
Softheon has become a leader in the cloud-based health insurance exchange through its innovative technology solutions, as evidenced by its ongoing partnerships with over 90 health insurance plans and eight state health insurance agencies. Since the Affordable Care Act’s inception, Softheon has impacted over 7 million unique individuals and processed more than $25 billion in premium payments.
By offering modular solutions designed to integrate with existing systems, Softheon reduces administrative burdens by streamlining critical processes in healthcare. Softheon’s rapidly adapting technology and agile approach to implementation enables clients to proactively respond to changing regulatory environments and consumer demand, making it a key partner over the past two-plus years of rapid change within the healthcare landscape.
Softheon’s technology has been recognized as a leading Software-as-a-Service (SaaS) and Business Process-as-a-Service (BPaaS) provider by market research companies like IDC as well as key health industry organizations such as America's Health Insurance Plans (AHIP), Association for Community Affiliated Plans (ACAP), and HealthCare Executive Group (HCEG).
Softheon’s customizable solution handles all regulatory and operational requirements associated with entering the ACA Marketplace, allowing large health providers to focus on ensuring that they are providing the best quality health plans to their members.
When access to healthcare has never been more crucial, Softheon’s user-friendly software delivers a convenient experience through decision support tools, robust payment options, customizable grace periods and automatic compliant member communication systems. Because of Softheon’s innovations, more individuals are able to access and keep their health insurance – leading to healthier populations overall.
- You have the option to answer this final question: Reference any attachments of supporting materials throughout this nomination and how they provide evidence of the claims you have made in this nomination (up to 250 words):
Total 228 words used.
Despite being over two decades old, Softheon is continuing to grow to meet the demand for its solutions, as proven by the addition of a Chief Financial Officer and Chief Information Officer in 2021.
One of the premier business growth indicators, Softheon’s appearance on the Inc. 5000 list is a testament to the growth it’s experienced over the last few years.
The unprecedented nature of the pandemic led to vast opportunities within the Affordable Care Act (ACA) Marketplace, resulting in rapid growth for Softheon as a key partner for seamless entrance.
Softheon’s broadened offerings are an key indicator of the continued innovation from employees who are motivated to work hard in pursuit of Softheon’s mission.
Softheon's growing number of strategic partnerships demonstrate sustained growth both within the company and in the industry as a whole.
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