Softheon

United States – November 02, 2026 -- Marketplace insurers are proposing a median 15% premium increase for 2027, and Softheon is offering health plans a free 20-minute consultation to find operational bottlenecks before open enrollment (OE) volume peaks.

Carrier exits could send hundreds of thousands of members shopping for coverage

Carrier exits and footprint changes mean hundreds of thousands of Marketplace members could be shopping for new coverage in 2027. Changes across Marketplace and public coverage programs could also bring consumers into OE with more questions about eligibility, subsidies, affordability and where to find coverage.

Minnesota – October 30, 2026 -- UCare, a nonprofit Minnesota health plan, recovered $2.1 million in additional advance premium tax credit (APTC) reimbursements after partnering with Softheon to replace manual shopping, enrollment and billing processes.

Manual processes had blocked UCare's On-Exchange scaling and Off-Exchange entry

UCare said manual workflows in shopping, enrollment and billing limited its ability to scale On-Exchange operations. The same constraints held back its expansion into the Off-Exchange market. UCare turned to Softheon to address both the scalability problem and the time-consuming manual work, with the aim of improving its health plan offerings and member experience.

APTC reconciliation accuracy rose 2.5%, driving the $2.1 million gain

The 2.5% improvement in APTC reconciliation accuracy produced the $2.1 million in extra reimbursements, the largest financial result UCare reported.