GetInsured provides a cloud‑native SaaS platform that automates end‑to‑end health‑insurance enrollment for state marketplaces and private insurers. The solution uses microservices, AI‑driven eligibility and plan‑matching, and integrated consumer assistance tools, with FHIR‑compatible APIs and HIPAA‑compliant security. It also includes analytics dashboards and managed implementation services to shorten time‑to‑market and lower total cost of ownership.
Funding
Funding not disclosed
Founders
Product
Problem
State and private health programs often rely on legacy, on‑premise systems that are costly to maintain, difficult to scale, and lack integrated consumer support, leading to delayed enrollment launches and poor user experiences for millions of beneficiaries.
Solution
GetInsured delivers a cloud‑native, SaaS health‑insurance exchange platform that automates the end‑to‑end enrollment workflow for state‑based marketplaces and private insurers. The solution combines a microservices architecture with AI‑driven eligibility and plan‑matching tools, enabling rapid configuration and real‑time scalability. Integrated consumer assistance center operations and project‑management services ensure seamless enrollment, compliance with CMS requirements, and coordinated carrier onboarding. Secure, API‑first design supports FHIR and other standards for data exchange with Medicaid, Medicare, and legacy systems, while built‑in analytics dashboards provide operational insights and performance‑based reporting. By offering a fully managed implementation model, GetInsured reduces time‑to‑market and total cost of ownership for public and private health programs.
Target Audience
Primary customers are state health agencies operating state‑based marketplaces and private insurers or health exchanges that require a modern, scalable enrollment platform with integrated consumer support.
Features
- Cloud‑based exchange engine built on AWS with containerized microservices for high availability and elastic scaling
- AI‑powered eligibility verification, plan recommendation, and subsidy calculation to accelerate enrollment decisions
- Integrated consumer assistance suite (call‑center UI, chat, self‑service portal) with omnichannel routing and performance dashboards
- End‑to‑end implementation services: requirements gathering, system configuration, carrier integration, CMS certification support, and post‑launch operations
- Secure data handling with HIPAA‑compliant encryption, role‑based access controls, and audit logging
- Open APIs supporting FHIR, X12, and custom data feeds for Medicaid, Medicare, and private payer integrations
- Real‑time reporting and analytics dashboards for enrollment metrics, cost tracking, and KPI monitoring
- Performance‑based contract framework that aligns fees with enrollment volumes and service level outcomes