Platform

Rely on GoHealth’s proven architecture and experience to power the online purchase and administration of health coverage.

Components

The GoHealth Private Exchange solution includes the following components to create a full-service operation for offering defined contribution and purchasing health insurance:

  • Employer Portal - Employers define contributions, customize benefits portfolio, and track employee activity.
    • Create HRA plan designs, manage contributions and configure employee date of eligibility to receive benefits
    • View reports on employee participation, financial exposure, etc.
    • Download approved claim information for employee reimbursement
  • Employee Portal - Employees can search, compare and enroll in health plans in addition to managing ongoing administration of qualified claim submissions for reimbursements.
    • Manage personal information and qualified dependents
    • Download documents by plan period
    • View quotes and enroll in plans through an integrated online apply process
    • Submit claims to be reimbursed for qualified health expenses
    • View employer contributions
    • Access guided shopping support to make sure a plan selection is the right fit
  • Claims Administration Portal - Management of claims queues by the GoHealth claims staff
    • Claims portal manages approval/denial of HRA claims submitted by employees
    • Reports on claim submissions, approval rates, and documentation requirements
    • The employer no longer has to administer group enrollment, changes, etc.
  • Broker Portal - Dedicated or third party agents can assist throughout the setup and enrollment process.
    • Move or setup employers currently offering group benefits to the platform
    • Assist employers with setup
    • Help navigate employees through the shopping, enrollment and claims submission process
    • Outsourced call center agents, such as GoHealth licensed agents, can log into the broker portal to provide assistance throughout the process to both employers and employees

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