Softheon Information

Softheon builds the infrastructure behind modern health coverage. For more than 25 years, Softheon has helped health plans operate at scale across the most complex healthcare markets in the country. Our purpose-built SaaS and BPaaS solutions power the full coverage lifecycle, from shopping and enrollment to billing, payments, reconciliation, and ongoing member engagement. Today, one in three ACA health plans relies on Softheon, and our platform supports tens of millions of enrollments and billions in premium transactions across ACA Marketplaces, Medicaid, Medicare Advantage, and employer-funded models like ICHRA. What sets Softheon apart is not just technology, but execution. Our modular platform integrates with existing ecosystems, adapts quickly to regulatory change, and reduces administrative burden without sacrificing accuracy, compliance, or member experience. Health plans choose Softheon to modernize operations, control costs, and grow sustainably in highly regulated, margin-sensitive environments. Trusted by CMS and recognized by organizations including IDC, AHIP, ACAP, and HCEG, Softheon partners with mission-driven organizations working to expand access to affordable, high-quality coverage.