Softheon

Softheon

Healthcare tech platform for insurance enrollment

Overview

Company Does Not Provide H1B Sponsorship

Softheon provides healthcare technology solutions for health insurers, government programs, state exchanges, and associations. Its platform includes eCommerce, eligibility checks, and enrollment tools designed to support the distribution and management of health plans such as ACA, Medicare, and Medicaid. The product helps insurers and government programs transform digital operations by automating and streamlining how plans are offered, enrolled, and paid for. Unlike narrower software providers, Softheon serves a broad base that includes health plans, government programs, brokers, and consumers, and it charges through subscriptions, transaction fees, and service agreements. The company is trusted by more than 60 health organizations and has managed millions of lives and processed billions of payments. The goal is to make healthcare more affordable, accessible, and plentiful by enabling efficient, scalable administration of health insurance.

About Softheon

Simplify's Rating
Why Softheon is rated
C
Rated C on Competitive Edge
Rated B on Growth Potential
Rated D+ on Differentiation

Industries

Government & Public Sector

Enterprise Software

Financial Services

Healthcare

Company Size

201-500

Company Stage

Seed

Total Funding

$200K

Headquarters

Town of Brookhaven, New York

Founded

2000

Simplify Jobs

Simplify's Take

What believers are saying

  • 22 Health launched Florida ACA marketplace using Softheon's enrollment platform in 2025.
  • HealthPartners adopted Phase III EDE solution to enhance Wisconsin ACA shopping experiences.
  • Community First selected ICHRA Connector Cloud December 2, 2025, expanding San Antonio access.

What critics are saying

  • Optum captures 60-80% ACA tech share from Softheon's clients within 12-24 months.
  • CMS 2026 EDE rules force Softheon's platform rebuilds, causing client loss in 3-6 months.
  • HealthSherpa v2.0 AI launch obsoletes Softheon's eligibility, driving churn in 6-12 months.

What makes Softheon unique

  • CITIZ3N subsidiary launched April 3, 2024, targets government ACA and Medicaid solutions.
  • Agentic AI automates 90% of workflows with human-in-the-loop compliance for health plans.
  • Named to TIME's Top HealthTech Companies of 2025 for ACA and ICHRA innovations.

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Funding

Total Funding

$200k

Below

Industry Average

Funded Over

1 Rounds

Seed funding is usually the first official round after pre-seed, when a startup has a prototype or concept. It’s typically used to develop the product, test the market, and start building the team. Investors here are often angel investors or early-stage venture capitalists.
Seed Funding Comparison
Below Average

Industry standards

$3.3M
$200k
Softheon
$1.5M
Slack
$2M
Netflix
$2.3M
Instacart
$3M
Robinhood

Benefits

Health Insurance

Vision Insurance

Dental Insurance

401(k) Retirement Plan

401(k) Company Match

Home Office Stipend

Phone/Internet Stipend

Wellness Program

Unlimited Paid Time Off

Parental Leave

Growth & Insights and Company News

Headcount

6 month growth

0%

1 year growth

2%

2 year growth

3%
PR Newswire
Feb 19th, 2026
22 Health launches ACA marketplace in Florida with Softheon technology support

22 Health, a provider-sponsored health plan serving Broward County, Florida, has launched its first Affordable Care Act marketplace plans using Softheon's technology platform. The launch marks 22 Health's entry into the health insurance marketplace following its first open enrolment period. 22 Health is a division of Community Care Plan, owned by Broward Health and Memorial Healthcare System, which has provided healthcare coverage to Florida families for 25 years through state-sponsored programmes. Softheon provided comprehensive support for the marketplace launch, including shopping and enrolment processes, payment and billing support, premium reconciliation, and compliance assistance. The healthcare technology company, founded in 2000, has 25 years of experience providing ACA marketplace solutions and currently serves over 100 health plans.

PR Newswire
Sep 26th, 2025
Softheon Named to TIME's World's Top HealthTech Companies of 2025

Softheon is recognized as one of the World's Top HealthTech Companies of 2025 by TIME.

PR Newswire
Sep 12th, 2024
Softheon Recognized in Multiple Gartner(R) Reports

Softheon has been named as a Sample Vendor in the Hype Cycle for Healthcare Data, Analytics and AI, 2024.

StreetInsider
Apr 27th, 2024
Human Augmentation Market to Cross USD 873.51 billion by 2031 | Ekso Bionics, Garmin, Vuzix, Google, B-Temia

Industry titans are actively patenting technologies, investing in promising startups, and engaging in strategic mergers and acquisitions like Softheon's acquisition of NextHealth technologies - underscoring the segments growth potential.

PR Newswire
Apr 3rd, 2024
Softheon Launches CITIZ3N, New Subsidiary Dedicated to Government Solutions in Healthcare

STONY BROOK, N.Y., April 3, 2024 /PRNewswire/ - Softheon, a leading cloud-based eligibility, enrollment, and billing provider for health plans and government agencies, today announces the launch of CITIZ3N, a subsidiary dedicated to revolutionizing government solutions in healthcare.

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