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
B-
Rated B on Competitive Edge
Rated B on Growth Potential
Rated C 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

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Simplify's Take

What believers are saying

  • 22 Health launched Florida ACA plans on Softheon in February 2026.
  • Softheon launched CITIZ3N in April 2024, widening government healthcare software reach.
  • HealthPartners and other carriers keep adopting Softheon for direct enrollment and marketplace operations.

What critics are saying

  • ACA subsidy expiration in 2026 lifts premiums, hurting enrollment and Softheon transaction volume.
  • Marketplace concentration leaves Softheon exposed if CMS rules or exchange standards change quickly.
  • Iver? no, no layoffs or funding disclosed; private-company opacity complicates diligence and exit timing.

What makes Softheon unique

  • Softheon’s ACA Marketplace Cloud unifies enrollment, billing, payments, and member management.
  • KLAS March 2026 rated Softheon above software average; 100% respondents would buy again.
  • NextHealth acquisition added AI analytics, expanding Softheon beyond marketplaces into care management.

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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

-2%

1 year growth

0%

2 year growth

0%
PR Newswire
Jul 22nd, 2026
CITIZ3N Government Solutions now available through GSA Multiple Award Schedule.

CITIZ3N Government Solutions now available through GSA Multiple Award Schedule. Jul 22, 2026, 09:00 ET Contract streamlines access for eligible state and local agencies and broadens CITIZ3N's reach across government STONY BROOK, N.Y.,, July 22, 2026 /PRNewswire/ - CITIZ3N Government Solutions, a technology provider for government agencies overseeing health benefits, announced it has been awarded a General Services Administration (GSA) Multiple Award Schedule (MAS) contract, giving government agencies a more efficient way to procure the company's technology solutions. In January 2026, CITIZ3N was listed among the Medicaid technology vendors working with CMS and GSA on an expedited path to the GSA Schedule. The contract is expected to have its most immediate impact at the state and local level, where eligible agencies can use an established cooperative purchasing path to acquire qualifying solutions. The award makes CITIZ3N's technology available through a trusted, federal contract vehicle, creating a foundation for growth with federal agencies and prime contractors. Available through the GSA MAS are CITIZ3N solutions designed to address specific operational needs across Medicaid, Health & Human Services, State-Based Marketplaces, and government health benefits: * CITIZ3N Verify Engage: Helps state Medicaid agencies administer community engagement requirements through automated verification, exemption workflows, member reporting, outreach, documentation, and audit-ready reporting. The solution integrates with existing eligibility systems. * CITIZ3N Verify Eligibility: Automates identity, residency, income, employment, and asset verification to reduce manual work, accelerate eligibility decisions, and improve accuracy. * CITIZ3N Verify FWA (Fraud, Waste, and Abuse): Uses data analysis, risk assessment, and scoring to identify potentially suspicious activity, strengthen program integrity, and help reduce fraud, waste, and abuse. * CITIZ3N State-Based Marketplace solutions: Provides modular shopping, enrollment, payment, data, and administrative capabilities that can integrate with existing exchange systems or operate as an end-to-end marketplace platform. Government agencies are under increasing pressure to improve operational efficiency and respond to evolving program requirements across Medicaid, Health Insurance Marketplaces, and other government health programs. For example, recent research from CITIZ3N found that more than one in four Medicaid participants are unsure whether upcoming community engagement requirements apply to them, highlighting one of the operational and communication challenges states face as they prepare for the January 1, 2027, community engagement implementation deadline. By making its solutions available through the GSA MAS, CITIZ3N gives eligible agencies an established path to acquire technology while reducing procurement friction. "Agencies are under pressure to implement new programs and policy changes on aggressive timelines, often while working across multiple systems and complex procurement processes," said Rob Miller, General Manager of CITIZ3N. "Our GSA Multiple Award Schedule contract gives eligible state and local agencies a more efficient way to procure the technology they need and expands our accessibility to federal agencies and prime contractors. Agencies can spend less time on procurement and more time delivering services to the people who depend on them." CITIZ3N, a subsidiary of healthcare technology company Softheon, develops integrated, modular platforms that help government agencies modernize operations without replacing existing systems. To learn more about CITIZ3N and its solutions available through the GSA Multiple Award Schedule, visit www.CITIZ3N.com. About CITIZ3N CITIZ3N Government Solutions is a premier provider of integrated, modular platforms specifically tailored for government agencies overseeing Affordable Care Act (ACA) Marketplaces, Medicaid, Health & Human Services (HHS) and Government Health Benefits for Employees. The collaboration between CITIZ3N and Softheon epitomizes a shared vision of promoting innovative solutions that enhance affordability, accessibility, and efficiency, thereby fostering healthier citizens. For more information on CITIZ3N's solutions, visit www.CITIZ3N.com. SOURCE CITIZ3N

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.

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