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Under 65 Individual Quoting API

Fully insured medical and ancillary quoting infrastructure

Carriers

Traditional brokers and WBEs are leveraging multi-carrier quoting technology to improve their productivity and better serve their clients. Carriers do not have to build quoting/rating APIs to gain representation on these platforms. Vericred brings your rating algorithms, base rates, factors, business, and rounding rules into our Platform and delivers individual and family quotes through an API to our InsurTech partners.

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InsurTech

With Vericred’s Individual Rating API, you can build a medical and ancillary quoting solution without building and maintaining your own rating engine and the underlying data. Our individual rating API supports shop-by-doc and shop-drug and returns subsidy estimations.

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Key Attributes

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Robust Functionality

Our Individual Quoting API is more than just plan and rate data – it includes all of the logic around plan availability, rate build-up, and subsidy estimations as well as supporting shop-by-doc and shop-by-drug.

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Multiple Lines of Coverage

In addition to ACA Medical, our Individual Rating API delivers dental and vision quotes with other lines of coverage coming.

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Robust Inventory

Our Individual Quoting API includes all ACA carriers and plans including CSRs, on-exchange and off-exchange, FFM states, and SBM states. We also deliver dental and vision plans from select carriers.

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Normalized Benefits

Building an apples-to-apples experience for brokers, employers, and employees is hard if the same benefit design is presented three different ways by three different carriers. We developed a Bakus-Naur Form (BNF) context-free grammar to apply to all benefit presentations. This allows for consistent presentation of benefits across carriers.

Use Cases

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Broker Quoting

If you are building a broker-facing quoting solution, our ACA Individual Quoting API includes everything you need to power a robust quoting experience with or without decision support.

Shop-by-Doc

Provider centric search is as easy as passing us provider NPIs (we power your search), and we’ll return who’s in and who’s out for each returned plan.

Subsidy Calculations

The API returns subsidy estimations based on household income and size.

Shop-by-Drug

Pass us drug IDs (we’ll help you here too), and we’ll return what drugs are covered by each plan and at what tier level.

Anonymized Asset Links

We provide anonymized links to SBCs and carrier logos hosted on our CDN.

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Digital Brokers (WBEs)

If you are standing up a Web Based Entity, our ACA Individual Quoting API includes everything you need to power a robust consumer experience with or without decision support.

Shop-by-Doc

Provider centric search is as easy as passing us provider NPIs (we power your search), and we’ll return who’s in and who’s out for each returned plan.

Subsidy Calculations

The API returns subsidy estimations based on household income and size.

Shop-by-Drug

Pass us drug IDs (we’ll help you here too), and we’ll return what drugs are covered by each plan and at what tier level.

Anonymized Asset Links

We provide anonymized links to SBCs and carrier logos hosted on our CDN.

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Exchanges

If you are standing up a private exchange, our ACA Individual Quoting API includes everything you need to power a robust consumer experience with or without decision support.

Shop-by-Doc

Provider centric search is as easy as passing us provider NPIs (we power your search), and we’ll return who’s in and who’s out for each returned plan.

Subsidy Calculations

The API returns subsidy estimations based on household income and size.

Shop-by-Drug

Pass us drug IDs (we’ll help you here too), and we’ll return what drugs are covered by each plan and at what tier level.

Anonymized Asset Links

We provide anonymized links to SBCs and carrier logos hosted on our CDN.

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ICHRAs

ICHRAs are hot, and our Individual Quoting API powers both employer decision support solutions (especially when paired with our ICHRA Affordability Calculator) as well as employee shopping experiences.

Shop-by-Doc

Provider centric search is as easy as passing us provider NPIs (we power your search), and we’ll return who’s in and who’s out for each returned plan.

Subsidy Calculations

The API returns subsidy estimations based on household income and size. For small groups considering shifts to ICHRAs, potential employee subsidies may inform whether the employer builds an affordable ICHRA or an “unaffordable” ICHRA.

Shop-by-Drug

Pass us drug IDs (we’ll help you here too), and we’ll return what drugs are covered by each plan and at what tier level.

Anonymized Asset Links

We provide anonymized links to SBCs and carrier logos hosted on our CDN.

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Lead Generation

The value of an individual health insurance lead increases as you move the prospect down the funnel. Our Individual Quoting API includes everything you need to power a robust experience guiding the individual to the right plan.

Shop-by-Doc

Provider centric search is as easy as passing us provider NPIs (we power your search), and we’ll return who’s in and who’s out for each returned plan.

Subsidy Calculations

The API returns subsidy estimations based on household income and size.

Shop-by-Drug

Pass us drug IDs (we’ll help you here too), and we’ll return what drugs are covered by each plan and at what tier level.

Anonymized Asset Links

We provide anonymized links to SBCs and carrier logos hosted on our CDN.

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Case Study

See how health insurance marketplace Gravie saves hundreds of hours of manual data collection annually by integrating with Vericred’s individual quoting API.

API Calls and Response

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API Calls

  • Individual/family location
  • Age & tobacco status of covered individuals
  • Household income (optional)
  • Preferred doctors (optional)
  • Prescription drugs (optional)
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API Response

  • Available plans
  • Plan benefits
  • Plan premiums
  • Subsidy estimation
  • Providers in and out of each plan’s network
  • Prescription drugs covered by each plan

Individual Rating API Documentation

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