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Gain confidenceHealth Insurance Exchange (HIX) audits

Assessing and eliminating risk for a more secure and effective exchange 

Our risk-based audit approach focuses on the controls with higher risk and streamlines testing to provide you with an efficient process to achieve compliance. Based on best practices, professional judgment, and collaboration with clients, we assess the risk of potential noncompliance impacts.

We keep abreast of the latest updates to audit program requirements and federal regulations to help ensure our clients are in compliance with Title 45, Code of Federal Regulation, Part 155 (45 CFR 155).

Our Health Insurance Exchange (HIX) audits provide you with: 

  • Insight on potential program weaknesses and high-risk areas, including eligibility and self-attested data verification 
  • Practical and attainable improvement recommendations 
  • Support to remediate audit findings  
  • Guidance on new processes and controls to keep you current on the latest compliance updates 

Every state-based HIX is required to have an audit by an independent entity
We bring perspective from working with nearly half of the State-Based Marketplace (SBMs) across the country, including Massachusetts' Health Insurance Connector Authority (Connector), Minnesota's Health Insurance Marketplace (MNsure), Nevada's Silver State Health Insurance Exchange (SSHIE), Pennsylvania's Health Insurance Exchange Authority (Pennie), Rhode Island's Health Benefits Exchange (HealthSource RI), Vermont Health Connect (VHC), and Washington Health Benefits Exchange (WAHBE).

To learn more, please contact our HIX audit team.  

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