Assembling...
npx arkitekton add HC-109ACA eligibility engine implementing MAGI-based income calculation, Medicaid/CHIP threshold checks, and QHP eligibility determination per 45 CFR 155.305.
| Control | CMS-EDE |
|---|---|
| Eligibility Determination | |
| Magi Income Calculation |
Pre-built solutions that include this construct. Deploy a complete application to Studio.
EDE Enrollment Platform
Complete Enhanced Direct Enrollment platform for ACA marketplace integration. Includes identity proofing (RIDP), eligibility determination, plan quoting, APTC calculation, and 834 enrollment submission — fully compliant with CMS EDE requirements.
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End-to-end claims adjudication and processing hub with X12 EDI parsing, eligibility verification, medical coding (ICD-10/CPT), fraud detection, and claims status tracking. Designed for payers and TPAs.
Revenue Cycle Management
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Dental Practice Suite
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EDE Phase 1 Basic Portal
Minimum viable EDE platform for CMS Phase 1 approval with identity proofing, basic eligibility, plan display, and enrollment submission for simple applicant scenarios.
EDE Phase 3 Full Platform
Comprehensive EDE Phase 3 platform with full eligibility determination, APTC/CSR calculation, DMI/SVI resolution, document upload, consumer notices, and multi-language support for all applicant types.
EDE Renewal Operations Platform
Annual renewal and redetermination operations platform with passive renewal automation, active renewal workflows, income re-verification, consumer notice orchestration, and CMS reporting.
These constructs have compatible ports for seamless integration.
Good overall, but the learning curve is a bit steep for junior developers. Once you get past that, it is incredibly powerful.
Production-ready out of the box. We deployed to 12 microservices without a single compatibility issue. Highly recommended.
The variant system is a game-changer. Being able to swap between compact and full versions without code changes is brilliant.
Meets all our compliance requirements. Passed our SOC 2 audit without any flags related to this construct.
Clean architecture and zero unnecessary dependencies. This is how every construct should be built.
ark add HC-109// No variant available for standard size
No code variants available yet
Variants for Eligibility Determination are coming soon