TPA services for self-funded employers

Benefits worth staying for.

Most plans burn the premium. We name it. Every employee watches a balance with their name on it grow, sees the posted price before care, and pays with one card. Nobody quits a benefit that keeps getting better.

Same self-funded structure. Same stop-loss. Everything underneath changes.

Member Portal Money overview: total balance, monthly money in, interest, deductible met, and the twelve-month activity chart

Screens are the real Member Portal and app, shown with sample data.

The annual renewal

Every September, the same drill. Negotiate. Cut. Apologize. Repeat.

$26,9931

the average family premium in 2025, employer and employee combined

+26%1

increase in that premium over the last five years

34¢2

of every healthcare dollar spent on administration, not care

1. KFF Employer Health Benefits Survey, 2025. 2. Himmelstein et al., Annals of Internal Medicine, 2020, share of U.S. health spending on administration.

Your employees’ premiums vanish into a carrier’s pool. Nothing builds. Nothing stays. There is a better architecture, and it starts with what the money does.

What Your Employees Experience

Sarah's skin check, step by step.

This is what a health plan feels like when the money has your name on it. No claims department. No paperwork. A 30-minute doctor visit that takes 30 minutes. Every screen is the real app, on sample data.

Hypothetical example for illustrative purposes.

Step 1 of 8 · SEE

Sarah notices a mole that changed shape

She wants a dermatologist to look at it. So she picks one. Any one. No network, no referral, no permission. Dr. Patel, Tuesday, 10am.

Price Shop: posted prices near her zip, with a dermatology skin exam from $185

Traditional Insurance

1.Call insurance to verify coverage
2.Check if provider is in-network
3.Get a referral from primary care
4.Wait for prior authorization
5.See the doctor (finally)
6.Get a bill weeks later
7.Wait for the Explanation of Benefits
8.Dispute the charge you don't recognize
9.Pay whatever they decide
Time spent on insurance: 3+ hours

Enough! Health

Pick any dermatologist you want
Ask for the published self-pay price
See the price upfront: $185
Get your skin check
Tap your Care Approved Card
Provider paid same day
What you don't spend stays in your Reserve
Time spent on insurance: 0 minutes

Simple enough that HR never gets a phone call. Named enough that nobody wants to leave it behind.

For HR

What HR stops doing.

Simple enough that HR never gets a phone call. The left column is the job today. The right column is what happens instead.

Six weeks of renewal negotiation every fall
One monthly contribution you set. No renewal, no repricing.
Cutting the dental rider to hold the line
Nothing to cut. The plan design does not reset in January.
Fielding "is this in network?" calls
Any provider at its posted price. The app answers before they ask.
Explaining dependents, tiers, and EOBs
Their Care Circle is in the app. A Care Event Summary replaces the EOB.
Chasing claims and denials for employees
A Member Advisor is the first line, not your HR generalist.
Form 5500, SPD and SMM, MHPAEA analysis, RxDC
Owned by the administrator. You review and sign.
Member Portal: a family plan with the plan holder, spouse, and two children

The family is in the portal, with tiers and ages, so nobody has to explain “dependent” to anyone.

The Care Approved Card in the app, front
The Care Approved Card in the app, back, with member name and ID

The Care Approved Card

The card is the plan.

Most of what a claims department does today happens at the point of sale, from the plan’s own coverage rules. Every transaction creates a verified record.

Any provider
Any provider accepting its own published price is in-network by definition. There is no network to fall out of.
Paid in 24 to 48 hours
The provider's published rate, paid at card speed. No claim forms. No prior authorization.
The right pocket pays
Health dollars, Reserve, then the plan's claims fund, automatically. One swipe: adjudicated, paid, proven.

$0 spent on claims clearinghouses and prior-auth machinery. Card issuance begins this October.

The proof

Bring us twelve months of claims. We’ll reprice every line.

A benchmark is a claim. A measurement is a fact. We would rather show you your own plan against posted prices than promise you a percentage.

  1. 1

    Send the claims file

    Twelve months of claims from your current administrator. We sign an NDA first.

  2. 2

    Get the repricing analysis

    We reprice every line at the posted price for the same service in your market. You see it line by line.

  3. 3

    Decide with your own numbers

    No benchmark, no projection. A measurement of your plan against published prices. The first meeting and the analysis are free.

What your people get

Does not feel like insurance. Feels like an app that works.

Posted prices on a map, a balance with their name on it, one card, and a person to call. Cards, app and named balances are live on day one.

Price Shop: posted prices near you
Posted prices before care
App home with the Reserve balance
A Reserve with their name on it
The Care Approved Card in the app
One card, no claim forms

Plan options

One architecture. Three ways in, in order.

  1. Available now

    TPA services

    Third-party administration for self-funded plans of any size. Your stop-loss, your PBM, our administration. One flat, fully disclosed PEPM. No spread pricing.

    Details →
  2. Coming next

    Captive group plan

    Pooled risk for employers of 100 to 1,000 on the same architecture.

    Details →
  3. Coming next

    ICHRA

    Individual coverage HRA for employers of 25 to 250 who want defined contribution with the same app and card.

    Details →

Enough! Health is not a retirement account, investment vehicle, or brokerage product. The Reserve is a health plan feature, not a securities product.

Questions plan sponsors ask

Before the first call.

Do we change our stop-loss or PBM?
No. Your stop-loss and your PBM stay yours. We administer the plan underneath them.
What does the Reserve cost us?
You set a monthly contribution per employee. It funds a balance in the employee's name that pays for care and rolls forward. It is plan money, not compensation, and it is not an investment product.
What happens to an employee's Reserve if they leave?
It stays usable for care under the plan's spend-down rules. It never disappears into a pool.
How long does implementation take?
Assess, contract, migrate, go live. Most employers are nine to twelve months out from a first meeting to a January 1 effective date, and cards, app and named balances are live on day one.
Who talks to our employees?
A Member Advisor, one tap from any screen in the app. Your HR team is not the help desk.
Which states?
TPA services are offered to self-funded plans nationally under ERISA. Tell us your state on the form and we will confirm licensing for your group.

Tell us about your group.

Employer or broker, headcount, and state. We reply within one business day with whether we can serve your group and what the repricing analysis needs.

No newsletter. One reply from a person.