Marpai Health
Marpai Health is a U.S. Third Party Administrator that uses its AI-powered SMART platform to administer self-funded employer health plans, in-house PBM (MarpaiRx), and cost-containment modules for small and mid-market self-funded employers and their brokers.
- Company typePublic
- Founded2019
- HeadquartersNew York, United States
- Headcount51–100
- GTM typeB2B
- OfferingServices
What Marpai Health does
Marpai Health is a U.S.-based Third Party Administrator (TPA) for self-funded employer health plans, operating nationwide through its operating entity Marpai Administrators LLC (headquartered in Tampa, FL) under the publicly traded parent Marpai, Inc. (OTCQX: MRAI, formerly Nasdaq until May 2024). The company administers health, COBRA, dental, and vision benefits, processes over 500,000 claims annually, and serves employers through both direct enterprise field sales and a broker/consultant channel, with named flagship network partnerships including Aetna and Cigna. Its target customers are mid-market and small (under 100 lives) self-funded employers seeking to lower health plan costs relative to fully insured arrangements.
Marpai's product surface is built around its proprietary SMART Health Plan Services System, which combines machine learning and rule-based claims automation with a member-facing portal/app (myMarpai/GoMarpai) and predictive clinical routing. Layered modules include MarpaiRx, an in-house Pharmacy Benefit Management solution with flat-fee pricing and rebate pass-through; PACCS, a performance-based specialty pharmacy savings program; Marpai Connect, a value-based care network that enrolls high-risk members into value-based clinical programs; an out-of-network claims repricing engine (Firefly/Marpai Repricing Insights); a price transparency/medical shopping tool (integrated with myMedicalShopper); and the Marpai Vitality Plan, a tailored offering for small employers.
Marpai generates revenue primarily through recurring TPA administration fees per member/employee, PBM (MarpaiRx) unit and shared-savings pricing, performance-based PACCS economics, and stop-loss placement. The company is currently sub-scale and unprofitable (Q1 2026 revenue of $4.4M, down from $5.4M in Q1 2025; net loss of $3.2M; operating loss of $2.5M), but is executing a cost-reduction program (10% YoY cost decline to $6.9M in Q1 2026) and has secured ~192,000 incremental committed member lives for rollout between August 2026 and January 2027, targeting run-rate profitability in H2 2026. Growth has been funded through a series of post-IPO capital raises including a $7.4M public offering (2023), $11.83M convertible notes (2024), $3.9M PIPE (2025), and multiple smaller insider/private placements including a CEO loan, against a market capitalization of approximately $11.6M as of late March 2026.
Marpai Health firmographics
Firmographics- Name
- Marpai Health
- Legal name
- Marpai Administrators LLC
- Website
- https://marpaihealth.com
- Company type
- Public
- Founded year
- 2019
- Operating status
- Operating
- Headcount range
- 51–100 employees
- Short description
- Marpai Health is a U.S. Third Party Administrator that uses its AI-powered SMART platform to administer self-funded employer health plans, in-house PBM (MarpaiRx), and cost-containment modules for small and mid-market self-funded employers and their brokers.
- Ownership category
- akta.pro rank
Marpai Health industry classification
Industry- Product category
- Third-Party Healthcare Plan Administration (TPA)
- NAICS
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)
- SIC
- Hospital & Medical Service Plans (6324), Accident & Health Insurance (6321)
- akta.pro primary industry
- Self-Funded Employer Plan TPA (ASO Administration) (HLAEALAA)
- akta.pro secondary industry
- Dental & Vision Third-Party Administration (TPA) (FSAIAHAL)
Keywords
Where Marpai Health is headquartered
LocationHeadquarters
- HQ city
- New York
- HQ country
- United States
- HQ region
- North America
Offices3 records
Markets served
Marpai Health business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Technology or R&D, Personnel, Operations, Marketing or Sales, Infrastructure
Revenue model
- TPA Administration Fees: Recurring per-member/per-employee administrative fees for health, COBRA, dental, vision, and compliance plan administration; Marpai states its services come at the same administration fee as a standard TPA while delivering more value.
- MarpaiRx PBM Revenue: Pharmacy Benefit Management revenue from in-house PBM services including flat-fee pricing, eligible rebates passed to employers, specialty and mail-order pharmacy, and 60,000-pharmacy network access.
- Stop Loss Solutions Revenue: Revenue from A+ Stop Loss solutions with up to 20% premium savings via competitive quotes from leading carriers, plus captive solutions and Specialty RBP quotes; per-broker quote-based engagements.
- Cost Containment & Repricing Services: Revenue tied to cost containment programs including out-of-network repricing, reference-based pricing, subrogation, and Pharmacy Advocacy Cost Containment Solution (PACCS); some programs feature shared-savings economics where employers pay a portion of generated savings.
- Value-Based Care Network Revenue (Marpai Connect): Recurring revenue from value-based contracts with clinical programs that enroll high-risk members; aligns with member outcomes and chronic-condition cost reduction.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Multi-year contract | TPA administration: same flat fee as a standard TPA with enhanced AI and member services |
| Unit Pricing | Pay-as-you-go | MarpaiRx PBM: flat fee per claim with rebates passed to employers |
| Outcome Based/ Performance | Pay-as-you-go | PACCS specialty pharmacy savings: pay only a portion of savings when generated |
| Other | Annual | Stop Loss: quote-based via broker request form |
| Subscription | Annual | Marpai Vitality Plan: tailored package for small employers under 100 employees |
Go-to-market motion5 records
Distribution channels4 records
Marketing channels10 records
Marpai Health product offering
Product offeringCore offering
Marpai Health is an AI- and machine learning-powered Third-Party Administrator (TPA) for self-funded employer health plans, administering health, COBRA, dental, and vision benefits through the proprietary SMART Health Plan Services System. It also delivers an in-house Pharmacy Benefit Management solution (MarpaiRx), specialty pharmacy savings via PACCS, out-of-network claims repricing, a value-based care network (Marpai Connect), and a member-facing myMarpai portal and GoMarpai mobile app, serving employers and brokers nationwide.
Product overview
Marpai Health operates a single integrated AI-powered Third-Party Administration platform built around its proprietary SMART Health Plan Services System, augmented by distinct branded modules and sub-products. The core offering is Marpai TPA Services, the full-service Third-Party Administrator for self-funded employer health plans, which is delivered together with the myMarpai Portal and GoMarpai App member experience, SMART Claims Processing, the Marpai Connect value-based care network, the Marpai Repricing Insights / Firefly out-of-network repricing solution, and the myMarpai Medical Shopping Tool. Layered on top is MarpaiRx, Marpai's in-house Pharmacy Benefit Management sub-brand, supported by the PACCS pharmacy advocacy cost-containment module. The Marpai Vitality Plan is a dedicated sub-product within the platform tailored to small employers with under 100 employee lives. Together, these products share Marpai's underlying machine-learning and deep-learning SMART platform, which powers claims automation, predictive cost and outcome modeling, anomaly detection for fraud and abuse, and personalized member guidance.
Differentiator
Problem solved
Functional benefit
Brands
- MarpaiRx: In-house Pharmacy Benefit Management (PBM) solution offering transparent pricing, rebate pass-through, and a network of 60,000 in-network pharmacies.
- Marpai Vitality
- Marpai Connect
- myMarpai
- GoMarpai
- PACCS
Products and services
- Marpai TPA Services (Third-Party Administration) Full-service AI-powered Third-Party Administrator for self-funded employer health plans, administering health, COBRA, dental, and vision benefits, SMART claims processing, plan design, compliance, and analytics. Operates nationwide through Marpai Administrators LLC with affiliated licensed administrators in select states.
- MarpaiRx (In-house Pharmacy Benefit Management) In-house Pharmacy Benefit Management offering flat-fee pricing, eligible rebates passed to employers, 60,000-pharmacy nationwide network, 88.84% Generic Dispensing Rate, in-house specialty and mail-order pharmacy, and integrated pharmacy savings programs. Targets self-funded employers and brokers.
- Marpai Vitality Plan Self-funded health plan built exclusively for small employers with under 100 employee lives, offering simplified implementation and comprehensive coverage including medical, dental, vision, COBRA, PBM, utilization management, out-of-network repricing, care management, and stop-loss placement.
- myMarpai Portal and GoMarpai App Member-facing portal and mobile application available on Apple iOS and Android, branded GoMarpai, providing digital health ID card, benefits view, deductible and spending tracking, claims review, provider search, family care management, telehealth access, and the myMarpai Medical Shopping Tool.
- PACCS (Pharmacy Advocacy Cost Containment Solution) Member-centric pharmacy savings program delivering up to 75% savings on specialty and high-cost medications. Employers pay only a portion of savings when generated, with integration to Marpai Care Management.
- Marpai Repricing Insights (Firefly OON Repricing) Out-of-network claims repricing solution offering up to 60% savings on OON claims, with HIPAA-compliant platform, industry-leading price reference database, Medicare Plus and Cost Plus methodologies, supplemental provider network with pre-negotiated rates, and in-house rapid claims resolution.
- A+ Stop Loss Solutions Stop Loss solutions for self-funded employer plans with up to 20% reduced premiums via competitive quotes from leading A+ rated carriers, captive solutions, and Specialty RBP quotes; delivered via the broker channel.
- Marpai Connect Value-Based Care Network Proprietary value-based care network that proactively identifies and enrolls high-risk, expensive members into established clinical programs operating under value-based contracts, with the goal of improving outcomes and reducing chronic-condition expenses.
- Care Management Services In-house nurse-led, multi-disciplinary care management services including Utilization Management, Case Management, Acute Care Management, and Chronic Care Management, guiding members 1:1 across the care continuum to avoid unnecessary, overpriced, excessive, and inappropriate care.
Quantifiable outcome
- Up to 60% savings on out-of-network claims via proprietary repricing engine
- +7 more outcomes
Companies that use Marpai Health
Customer profileNamed customers1 record
Segments5 records
Ideal customer profiles3 records
Marpai Health technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration1 record
AI capability8 records
Feature10 records
Marpai Health partnerships and signals
Strategic signalPartnerships
Seven partnerships are on record, tiered core, flagship and moderate.
- Healthcare solutions provider (3-year strategic marketing collaboration)coreThree-year strategic marketing agreement to promote MarpaiRx pharmacy benefit management services nationwide across self-insured employer groups and third-party administrators; emphasizes transparency, clinical outcomes, cost savings, and shared savings initiatives to support Marpai's profitability goal.
- Network representing up to 1.5 million covered livescoreMarketing agreement that grants Marpai access to a network representing up to 1.5 million covered lives, expanding MarpaiRx across the United States and significantly increasing the addressable market for healthcare solutions among large employer groups and healthcare organizations.
- Maestro HealthcoreMarpai, Inc. (MRAI) acquired Maestro Health for $22.1 million, with payment scheduled for April 1, 2024. The deal includes minimum payments over four years and aims to integrate the companies to reach positive EBITDA within 18 months; Millennium Trust subsequently acquired Maestro Health's Consumer Directed Benefits business in December 2023.
- AetnaflagshipPremier national provider network partner offering self-funded employer plan members access to top-quality care nationwide. Marpai has earned top quality marks from Aetna in claims processing, and renewed a key network access agreement with Aetna in 2025, adding the Aetna Faircost Optimizer to enhance cost containment for self-funded plans.
- CignaflagshipPremier national provider network partner providing self-funded employer plan members access to top-quality care nationwide; Marpai has earned top quality marks from Cigna in claims processing.
- The Phia GroupmoderateAdam Russo, Founder and CEO of The Phia Group, is quoted endorsing Marpai's claims-focused approach on the brokers page. Phia Group operates in claims cost containment and is referenced as a partner focused on stopping waste, abuse, fraud and neglect in claims dollars.
- Nielsen Benefits GroupmoderateEd Ligonde, Executive Vice President of the Nielsen Benefits Group, is quoted endorsing Marpai's AI- and member-centric TPA model on the brokers page; benefits broker using Marpai for self-funded employer clients.
Scale indicators22 records
Recent moves6 records
Expansion highlights6 records
Marpai Health competitors and assessment
Company assessmentDirect peers
- Collective Health: Tech-enabled third-party administrator for self-funded employer health plans, combining AI-driven navigation, integrated PBM, and member experience apps. Closely comparable to Marpai in target market (self-funded employers) and tech-led positioning.
- Capital Rx: Technology-first pharmacy benefit manager operating on a transparent flat-fee model with claim adjudication software (Judi). Directly comparable to MarpaiRx's flat-fee, rebate pass-through positioning and broader tech-led TPA ambitions.
- RxBenefits: PBM that partners with benefits consultants and TPAs to serve self-funded employer plans, including specialty drug management. Comparable to MarpaiRx's broker-channel distribution into self-funded employer plans.
- Imagine360: Reference-based pricing-focused TPA for self-funded employer health plans with cost containment programs. Closely aligned with Marpai's RBP, OON repricing, and savings-driven value proposition for self-funded plans.
- Gravie: Tech-enabled health benefits marketplace built around self-funded plans for small and mid-sized employers, with simplified administration and member experience. Comparable to Marpai Vitality's small-employer self-funded focus.
- Accolade: Personalized healthcare navigation and benefits platform sold primarily to self-funded employers via brokers and HR teams. Comparable to Marpai's member-centric, AI-driven engagement and broker channel for employer plans.
- OneDigital: Employee benefits consulting, brokerage, and TPA services firm that administers self-funded health plans for mid-market employers. Comparable as both a competitor TPA and a distribution channel for Marpai's services.
- HealthSCOPE Benefits: Third-party administrator specializing in self-funded employer health plans with custom plan design, claims administration, and cost containment. Direct competitor to Marpai in the self-funded TPA segment.
- WellDyneRx: Independent, mid-market-focused PBM serving self-funded employer plans and health plans, with transparent pricing and specialty pharmacy offerings. Directly comparable PBM; notably, Marpai's CFO previously served as CFO of HillCour, which controlled WellDyneRx prior to its sale to Carlyle.
Broad incumbents
- MedImpact Healthcare Systems: Large independent pharmacy benefit manager serving health plans, TPAs, and self-funded employers. Comparable to MarpaiRx as a PBM serving the self-funded channel, but with broader scale and more limited transparency positioning.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks7 records
Key highlights7 records
Customer concentration
Marpai Health social profiles
Digital presenceMarpai Health compliance and trust
Trust signalCompliance2 records
Marpai Health financial estimates
Financial estimateRevenue estimate
Valuation estimate
Marpai Health leadership team
Management profileNumber of profiles
Profiles4 records
Marpai Health subsidiaries and ownership
Company hierarchySubsidiaries6 records
Marpai Health funding detail
Funding detailFunding overview
Funding rounds6 records
Investors3 records
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Marpai Health M&A and investment
M&A and investmentM&A2 records
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Marpai Health
What does Marpai Health do?
Marpai Health is an AI- and machine learning-powered Third-Party Administrator (TPA) for self-funded employer health plans, administering health, COBRA, dental, and vision benefits through the proprietary SMART Health Plan Services System. It also delivers an in-house Pharmacy Benefit Management solution (MarpaiRx), specialty pharmacy savings via PACCS, out-of-network claims repricing, a value-based care network (Marpai Connect), and a member-facing myMarpai portal and GoMarpai mobile app, serving employers and brokers nationwide.
Is Marpai Health a public or private company?
Marpai Health is a public company. It is classified as public and is currently operating.
When was Marpai Health founded?
Marpai Health was founded in 2019. It employs 51 to 100 people.
Where is Marpai Health based?
Marpai Health is headquartered in New York, United States, in the North America region.
How does Marpai Health make money?
Five revenue lines are on record. TPA Administration Fees are the primary driver. The others are marpaiRx PBM Revenue, stop Loss Solutions Revenue, cost Containment & Repricing Services and value-Based Care Network Revenue (Marpai Connect).
Who are Marpai Health's main competitors?
Direct peers on record are Collective Health, Capital Rx, RxBenefits, Imagine360, Gravie, Accolade, OneDigital, HealthSCOPE Benefits and WellDyneRx. MedImpact Healthcare Systems is listed as a broad incumbent.
Does Marpai Health have an API?
No public API is recorded for Marpai Health.
What industry is Marpai Health in?
Marpai Health's product category is Third-Party Healthcare Plan Administration (TPA). Its primary akta.pro industry code is HLAEALAA, Self-Funded Employer Plan TPA (ASO Administration), with a secondary code of FSAIAHAL, Dental & Vision Third-Party Administration (TPA). Its NAICS code is 524292 and its SIC code is 6324.