Yuzu Health

What Yuzu Health does

Yuzu Health is a vertically integrated third-party administrator (TPA) that provides claims processing, payments, and plan management infrastructure for self-funded employer-sponsored health insurance plans. Founded in 2022 in New York by Max Kauderer, Ryan Lee, and Russell Pekala, the company has built an in-house technology stack from the ground up to replace legacy TPA systems running on 20–30+ year-old codebases. The platform comprises a proprietary claims adjudication engine, a custom auto-ledgering payments infrastructure, and member systems that together form a single source-of-truth data model, supplemented by a configurable Benefits Builder for plan design and white-labeled portals for employers, members, providers, brokers, and vendors.

Yuzu serves seven distinct customer segments — health plan disruptors, ASOs/carriers, brokerages, direct primary care practices, health systems, HR platforms/PEOs, and underwriters (MGUs and captives) — through a horizontal segmentation approach. The company operates on a recurring managed-services revenue model priced per-employee-per-month (PEPM), with multi-year contracts and no disclosed add-on fees or vendor markups. As of July 2025, the platform supported 10,592 active members across all 50 U.S. states and had facilitated over $1 billion in cumulative claims payments. Distribution combines direct enterprise sales (with regional sales directors covering GA, FL, NY, IL, and MA), a broker and partner-designer channel leveraging white-label capabilities, and self-serve inbound web entry points, with roughly 50% of business sourced from warm referrals.

The company has raised $40 million in total venture funding, including a $35 million Series A announced April 6, 2026, co-led by General Catalyst and Chemistry, with participation from Anthropic's Anthology Fund, Menlo Ventures' Anthology Fund, Bain Future Back Ventures, Timeless Ventures, Lachy Groom, and Neo. Proceeds are earmarked to expand the engineering team, scale the platform across all 50 states, and invest in additional products built on top of the system-of-record (pricing, real-time payments, plan configuration, workflow orchestration, and process automation). Yuzu Health Inc is a privately held Delaware C Corporation headquartered at 227 W 29th St, New York, NY.

Name

Yuzu Health

Legal name

Yuzu Health Inc

Website

https://yuzu.health

Company type

Private

Founded year

2022

Operating status

Operating

Headcount range

101–250 employees

Short description

Yuzu Health is a vertically integrated third-party administrator (TPA) that provides claims processing, payments, and plan management infrastructure for self-funded employer health insurance plans, serving health plan disruptors, ASOs, brokerages, and other plan operators across all 50 U.S. states on a recurring PEPM managed-services model.

Ownership category

akta.pro rank

Product category

Health Insurance Administration Software

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Third-Party Administrator (TPA) & Program Administrator Services (FSAJALAF)

akta.pro secondary industries

Care Management & Population Health Program Administration (HLAEALAG), Compliance, Reporting & Regulatory Administration (ERISA/ACA/No Surprises) (HLAEALAJ), Member Services & Contact Center Operations (TPA) (HLAEALAI), Medicare Plan Administration & Third-Party Services (TPA/BPO, Enrollment, Billing) (FSAIAGAI)

Keywords

• Third-party administration
• Health insurance platform
• Claims processing software
• Self-funded plan administration
• Benefits plan design

Headquarters

HQ city

New York

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales, Infrastructure

Revenue model

1. Third-Party Administration (TPA) Services: Vertically integrated TPA offering that processes claims, payments, and member administration on behalf of self-funded health plans. Recurring managed-services revenue per plan/employer group (industry-standard PEPM model; competitor benchmark cited at >$30 PEPM). Recurring and contract-based; no add-on fees per the company's positioning. Revenue scales with the number of employers and active members served (10,592 active members cited at one point; 50-state national footprint).
2. Platform Subscription (White-Label SaaS Layer): Recurring platform access for plan designers and brokers operating Yuzu-powered plans, including configurable Benefits Builder, partner integrations, and white-labeled member/employer portals.

Pricing tiers

Go-to-market motion3 records

Distribution channels3 records

Marketing channels5 records

Core offering

Yuzu Health is a vertically integrated third-party administrator (TPA) that provides a unified software platform for designing, launching, and administering self-funded health insurance plans. The platform combines an in-house claims adjudication engine, custom auto-ledgering payment infrastructure, and configurable member systems into a single source-of-truth operating system, with white-labeled portals for employers, members, providers, and brokers.

Product overview

Yuzu Health is a vertically integrated third-party administrator (TPA) platform providing a unified operating system for health insurance plan design, launch, and administration. The core Yuzu Health Platform combines an in-house Claims Engine, Payment Infrastructure (custom auto-ledgering system), and member systems with a configurable Benefits Builder for plan design, plus white-labeled Member, Provider, Employer, and Broker Portals that share a single source of truth. Provider-facing tools include Eligibility Check and Find a Claim, supported by workflow alerts, case management, and real-time reporting. The platform enables innovative plan designs through dedicated solutions: Tiered Networks, Steerage, Direct Contract, Dynamic Copay, Reference Based Pricing, Cash Pay, and Innovative Underwriting Processes, used by health plan disruptors, ASOs/carriers, brokerages, direct primary care groups, health systems, HR platforms/PEOs, and MGUs/captives.

Differentiator

Problem solved

Functional benefit

Products and services

• Yuzu Health Platform Vertically integrated third-party administrator platform providing a unified operating system for health plan design, claims processing, payments, and member administration across all 50 U.S. states, sold to health plan operators, ASOs/carriers, brokerages, and health systems.
• Member Portal

Quantifiable outcome

• 10,592 active members on Yuzu-administered plans
• +2 more outcomes

Named customers3 records

Segments7 records

Ideal customer profiles6 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability3 records

Feature6 records

Scale indicators6 records

Recent moves6 records

Expansion highlights6 records

Direct peers

• Decent: Decent is a modern self-funded health plan operator that builds and administers its own plans for small businesses and independent workers. It competes with Yuzu for the same pool of innovative plan operators and brokers seeking modern administration.
• Gravie: Gravie is a tech-forward employee benefits platform that administers self-funded health plans for employers. It targets a similar buyer (HR leaders at small and mid-sized employers) and competes on modern plan-design flexibility and member experience.
• Sana Benefits: Sana Benefits is a modern TPA built around small-business self-funded health plans. It is the most direct modern-TPA competitor to Yuzu, offering integrated plan design, claims administration, and member experience on its own proprietary stack.
• Take Command Health: Take Command is an ICHRA-focused administrator that helps employers set up and manage individual coverage reimbursement arrangements. It is a direct peer in the modern, tech-driven TPA segment, particularly around ICHRA plan configuration and administration.

Emerging players

• Thatch: Thatch is a health benefits platform enabling employers to offer ICHRA-style personalized benefits with employer contributions. It overlaps with Yuzu on plan-design flexibility and serves a similar employer buyer, though with a narrower ICHRA focus.

Broad incumbents

• USI Insurance Services: USI is one of the largest U.S. insurance brokerages with a substantial benefits and TPA practice serving mid-market and large employers. It is a benchmark incumbent for the broker channel that Yuzu relies on for warm referrals.
• Oscar Health: Oscar Health is a tech-forward individual and small-group health insurer that Yuzu's own leadership explicitly benchmarks on operational efficiency (Yuzu cited 19 employees vs. Oscar's >200 at a similar member milestone). Oscar represents the closest publicly observable proxy for tech-native health plan operations at scale.
• Mercer: Mercer (Oliver Wyman/Marsh McLennan) is a global benefits consulting and administration firm advising large employers on health and welfare plans. It represents the enterprise end of the incumbent buyer-influencer chain that shapes employer TPA selection.
• Alliant Insurance Services: Alliant is a large insurance brokerage and consulting firm offering benefits administration, TPA services, and stop-loss coverage to employers. It represents the incumbent channel broker that Yuzu's broker-led GTM motion must win over.
• HealthComp: HealthComp is one of the largest independent third-party administrators in the U.S., serving employers and health plans with claims administration, COBRA, and utilization management. It is the dominant legacy TPA incumbent whose 20-30 year-old technology stack Yuzu explicitly positions against.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• GitHubgithub.com/yuzu-health
• LinkedInlinkedin.com/company/yuzu-health

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Funding overview

Funding rounds3 records

Investors8 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Yuzu Health