Virtual Benefits Administrator
Virtual Benefits Administrator (VBA) is a private U.S. SaaS provider delivering an integrated cloud-based claims and benefits administration suite to third-party administrators, health plans, and ancillary payers handling medical, dental, vision, life, and disability benefits.
- Company typePrivate
- Founded2013
- HeadquartersMilwaukee, United States
- Headcount51–100
- GTM typeB2B
- OfferingSoftware
What Virtual Benefits Administrator does
Virtual Benefits Administrator (VBA) is a private U.S. software company headquartered in Milwaukee, Wisconsin, founded in 2009 and operating with 125+ employees—approximately 90% of whom work remotely. The company provides a cloud-based, integrated SaaS suite for healthcare claims and benefits administration, targeted at third-party administrators (TPAs), health plans, and ancillary payers managing medical, dental, vision, life, disability, and voluntary benefits. The platform is built on a serverless computing architecture with an API-first design and more than 4,000 RESTful (OAS3-compliant) endpoints, supporting a 99.999% uptime SLA and configurable deployment either as individual modules or as a fully integrated ecosystem.
The product portfolio centers on VBASoftware (core claims and benefits administration with revenue cycle management, care coordination, and 260+ canned reports) and is complemented by VBAGateway (multi-stakeholder portals with multi-factor authentication and 50-language translation), VBAMobile, VBAVoice (IVR and omnichannel communications), VBAnalytics (predictive analytics and HEDIS reporting), VBAPI (integration platform), VBAdjudicate (serverless adjudication engine), and VBAssist (AI-powered virtual assistant). VBA monetizes through annual subscription licensing, with pricing quoted per engagement; revenue is supplemented by an ecosystem of 15+ preferred partners covering payment integrity, repricing, PBM, price transparency, and BPO services, and the company reports more than 250 trading partner integrations.
VBA distributes through a direct enterprise sales motion anchored by the VBAEdge structured evaluation framework and 30-60 minute virtual demonstrations, targeting U.S. healthcare payers only. The company holds HIPAA and SOC 2 Type 2 compliance, 100% U.S.-based development and support, and was named a Gartner Representative Vendor in the 2026 Market Guide for U.S. Healthcare Payers' Core Administrative Processing Solutions. In August 2023, VBA closed a $156 million growth investment led by Spectrum Equity with Arthur Ventures, and 2024-2026 brought a CEO transition (Daniel Laroue), a new COO (Rick Ellsworth), and a new CRO (Joe Richlen) to professionalize the leadership team for scaling.
Virtual Benefits Administrator firmographics
Firmographics- Name
- Virtual Benefits Administrator
- Legal name
- Virtual Benefits Administrator
- Website
- https://vbasoftware.com
- Company type
- Private
- Founded year
- 2013
- Operating status
- Operating
- Headcount range
- 51–100 employees
- Short description
- Virtual Benefits Administrator (VBA) is a private U.S. SaaS provider delivering an integrated cloud-based claims and benefits administration suite to third-party administrators, health plans, and ancillary payers handling medical, dental, vision, life, and disability benefits.
- Ownership category
- akta.pro rank
Virtual Benefits Administrator industry classification
Industry- Product category
- Healthcare Claims and Benefits Administration Software
- NAICS
- Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518)
- SIC
- Services-Prepackaged Software (7372)
- akta.pro primary industry
- Vision Benefit Administration (VBA) / Vision TPA (ASO) (HLAEAJAI)
Keywords
Where Virtual Benefits Administrator is headquartered
LocationHeadquarters
- HQ city
- Milwaukee
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Virtual Benefits Administrator business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Personnel, Technology or R&D, Infrastructure, Marketing or Sales, Operations
Revenue model
- SaaS Platform Subscriptions: VBA generates revenue through subscription-based SaaS licensing of its integrated suite of healthcare administration solutions including VBASoftware, VBAGateway, VBAnalytics, VBAVoice, and VBAPI. Solutions can be deployed individually or as an integrated ecosystem.
- Preferred Partner Solutions: Revenue from integrated partner solutions that extend VBA platform functionality including payment integrity, claims editing, repricing, provider data management, PBM services, fraud detection, price transparency, and wellness programs.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | Enterprise SaaS Platform - Custom pricing based on organization size and needs |
Go-to-market motion1 record
Distribution channels3 records
Marketing channels6 records
Virtual Benefits Administrator product offering
Product offeringCore offering
VBA provides a cloud-based, integrated SaaS suite for healthcare claims and benefits administration. The core platform VBASoftware processes medical, dental, vision, HRA/HSA, flex, life, and disability claims, complemented by VBAdjudicate for high-speed serverless adjudication, VBAGateway portals, VBAnalytics, VBAVoice IVR, VBAPI, and VBAssist generative AI. The suite can be deployed individually or as an integrated ecosystem for TPAs, health plans, and ancillary payers.
Product overview
VBA offers a platform-plus-modules architecture centered on VBASoftware, a cloud-based core claims and benefits administration system. The integrated ecosystem includes VBAGateway (user engagement portals for members, providers, employers, and brokers), VBAMobile (mobile app extension), VBAVoice (omni-channel customer support with IVR), VBAnalytics (business intelligence and predictive analytics), and VBAPI (API platform with thousands of endpoints). Key enhancements include VBAdjudicate (serverless claims processing engine) and VBAssist (AI-powered virtual assistant). VBAEdge provides a structured evaluation framework for platform modernization assessments. The solutions work together as an integrated ecosystem or independently, serving health plans, TPAs, and ancillary payers.
Differentiator
Problem solved
Functional benefit
Brands
- VBASoftware: Cloud-based core administrative processing solution for claims and benefits administration
- VBAGateway
- VBAnalytics
- VBAVoice
- VBAPI
- VBAMobile
- VBAdjudicate
- VBAssist
- VBAEdge
- VBA Data Management Services
Products and services
- VBASoftware Cloud-based core claims and benefits administration platform handling medical, dental, vision, HRA/HSA, flex plans, life, disability and more. Includes revenue cycle management, care coordination, provider/network management, configuration services, and over 260 canned reports with SQL access. Built for healthcare payers including TPAs, health plans, and ancillary payers.
- VBAGateway Cloud-based portal solution providing personalized digital experiences for members, providers, employers, and brokers. Includes real-time connectivity, multi-factor authentication, and multi-language support across 50 languages.
- VBAMobile Mobile app extending VBAGateway experience, allowing members to access plan information anytime from mobile devices with responsive design across all platforms.
- VBAVoice Multi-channel communications solution with IVR and notification capabilities seamlessly integrated with VBA's cloud-based platform. Provides 24/7 interactive voice response with documented call deflection up to 55%.
- VBAnalytics Analytics and reporting solution combining reports and dynamic visuals with real-time interactive dashboards, drill-down capabilities, and machine-learning powered predictive risk analysis and population health recommendations, including HEDIS measure insights.
- VBAPI API platform providing backend access to the VBA suite with thousands of endpoints (4,000+) for create, read, update, delete, batch, list, and search functions across benefits, claims, enrollment, and accounting. Fully adheres to OAS3 standards for RESTful APIs and includes a Developer Kit.
- VBAdjudicate Lightning-fast claims adjudication engine using serverless computing with unparalleled processing speeds and unlimited parallel processing power for tens of thousands of claims in minutes.
- VBAssist AI-powered virtual assistant using generative AI and large language models to provide instant and accurate answers for VBASoftware users, enhancing productivity and accuracy.
- VBASoftware 4.0 Next-generation desktop application version of VBASoftware with modern interface, improved navigation options, and a streamlined training process for users.
- VBAEdge Structured evaluation framework that helps organizations assess their current environment, identify opportunities for improvement, and build a clear path forward for platform modernization prior to a purchase decision.
- VBA Data Management Services Managed data services handling setup with clients, vendors, and trading partners, and secure storage and transfer of files. Supports EDI (834, 835, 837, 999, etc.), NCPDP, NACHA, XML, and proprietary flat formats using Microsoft SSIS and VBA's EDM tool.
Quantifiable outcome
- 7.61x increased organizational efficiency for one TPA replacing outdated claims processing system
- +4 more outcomes
Companies that use Virtual Benefits Administrator
Customer profileNamed customers7 records
Segments7 records
Ideal customer profiles3 records
Virtual Benefits Administrator technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
Integration14 records
AI capability7 records
Feature6 records
Virtual Benefits Administrator partnerships and signals
Strategic signalPartnerships
13 partnerships are on record, tiered core and minor.
- BaseLoad (SDS2)coreProvider data management and 1099 services partner. Improves ongoing provider matching rates to 99%, cleans up provider data for better adjudication, and avoids cost of incorrect data submitted to IRS.
- Pharmacy Benefit Management (PBM) ServicescorePBM partner providing experience reduced claims costs and savings on both administration fees and drug costs (up to 30% reduction of total spend).
- echo (Provider Electronic Payments)coreProvider electronic payments solution enabling clients to spend up to 80% less time reconciling payments and improve operational efficiency.
- AG Context HealthcarecoreClaims repricing partner streamlining claims repricing processes and reducing total healthcare claims spend.
- Context HealthcarecoreFraud, waste, and abuse protection partner increasing quality of outcomes while reducing administrative costs with advanced analytics.
- ZeliscoreHealthcare payments company providing reference-based pricing and real-time repricing solutions. Offers single integration with Zelis Quick Reprice for post-adjudication and pre-payment savings.
- MPX (Member and Provider Communications)coreMember and provider communications partner managing high-touch communications from one central location including welcome kits, ID cards, EOBs, EOPs, and ad-hoc letters.
- PDHIcoreHealth assessments and wellness partner offering comprehensive wellness programs plus NCQA-compliant Health Appraisal and Self-Management Tools.
- Zelis+PayspancorePremium payment and management partner providing PCI compliant solution for credit card and ACH payments.
- Valenz (Talon)corePrice transparency and medical cost estimator partner enabling consumers to shop online for healthcare needs and ensuring compliance with cost transparency regulations.
- Smart Data SolutionscoreAI-native healthcare workflow automation partner accelerating digital transformation across payer and provider operations. Includes digital mailroom, clearinghouse services, claims operations automation, and document intelligence.
- Healthcare Bluebook (Quantros)coreValue-based care reporting partner providing Quantros quality scores for over half a million physicians and hospitals for network performance evaluation and tiered network design.
- netmarkminorBusiness process outsourcing partner providing experienced claims examiners, adjusters, provider reconsideration experts, and appeal adjudicators for payers with expertise in data conversion, plan building, call center and more.
Scale indicators9 records
Recent moves6 records
Expansion highlights6 records
Virtual Benefits Administrator competitors and assessment
Company assessmentBroad incumbents
- TriZetto (Cognizant): TriZetto, owned by Cognizant, is one of the largest incumbent vendors of payer core administrative processing solutions and benefits administration software, serving many of the same health plan and TPA customers as VBA.
- Optum (UnitedHealth Group): Optum is a massive incumbent in healthcare payer services and software, offering core admin, analytics, payment integrity, and consulting that compete broadly with VBA across payer workflows.
- Change Healthcare (Optum): Change Healthcare, now part of Optum, provides revenue cycle management, claims processing, and interoperability services for payers, overlapping with VBA's claims and integration offerings.
Others
- Mphasis: Mphasis provides application development and managed services for healthcare payers, often building and integrating benefits administration solutions adjacent to VBA's SaaS platform.
- Wipro: Wipro is a large IT services provider with a healthcare payer practice, often implementing and customizing core admin platforms; competes indirectly with VBA on services-led payer engagements.
Direct peers
- Edifecs: Edifecs provides healthcare data integration, interoperability, and core administrative processing technology, overlapping with VBA's VBAPI platform and EDI/integration services for payers.
- HealthEdge: HealthEdge provides a cloud-native core administrative processing platform (HealthRules) for health plans, directly competing with VBASoftware for payer claims and benefits administration workloads.
- ZeOmega: ZeOmega provides the Jiva payer care management and population health platform, comparable to VBA in serving health plans with integrated administration, engagement, and analytics solutions.
- Cotiviti: Cotiviti delivers payment integrity, claims editing, and analytics for payers, overlapping with VBA's preferred-partner ecosystem and VBAnalytics value-based care reporting capabilities.
- UST HealthProof: UST HealthProof offers a cloud-based core administrative platform for health plans, directly comparable to VBASoftware for medical claims, benefits administration, and member engagement.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat6 records
Key risks5 records
Key highlights7 records
Customer concentration
Virtual Benefits Administrator social profiles
Digital presenceVirtual Benefits Administrator compliance and trust
Trust signalCompliance2 records
Virtual Benefits Administrator financial estimates
Financial estimateRevenue estimate
Valuation estimate
Virtual Benefits Administrator leadership team
Management profileNumber of profiles
Profiles25 records
Virtual Benefits Administrator funding detail
Funding detailFunding overview
Funding rounds1 record
Investors2 records
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Virtual Benefits Administrator M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Virtual Benefits Administrator
What does Virtual Benefits Administrator do?
VBA provides a cloud-based, integrated SaaS suite for healthcare claims and benefits administration. The core platform VBASoftware processes medical, dental, vision, HRA/HSA, flex, life, and disability claims, complemented by VBAdjudicate for high-speed serverless adjudication, VBAGateway portals, VBAnalytics, VBAVoice IVR, VBAPI, and VBAssist generative AI. The suite can be deployed individually or as an integrated ecosystem for TPAs, health plans, and ancillary payers.
Is Virtual Benefits Administrator a public or private company?
Virtual Benefits Administrator is a private company. It is classified as venture growth investor backed and is currently operating.
When was Virtual Benefits Administrator founded?
Virtual Benefits Administrator was founded in 2013. It employs 51 to 100 people.
Where is Virtual Benefits Administrator based?
Virtual Benefits Administrator is headquartered in Milwaukee, United States, in the North America region.
How does Virtual Benefits Administrator make money?
Two revenue lines are on record. SaaS Platform Subscriptions are the primary driver. The others are preferred Partner Solutions.
Who are Virtual Benefits Administrator's main competitors?
Broad incumbents on record are TriZetto (Cognizant), Optum (UnitedHealth Group) and Change Healthcare (Optum). Others are Mphasis and Wipro. Direct peers are Edifecs, HealthEdge, ZeOmega, Cotiviti and UST HealthProof.
Does Virtual Benefits Administrator have an API?
Yes. VBAPI provides backend access to the VBA platform with thousands of APIs. Includes create, read, update, delete, batch, list and search functions across benefits, claims, enrollment, accounting and more. Offers hundreds of advanced endpoints for adjudication, authorizations, and enrollments. Supports interfaces for automated input/output to external systems, data ingestion and automated jobs, one-time data loads, custom portals and interfaces, and functionality specific to business needs. Fully adheres to OAS3 standards for RESTful APIs. Comes with a Developer Kit including secure API key, software development kit consolidating all web APIs into a single library (Java, C#, JavaScript, and more), and a developer web portal with complete data dictionary, online code examples and an interactive tool. Developer documentation is at vbasoftware.com/vbapi.
What industry is Virtual Benefits Administrator in?
Virtual Benefits Administrator's product category is Healthcare Claims and Benefits Administration Software. Its primary akta.pro industry code is HLAEAJAI, Vision Benefit Administration (VBA) / Vision TPA (ASO). Its NAICS code is 518 and its SIC code is 7372.