Sunshine Health
Sunshine Health is a Florida-based managed care organization and Centene subsidiary providing Medicaid, Medicare Advantage, and ACA Marketplace health plans, including specialty plans for child welfare, SMI, HIV, and chronically ill children, supported by 11 community centers and integrated workforce and social determinants programs.
- Company typePrivate
- Founded2007
- HeadquartersSunrise, United States
- Headcount1,001–5,000
- GTM typeB2C
- OfferingServices
What Sunshine Health does
Sunshine Health is a Florida-based managed care organization and wholly-owned subsidiary of Centene Corporation, founded in 2007 and headquartered in Sunrise/Fort Lauderdale, Florida, with a workforce of 1,001-5,000 employees. The company provides government-sponsored health insurance across Medicaid managed care (including MMA, Long Term Care, and four specialty plans serving child welfare, serious mental illness, HIV, and children with chronic conditions), Medicare Advantage (operated under the Wellcare brand), and ACA Marketplace plans (Ambetter from Sunshine Health). Its portfolio extends beyond insurance to include the Start Smart for Your Baby maternity program, Sunshine Health Works workforce development initiative, Launchpad job support, telehealth services (including KidzDocNow pediatric and Brave Health behavioral platforms), disease management programs covering 16+ chronic conditions, and a member rewards program.
The underlying technology stack consists of a digital health platform comprising a member portal, mobile application (available on iOS and Android), the Wellframe digital health coaching platform, and integrated care management systems. Members access care through contracted provider networks across Florida, supported by 11 physical Community Connections Centers (Welcome Rooms) located in major metropolitan areas including Miami, Orlando, Tampa, Jacksonville, and Fort Lauderdale. Multi-language support spans 16+ languages to serve Florida's diverse population.
The business model operates on capitated per-member-per-month premium revenue from Florida Medicaid, CMS (for Medicare Advantage), and ACA Marketplace subsidies, with no public premium pricing. Members are acquired through Florida's Medicaid managed care enrollment system, the Medicare Advantage market, the ACA Marketplace, and broker/community partnerships. Distribution is anchored by the contracted provider network and supplemented by social media, the mobile app, Community Connections Centers, and a new athlete ambassador program (via Parity platform and Paralympian Dana Mathewson) launched in late 2025. Strategic community investments in food insecurity ($410,000 with Centene Foundation), childcare and transportation grants ($100,000), and 50 nonprofit health-related social needs grants ($106,000) demonstrate an integrated social determinants of health strategy tied to member outcomes and Medicaid quality metrics.
Sunshine Health firmographics
Firmographics- Name
- Sunshine Health
- Legal name
- Sunshine Health
- Website
- https://sunshinehealth.com
- Company type
- Private
- Founded year
- 2007
- Operating status
- Operating
- Headcount range
- 1,001–5,000 employees
- Short description
- Sunshine Health is a Florida-based managed care organization and Centene subsidiary providing Medicaid, Medicare Advantage, and ACA Marketplace health plans, including specialty plans for child welfare, SMI, HIV, and chronically ill children, supported by 11 community centers and integrated workforce and social determinants programs.
- Ownership category
- akta.pro rank
Sunshine Health industry classification
Industry- Product category
- Managed Care Health Insurance
- NAICS
- Health and Welfare Funds (525120), Health Care and Social Assistance (62)
- SIC
- Accident & Health Insurance (6321), Services-Health Services (8000)
- akta.pro primary industry
- Employer Wellness & Population Health Programs (HLAEAAAH)
- akta.pro secondary industries
- MA Chronic Condition Management & Supplemental Benefits (SSBCI) (HLAEACAI), Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage) (BPAIAKAH)
Keywords
Where Sunshine Health is headquartered
LocationHeadquarters
- HQ city
- Sunrise
- HQ country
- United States
- HQ region
- North America
Offices12 records
Markets served
Sunshine Health business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure, Others
Revenue model
- Medicaid Capitated Premiums: Sunshine Health receives capitated (per-member-per-month) payments from the Florida Medicaid program to provide managed care coverage to enrolled members across various plan types including MMA, Long Term Care, and specialty plans
- Medicare Advantage Premiums: Medicare Advantage plans (Wellcare brand) generate premium revenue from CMS and member cost-sharing
- Health Insurance Marketplace Premiums: Ambetter from Sunshine Health generates premium revenue from subsidized marketplace enrollments and member contributions
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Government-funded healthcare plans with subsidized or zero-cost premiums for eligible beneficiaries |
Go-to-market motion1 record
Distribution channels4 records
Marketing channels5 records
Sunshine Health product offering
Product offeringCore offering
Sunshine Health is a Florida-based managed care organization that sells government-sponsored health insurance plans — primarily Medicaid managed care (including specialty plans for child welfare, serious mental illness, HIV, and children with chronic conditions), Medicare Advantage, and ACA Marketplace plans (Ambetter from Sunshine Health) — to eligible individual members. It coordinates care through contracted provider networks and supplements its core insurance products with member support programs such as Start Smart for Your Baby, disease management, telehealth, and the Sunshine Health Works workforce development program.
Product overview
Sunshine Health is a Florida-based managed care organization and subsidiary of Centene Corporation offering a portfolio of health insurance plans and wellness programs. The core offering includes Medicaid managed care and Medicare Advantage plans, supplemented by specialized plans for distinct populations: Sunshine Health Pathway to Shine (child welfare), Sunshine Health Mindful Pathways (serious mental illness), Sunshine Health Power to Thrive (HIV), and Children's Medical Services Health Plan (children with chronic conditions). The company also offers Ambetter marketplace plans. Beyond insurance products, the portfolio includes support programs such as Start Smart for Your Baby (maternity/newborn), Sunshine Health Works (workforce development), Launchpad (job support), Community Connections Centers (11 physical locations), Telehealth Services, Rewards Program, and Disease Management Programs covering 16+ chronic conditions. The portfolio operates as a platform model where members can access multiple coordinated services through a single managed care relationship.
Differentiator
Problem solved
Functional benefit
Brands
- Sunshine Health Works: Workforce development program that trains participants in healthcare certifications and creates career pathways
- Start Smart for Your Baby
- Ambetter from Sunshine Health
- Community Connections
- Wellcare
Products and services
- Medicaid Managed Care Florida Medicaid managed care plan providing comprehensive health coverage (medical, pharmacy, dental, behavioral health) for eligible low-income individuals and families enrolled through the Florida Medicaid program.
- Comprehensive Long Term Care Long-term care managed plan covering extended care services for Florida Medicaid members with chronic conditions or disabilities requiring ongoing support, including caregiver resources and participant direction options.
- Sunshine Health Pathway to Shine Specialty Medicaid plan for children and youth in Florida's child welfare system, including those in foster care, adoption assistance, or guardianship, providing healthcare coordination and support services.
- Sunshine Health Mindful Pathways Specialty plan for Florida Medicaid adults with serious mental illness (SMI), providing integrated behavioral and physical health services with dedicated care management.
- Sunshine Health Power to Thrive Specialty plan for Florida Medicaid individuals living with HIV, offering coordinated care and support services addressing both health and social needs.
- Children's Medical Services Health Plan Specialized health plan for children and youth under 21 with serious, chronic medical conditions, operated by Sunshine Health under the Florida KidCare program, providing specialized pediatric care coordination.
- Ambetter from Sunshine Health Health Insurance Marketplace plan offering qualified health plan coverage for individuals and families who do not qualify for Medicaid or Medicare, with tiered benefit options.
- Medicare Advantage Medicare Advantage plan for Medicare-eligible Florida residents, providing Part C coverage with additional benefits beyond Original Medicare, operated under the Wellcare brand by parent company Centene.
- Start Smart for Your Baby Maternity and newborn support program offering educational resources, care coordination, and rewards for pregnant members and new parents, including prenatal guidance, postpartum support, and breastfeeding assistance.
- Sunshine Health Works Workforce development program providing healthcare certifications, scholarships, employment pathways, and job support services for Medicaid members and community members seeking healthcare careers.
- Community Connections Centers Physical community centers located across 11 Florida cities (Fort Myers, Jacksonville, Lauderhill, Miami, Ocala, Orlando, Pensacola, Pinellas Park, Tallahassee, Tampa, West Palm Beach) providing member services, resources, and community programming.
Quantifiable outcome
- Nearly 1,900 participants trained in healthcare certifications through Sunshine Health Works program in 2025
- +2 more outcomes
Companies that use Sunshine Health
Customer profileNamed customers7 records
Segments8 records
Ideal customer profiles4 records
Sunshine Health technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature6 records
Sunshine Health partnerships and signals
Strategic signalPartnerships
Eight partnerships are on record, tiered significant, key, major and core.
- 5 Florida Nonprofit Organizations (Childcare and Transportation Grants)significantSunshine Health awarded $100,000 in grants to five nonprofit organizations across Florida to improve workforce access through childcare and transportation support, helping vulnerable populations access employment, training, and healthcare services across more than 40 counties.
- Parity (Women Athletes Sports Marketing Platform)keySunshine Health partnered with Parity, a sports marketing platform for women athletes, to promote health awareness in Florida. The collaboration supports Florida's Medicaid program by focusing on mental health, child and maternal health, and community wellness through athlete ambassador content.
- Dana Mathewson (Paralympian Athlete Ambassador)keyParalympian wheelchair tennis champion and cancer advocate Dana Mathewson serves as Sunshine Health's first athlete ambassador, sharing health awareness campaign content across her social media channels to promote mental health, maternal health, and community wellness.
- Farm Share, Inc.majorSunshine Health and Centene Foundation invested $300,000 in Farm Share, a Florida food bank, to distribute at least 125,000 pounds of food (over 104,000 meals) to address food insecurity across the state.
- 50 Florida Nonprofit Organizations (Health-Related Social Needs Grants)significantSunshine Health awarded $106,000 in grants to 50 nonprofit organizations across Florida to support health-related social needs including food insecurity, homelessness, and maternal health.
- 12 Local Florida CollegescoreSunshine Health Works workforce development program partners with 12 local colleges to provide healthcare certification training, including Certified Nursing Assistant, Home Health Aide, and Licensed Practical Nurse programs. The partnerships enable career pathways for community members and Medicaid beneficiaries entering or re-entering the healthcare workforce.
- Florida Healthcare ProviderscorePartnership with healthcare providers to offer clinical training sites and employment pathways for Sunshine Health Works program graduates who earn healthcare certifications.
- Florida Community OrganizationscoreCommunity organizations partner with Sunshine Health Works to support workforce development participants with wraparound services and employment placement assistance.
Scale indicators8 records
Recent moves5 records
Expansion highlights4 records
Sunshine Health competitors and assessment
Company assessmentDirect peers
- Simply Healthcare Plans: Florida Medicaid managed care organization and fellow Centene subsidiary serving Medicaid and Medicare Advantage members across Florida. Direct peer given shared parent, overlapping product portfolio, and same Florida Medicaid contract structure.
- Florida Blue: Florida's Blue Cross Blue Shield licensee, offering Medicaid managed care, Medicare Advantage, and individual/family plans in Florida. Direct competitor for Florida Medicaid contracts and Marketplace enrollment.
- Molina Healthcare: Government-sponsored healthcare specialist operating Medicaid and Medicare Advantage plans in Florida. Highly comparable business model focused on low-income and complex populations.
- Amerigroup Florida (Elevance Health): Elevance Health's Medicaid managed care subsidiary in Florida serving TANF, CHIP, and complex populations. Direct competitor for Florida Medicaid contracts.
- CareSource Florida: Nonprofit managed care organization with Florida Medicaid contracts serving low-income and complex populations. Direct competitor with similar mission-driven positioning.
Broad incumbents
- Humana: Major national health insurer with significant Florida Medicare Advantage and Medicaid presence. Competes with Sunshine Health for both MA and Medicaid members across Florida.
- UnitedHealthcare: Nation's largest health insurer offering Medicaid, Medicare Advantage, and individual marketplace plans in Florida. Competes across all of Sunshine Health's major product lines.
- Aetna (CVS Health): National insurer offering Medicaid managed care and Medicare Advantage in Florida as part of CVS Health's integrated care strategy. Competes in both government-sponsored product lines.
Regional players
- Children's Medical Services Health Plan (Florida): Florida's specialty Medicaid plan for children with chronic conditions. Operates as a state-administered plan that Sunshine Health administers; comparable in serving the same specialized pediatric population.
- Prestige Health Choice: Florida-focused Medicaid managed care plan serving children and complex populations. Comparable niche focus on specialty Medicaid populations in the same state.
Market position
Strengths4 records
Weaknesses4 records
Competitive moat5 records
Key risks5 records
Key highlights6 records
Customer concentration
Sunshine Health social profiles
Digital presenceSunshine Health financial estimates
Financial estimateRevenue estimate
Valuation estimate
Sunshine Health leadership team
Management profileNumber of profiles
Profiles1 record
Sunshine Health funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Sunshine Health M&A and investment
M&A and investmentM&A
Investments80 records
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Sunshine Health
What does Sunshine Health do?
Sunshine Health is a Florida-based managed care organization that sells government-sponsored health insurance plans — primarily Medicaid managed care (including specialty plans for child welfare, serious mental illness, HIV, and children with chronic conditions), Medicare Advantage, and ACA Marketplace plans (Ambetter from Sunshine Health) — to eligible individual members. It coordinates care through contracted provider networks and supplements its core insurance products with member support programs such as Start Smart for Your Baby, disease management, telehealth, and the Sunshine Health Works workforce development program.
Is Sunshine Health a public or private company?
Sunshine Health is a private company. It is classified as corporate owned and is currently operating.
When was Sunshine Health founded?
Sunshine Health was founded in 2007. It employs 1,001 to 5,000 people.
Where is Sunshine Health based?
Sunshine Health is headquartered in Sunrise, United States, in the North America region.
How does Sunshine Health make money?
Three revenue lines are on record. Medicaid Capitated Premiums are the primary driver. The others are medicare Advantage Premiums and health Insurance Marketplace Premiums.
Who are Sunshine Health's main competitors?
Direct peers on record are Simply Healthcare Plans, Florida Blue, Molina Healthcare, Amerigroup Florida (Elevance Health) and CareSource Florida. Broad incumbents are Humana, UnitedHealthcare and Aetna (CVS Health). Regional players are Children's Medical Services Health Plan (Florida) and Prestige Health Choice.
Does Sunshine Health have an API?
No public API is recorded for Sunshine Health.
What industry is Sunshine Health in?
Sunshine Health's product category is Managed Care Health Insurance. Its primary akta.pro industry code is HLAEAAAH, Employer Wellness & Population Health Programs, with a secondary code of HLAEACAI, MA Chronic Condition Management & Supplemental Benefits (SSBCI). Its NAICS code is 525120 and its SIC code is 6321.