Lumelight
Lumelight is a private employee benefits compliance, claims, and analytics firm serving self-insured employers, TPAs, PBMs, and benefits brokers through a SaaS platform and consulting services, distributed primarily via channel partners.
- Company typePrivate
- Founded2025
- HeadquartersPikesville, United States
- Headcount251–500
- GTM typeB2B
- OfferingServices
What Lumelight does
Lumelight is a private U.S. employee benefits compliance, claims, and analytics firm serving self-insured employers, third-party administrators (TPAs), pharmacy benefit managers (PBMs), general agencies, and benefits brokers/consultants. The company organizes its offering around three integrated service areas — Compliance, Claims, and Analytics — delivered through a portfolio that includes the Lumelight One premium consulting tier (including an Enterprise edition for TPAs/PBMs/General Agencies), the Lumelight SIR SaaS analytics platform for self-funded plans, the iVerifyPro dependent eligibility verification platform, and Lumelight One Compass (ERISA/Form 5500 support). Underlying technology is a cloud-hosted SaaS platform on Amazon Web Services with HIPAA-compliant infrastructure, holding SOC 2 Type II, HIPAA, and HITRUST CSF certifications, with a real-time API integration into ADP Workforce Now that enables point-of-enrollment dependent verification.
Lumelight firmographics
Firmographics- Name
- Lumelight
- Legal name
- Lumelight
- Website
- https://lumelight.com
- Company type
- Private
- Founded year
- 2025
- Operating status
- Operating
- Headcount range
- 251–500 employees
- Short description
- Lumelight is a private employee benefits compliance, claims, and analytics firm serving self-insured employers, TPAs, PBMs, and benefits brokers through a SaaS platform and consulting services, distributed primarily via channel partners.
- Ownership category
- akta.pro rank
Lumelight industry classification
Industry- Product category
- Employee Benefits Compliance Services
- NAICS
- Management, Scientific, and Technical Consulting Services (5416), Agencies, Brokerages, and Other Insurance Related Activities (5242)
- SIC
- Services-Engineering, Accounting, Research, Management (8700), Services-Computer Programming, Data Processing, Etc. (7370)
- akta.pro primary industry
- Data Analytics & Business Intelligence Services (BPAHALAC)
- akta.pro secondary industry
- Benefits Administration & Enrollment Support (BPAAAIAB)
Keywords
Where Lumelight is headquartered
LocationHeadquarters
- HQ city
- Pikesville
- HQ country
- United States
- HQ region
- North America
Offices3 records
Markets served
Lumelight business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Technology or R&D, Marketing or Sales, Operations, Infrastructure
Revenue model
- Compliance Services Subscription: Annual subscription-based compliance services including 5500 Filings, ACA Employer Reporting, Compass ERISA Suite, Compliance Assessments, Compliance Planner, HIPAA Privacy & Security, Mental Health Parity & NQTL Analysis, Nondiscrimination Testing, PCORI Filing, POP & Cafeteria Plan Documents, RxDC Reporting, Wrap Documents, and Gag Clause Analysis. Services are offered on an annual subscription basis with pricing varying by plan type and complexity.
- Claims Audit Services: Medical and prescription drug claims audits including implementation audits, claims audits, dependent eligibility verification (iVerifyPro), enrollment data transformation, and crossover claims. Revenue generated through per-engagement fees based on plan size and scope of audit.
- RxDC D1 Reporting: CMS drug cost reporting service filing D1 and P2 data files on behalf of group health plan sponsors. Pricing: $800 (Fully Insured), $1,200 (Level Funded), $1,600 (Self-Funded). Annual filing requirement per plan.
- Gag Clause Compliance Service: Annual attestation service for Gag Clause Prohibition Compliance Attestation to CMS. Pricing: Up to 3 vendors $500, additional vendors $100 each.
- Creditable Coverage Calculator: Medicare creditable coverage determination service. Pricing: $300 per prescription drug plan offering per year.
- Fiduciary Solutions: Fiduciary compliance services including Lumelight Fiduciary Essential (self-directed toolkit) and Lumelight One Fiduciary (full-service governance with dedicated consultant).
- Lumelight SIR Analytics Platform: SaaS analytics platform for self-insured employers providing reporting suite, stop loss integration, and claims analytics. White-labeled portal for consultants and brokers to share with clients.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | RxDC D1 Reporting by plan funding type |
| Subscription | Annual | Gag Clause Compliance by vendor count |
| Subscription | Annual | Creditable Coverage Calculator per plan option |
| Usage-based | Pay-as-you-go | Dependent Eligibility Verification Savings Calculator |
| Subscription | Annual | Lumelight Fiduciary Essential |
| Subscription | Annual | Lumilight One Fiduciary |
Go-to-market motion3 records
Distribution channels4 records
Marketing channels7 records
Lumelight product offering
Product offeringCore offering
Lumelight provides integrated employee benefits compliance, claims audit, and analytics solutions for self-insured employers, benefits brokers, TPAs, PBMs, and general agencies. Its core offerings include the Lumelight One premium consulting and attorney service, Lumelight One Enterprise compliance infrastructure for TPAs/PBMs/General Agencies, the Lumelight SIR self-insured reporting analytics platform, and the iVerifyPro dependent eligibility verification SaaS, supported by a broad catalog of regulatory filings, fiduciary governance, and claims audit services.
Product overview
Lumelight is an integrated workplace administration and compliance company offering a platform-plus-modules architecture with three integrated service areas: Compliance, Claims, and Analytics. The core offerings include Lumelight One (premium consulting), Lumelight One Enterprise (enterprise compliance infrastructure for TPAs/PBMs/General Agencies), and Lumelight SIR (SaaS analytics for self-insured employers). The product portfolio encompasses compliance solutions (ACA Reporting, Mental Health Parity Analysis, ERISA/Form 5500 support via Compass, HIPAA Privacy & Security, Wrap Documents, Nondiscrimination Testing, PCORI Filing, RxDC Reporting, Gag Clause Compliance, Creditable Coverage Calculator, Compliance Assessments, Compliance Planner), claims solutions (Medical & Rx Claims Audits, Implementation Audits, Crossover Claims, Enrollment Data Transformation, Business Process Outsourcing), analytics solutions (Lumelight SIR with Reporting Suite, Stop Loss Integration, Claims Analytics), and verification solutions (iVerifyPro including Full Population Dependent Verification, Working Spouse Verification, Ongoing Dependent Eligibility Verification, Spouse Re-Verification). Fiduciary governance solutions include Fiduciary Essential and Lumelight One Fiduciary. The company also acquired ClearFile, a regulatory compliance SaaS platform for healthcare filings, expanding its regulatory solutions portfolio.
Differentiator
Problem solved
Functional benefit
Brands
- Lumelight One: Premium service tier delivering senior consultants and attorneys, deeper strategic engagement, and customized solutions for high-stakes benefits challenges.
- Lumelight SIR
- iVerifyPro
- Lumelight One Compass
Products and services
- Lumelight One Premium, high-touch consulting service delivering senior consultant and attorney access, deeper strategic engagement, and customized solutions aligned with unique client challenges for employers facing complex benefits and compliance issues.
- Lumelight One Enterprise Enterprise compliance infrastructure for TPAs, PBMs, and General Agencies providing coordinated governance, structured discovery, and tailored compliance frameworks including MHPA Assessment, dependent verification, ACA compliance, fiduciary services, Compass ERISA support, claims audits, RxDC, and CAA transparency.
- Lumelight One Compass All-in-one employer benefits compliance solution that helps organizations meet ERISA requirements through expert guidance and document management support.
- Lumelight One Fiduciary Full-service fiduciary governance solution providing hands-on facilitation and consultant-led guidance including dedicated compliance consultant, custom fiduciary committee charter development, facilitated committee meetings, ongoing advisory access, and executive summaries.
- Fiduciary Essential Self-directed, technology-enabled fiduciary governance framework providing tools to organize governance through a comprehensive fiduciary toolkit, on-demand training series, annual compliance calendar, and cloud-based document repository.
- Lumelight SIR SaaS analytics platform purpose-built for self-insured employers and advisors that replaces manual processes with seamless automation to enable proactive cost management, accurate analytics, and full financial reporting from a single platform, with a white-labeled portal for consultants and brokers to share with clients.
- iVerifyPro Comprehensive dependent eligibility verification platform that makes verification effortless for employers and employees through accuracy, transparency, and ease at every interaction, with modules for Full Population Dependent Verification, Working Spouse Verification, Ongoing Dependent Eligibility Verification, and Spouse Re-Verification.
- Claims Audits Medical and prescription drug claims audit services combining clinical insight and data precision to ensure accurate, fair claims processing, including Implementation Audits and Medical + Rx Claims Audits.
- RxDC D1 Reporting Service CMS drug cost reporting service that helps plan sponsors, brokers, and TPAs collect, coordinate, and submit RxDC reports with confidence and accuracy, handling data collection, aggregation, validation, and final submission on behalf of group health plan sponsors.
- Gag Clause Compliance Service Annual attestation service for Gag Clause Prohibition Compliance Attestation to CMS that notifies plan vendors and submits attestations through the HIOS system on behalf of group health plan sponsors.
- Creditable Coverage Calculator Medicare creditable coverage determination tool using CMS guidance and simplified determination methods to generate summary reports, compliant participant notices, and CMS reporting instructions for plan sponsors.
- PCORI Filing Annual Patient-Centered Outcomes Research Institute fee calculation and filing service including plan eligibility determination, fee calculation, IRS Form 720 preparation, and payment guidance for applicable plan sponsors.
- Nondiscrimination Testing IRS nondiscrimination testing service covering Cafeteria, FSA, DCAP, HRA, and self-funded medical plans with automated identification of highly compensated and key employees to support compliance with Section 125 and related requirements.
- HIPAA Privacy & Security Comprehensive HIPAA support service including risk assessments, gap analyses, policy development, workforce training, and incident response support for benefits brokers, TPAs, and employer HR teams.
- Compliance Assessments Compliance posture assessments across ERISA, ACA, MHPAEA, and COBRA requirements including documentation reviews, tailored recommendations, and clear action plans for employers.
- Compliance Planner Year-round compliance roadmap providing a personalized compliance calendar with key federal and state deadlines, proactive reminders, expert support, and step-by-step checklists for benefits and HR teams.
- Wrap Plan Documents Wrap document services consolidating multiple benefit plans under a single ERISA plan, including document creation, legal review, and annual maintenance by dedicated compliance analysts.
- POP & Cafeteria Plan Documents Pre-tax benefits plan document services helping employers maintain compliance and protect tax-advantaged status through custom plan documents, summaries, election change forms, and annual nondiscrimination testing for POP and cafeteria plans.
- Business Process Outsourcing Back office support for claims entry, validation, and code normalization with scalable, flexible support based on specific client needs, supporting claims since 2009 with $1.5 billion in claims processed annually.
- Crossover Claims Reimbursement and substantiation solution automating the path from claims to payment by validating, formatting, and matching claims with precision and achieving substantiation rates up to 98%.
- Enrollment Data Transformation Data transformation service that converts fragmented enrollment files into streamlined, secure data systems supporting accuracy, compliance, and better outcomes through expert support and HIPAA-secure automation.
- ClearFile (Regulatory Filings SaaS) SaaS platform that automates complex regulatory filings for health insurers, pharmacy benefit managers, and government regulators, acquired from Goodroot in September 2025 to expand Lumelight's regulatory solutions portfolio.
Quantifiable outcome
- 2,573% average ROI across dependent eligibility audit programs
- +6 more outcomes
Companies that use Lumelight
Customer profileNamed customers6 records
Segments5 records
Ideal customer profiles5 records
Lumelight technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration1 record
Feature5 records
Lumelight partnerships and signals
Strategic signalPartnerships
Four partnerships are on record, tiered flagship, minor and core.
- The Council of Insurance Agents & BrokersflagshipLumelight is a sponsor organization for The Council of Insurance Agents & Brokers, onboarding alongside Anthem Blue Cross and Blue Shield and Ringmaster Technologies at the spring membership drive. The Council represents major insurance brokers and agents, providing access to key distribution partners.
- Anthem Blue Cross and Blue ShieldminorNew sponsor organization announced alongside Lumelight at The Council of Insurance Agents & Brokers spring membership drive. Both serve the insurance broker community.
- ClearFile (from Goodroot)coreLumelight acquired ClearFile from Goodroot. ClearFile, founded by Joe Boyle, provides a SaaS platform for regulatory filings in healthcare and now operates as part of Lumelight's portfolio. The acquisition expanded Lumelight's regulatory solutions and influence in the healthcare compliance industry. Transaction completed less than two years after ClearFile's founding.
- ADP (Workforce Now)coreReal-time API integration with ADP Workforce Now providing seamless dependent eligibility verification at point of enrollment. iVerifyPro available through ADP Marketplace. Integration eliminates separate contracts, streamlines billing through ADP monthly account, and automates data flow between systems.
Scale indicators10 records
Recent moves6 records
Expansion highlights7 records
Lumelight competitors and assessment
Company assessmentDirect peers
- USI Insurance Services: Large US insurance brokerage providing employee benefits consulting, compliance support, and risk management to mid-market and enterprise employers — directly comparable distribution model and benefits-compliance service mix.
- NFP: US benefits, insurance, and wealth management firm combining brokerage with proprietary benefits administration and compliance services — directly comparable integrated benefits platform model.
- PlanSource Benefits: Cloud-based benefits administration platform serving mid-market and enterprise employers with enrollment, billing, and compliance workflows — directly comparable SaaS benefits administration peer.
- OneDigital: One of the largest US employee benefits brokerages, offering compliance consulting, benefits administration, and analytics to employers through a broker-led distribution model — directly comparable to Lumelight's broker-channel GTM and integrated compliance offering.
Broad incumbents
- Mercer: Global consulting leader providing health and benefits consulting, including compliance and analytics to large employers — a broader incumbent that competes on benefits consulting engagements of the kind Lumelight serves.
- Benefitfocus (Voya Financial): Benefits administration technology platform now owned by Voya Financial, offering enrollment, compliance, and exchange solutions to employers and carriers — broader benefits tech incumbent with overlapping compliance capabilities.
- WTW (Willis Towers Watson): Global advisory firm providing health, benefits, and risk management consulting — broad incumbent that competes for the same enterprise benefits compliance and analytics work as Lumelight.
- ADP Lyric: ADP's HCM and benefits platform offering compliance, payroll, and benefits administration across its installed base — broad incumbent whose Marketplace listing for Lumelight signals both partnership and competitive overlap.
Emerging players
- Benefit Comply: Benefits compliance-focused consulting firm founded by Bob Radecki (now VP at Lumelight), offering ACA, ERISA, and HIPAA compliance services — niche specialty peer with overlapping subject-matter expertise.
- WEX Health: Benefits administration and HSA/consumer-directed benefits technology provider — comparable analytics and administration capabilities to Lumelight SIR, though narrower in compliance consulting.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat6 records
Key risks7 records
Key highlights7 records
Customer concentration
Lumelight social profiles
Digital presenceLumelight compliance and trust
Trust signalCompliance3 records
Lumelight financial estimates
Financial estimateRevenue estimate
Valuation estimate
Lumelight leadership team
Management profileNumber of profiles
Profiles10 records
Lumelight subsidiaries and ownership
Company hierarchySubsidiaries1 record
Lumelight funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Lumelight 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 Lumelight
What does Lumelight do?
Lumelight provides integrated employee benefits compliance, claims audit, and analytics solutions for self-insured employers, benefits brokers, TPAs, PBMs, and general agencies. Its core offerings include the Lumelight One premium consulting and attorney service, Lumelight One Enterprise compliance infrastructure for TPAs/PBMs/General Agencies, the Lumelight SIR self-insured reporting analytics platform, and the iVerifyPro dependent eligibility verification SaaS, supported by a broad catalog of regulatory filings, fiduciary governance, and claims audit services.
Is Lumelight a public or private company?
Lumelight is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was Lumelight founded?
Lumelight was founded in 2025. It employs 251 to 500 people.
Where is Lumelight based?
Lumelight is headquartered in Pikesville, United States, in the North America region.
How does Lumelight make money?
Seven revenue lines are on record. Compliance Services Subscription is the primary driver. The others are claims Audit Services, rxDC D1 Reporting, gag Clause Compliance Service, creditable Coverage Calculator, fiduciary Solutions and lumelight SIR Analytics Platform.
Who are Lumelight's main competitors?
Direct peers on record are USI Insurance Services, NFP, PlanSource Benefits and OneDigital. Broad incumbents are Mercer, Benefitfocus (Voya Financial), WTW (Willis Towers Watson) and ADP Lyric. Emerging players are Benefit Comply and WEX Health.
Does Lumelight have an API?
No public API is recorded for Lumelight.
What industry is Lumelight in?
Lumelight's product category is Employee Benefits Compliance Services. Its primary akta.pro industry code is BPAHALAC, Data Analytics & Business Intelligence Services, with a secondary code of BPAAAIAB, Benefits Administration & Enrollment Support. Its NAICS code is 5416 and its SIC code is 8700.