Collective Health

What Collective Health does

Collective Health is a modern third-party administrator (TPA) providing health benefits administration, claims processing, care navigation, and analytics to self-funded employers with 250 or more employees. Founded in 2013 and headquartered in San Francisco, the company operates an integrated platform that combines Collective TPA (claims adjudication, payments, and reporting), Navigation & Advocacy (a member-facing benefits front door with NCQA-accredited care navigation), and the Benefits Hub (aggregation of ancillary and digital health partners through the Premier Partner Program and The Partner Collective marketplace). The platform has processed 23.6 million claims and serves more than 70 enterprise clients covering approximately 500,000 members, including Pinterest, Activision Blizzard, Zoom, Rivian, Daikin, and Cornerstone OnDemand.

The technology architecture is built on modern cloud infrastructure with an AI layer called Collective AI (CAI), developed in collaboration with Google Cloud and launched in February 2026. CAI delivers 24/7 member-facing conversational AI within the My Collective portal, real-time documentation support for Member Advocates, and plan-design insights for employers, all under a privacy-by-design framework that prevents employee health data from training external models. Supporting products include Collective Compass (claims analytics and employer reporting), The Partner Collective (digital health marketplace with 100+ integrated partners), the Compass employer portal, and Guide PPO (a structured health-plan design option). The company maintains HITRUST r2 (270 controls across 19 domains), SOC 2 Type II, and NCQA Case Management credentials, and reports an 86% client satisfaction score and a 70 member NPS versus an industry average of 30.

Collective Health generates revenue primarily through quote-based, subscription-style contracts with self-funded employers, structured as per-employee-per-month (PEPM) fees typical of the TPA industry, on annual billing cycles. Distribution combines direct enterprise field sales targeting benefits leaders, broker and consultant referral channels, and white-label/embedded partnerships with regional health plans including Providence Health Plan, Highmark, and Health Care Service Corporation (HCSC). The company has raised $719 million in total venture funding across multiple rounds, including a $280 million Series F in May 2021 that valued it at approximately $1.5 billion, with key institutional backers SoftBank Vision Fund, Google Ventures, Founders Fund, and NEA.

Name

Collective Health

Legal name

CollectiveHealth, Inc.

Website

https://collectivehealth.com

Company type

Private

Founded year

2013

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

Collective Health is a modern third-party administrator providing integrated health benefits administration, claims processing, care navigation, and AI-powered member support to self-funded employers with 250+ employees, serving 70+ enterprise clients covering 500,000 members.

Ownership category

akta.pro rank

Product category

Health Benefits Administration (Third-Party Administrator)

NAICS

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

SIC

Services-Health Services (8000), Hospital & Medical Service Plans (6324)

akta.pro primary industry

Self-Funded Employer Plan TPA (ASO Administration) (HLAEALAA)

akta.pro secondary industry

Ancillary Benefits TPA (Dental/Vision/Life/Accident/Critical Illness) (HLAEALAN)

Keywords

• Health benefits administration
• Third-party administrator
• Self-funded employer benefits
• Care navigation services
• Health plan management

Headquarters

HQ city

San Francisco

HQ country

United States

HQ region

North America

Offices3 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Health Benefits Administration Services: Collective Health operates as a third-party administrator (TPA) providing health plan benefit administration services to self-funded employers. The company charges employers subscription/recurring fees for platform access, claims processing, care navigation, and analytics. Revenue is primarily B2B, recurring in nature based on employer contracts.
2. Partner Ecosystem/Integration Fees: Revenue from the Premier Partner Program where digital health solution providers integrate with the Collective Health platform, potentially through licensing or referral arrangements.

Pricing tiers

Go-to-market motion1 record

Distribution channels5 records

Marketing channels9 records

Core offering

Collective Health operates as an independent third-party administrator (TPA) for self-funded employers, integrating plan administration, claims adjudication and payments, care navigation and advocacy, pharmacy benefit management, stop-loss integration, and analytics on one platform. The offering pairs the core TPA technology with Collective AI (CAI) — an AI layer built with Google Cloud — and The Partner Collective ecosystem of more than 100 digital health point solutions, delivered through direct employer contracts, broker/consultant referrals, and white-label relationships with regional health plans.

Product overview

Collective Health is a health benefits administration platform for self-funded employers, offering a unified integrated technology platform that brings together plan administration, cost management, and member advocacy. The core product portfolio includes Collective TPA for third-party administration, Navigation & Advocacy for member support, and Benefits Hub for partner integration. The AI-powered layer consists of Collective AI (CAI), which operates within the My Collective member portal and supercharges the Member Advocate team. Supporting products include Collective Compass for employer analytics, The Partner Collective marketplace for digital health solutions, Care Navigation for complex case management, and the Compass employer portal. The platform serves self-funded employers typically with 500+ eligible employees and integrates with pharmacy benefit managers, provider networks, and various point solutions through its partner ecosystem.

Differentiator

Problem solved

Functional benefit

Products and services

• Collective TPA

Quantifiable outcome

• 50% reduction in healthcare cost trend over 5-year period
• +7 more outcomes

Named customers8 records

Segments5 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability5 records

Feature6 records

Partnerships

Seven partnerships are on record, tiered core, minor and major.

• Google CloudcoreTechnology or Integration · 26 February 2026Collective Health collaborated with Google Cloud to launch Collective AI (CAI), an AI-powered system that helps members understand benefits, access ID cards, and navigate care. Google Cloud provides technology infrastructure with privacy-by-design framework that protects employee health data and prevents it from training external models. Strategic technology partnership for AI capabilities.
• Providence Health PlancoreStrategic or Co-development Partner · 2 April 2025Providence Health Plan announced TPA partnership with Collective Health to introduce a new TPA platform for self-funded employers, combining Providence's regional healthcare expertise with Collective Health's technology. Platform aims to improve benefits management, transparency, and cost efficiency with Collective Health's clinical and analytical tools.
• Noom HealthcoreStrategic or Co-development Partner · 26 March 2025Collective Health and Noom partnered to launch Collective Health + Noom Med with SmartRx, an enterprise weight management solution with integrated GLP-1 drug program. Aims to deliver 28% potential cost savings on GLP-1 medications by bypassing traditional intermediaries. Addresses obesity affecting over 40% of U.S. adults.
• Sun LifeminorStrategic or Co-development PartnerSun Life and Collective Health's new integrated stop-loss offering gives employers more financial control of their healthcare investment.
• Uber HealthminorStrategic or Co-development PartnerPartnership to give select members easy access to transportation services, addressing social determinants of health.
• Health Care Service Corporation (HCSC)majorStrategic or Co-development PartnerHCSC and Collective Health announced plans to deliver streamlined, digital healthcare experience at scale through strategic partnership.
• One MedicalminorStrategic or Co-development PartnerJAMA Network Open study between Collective Health and One Medical found virtual + in-office primary care model linked to 45% lower employer total cost.

Scale indicators12 records

Recent moves8 records

Expansion highlights6 records

Emerging players

• HealthJoy: HealthJoy is a benefits navigation and virtual care platform for employers that consolidates point solutions into a single member experience. Comparable to Collective Health's Benefits Hub and navigation front door, though typically serving smaller employers than Collective Health's sweet spot.
• Castlight Health: Castlight Health provides health benefits navigation and analytics for self-funded employers, focused on cost transparency and engagement. Overlaps with Collective Health's navigation, advocacy, and Collective Compass analytics offerings.

Direct peers

• Centivo: Centivo is a health plan provider built specifically for self-funded employers, offering integrated plan administration, primary-care-centered networks, and cost-control analytics. Directly comparable to Collective Health's TPA+Navigation stack targeting mid-market and large self-funded employers.
• Included Health: Included Health (formed from Doctor On Demand + Grand Rounds) provides virtual care, navigation, and behavioral health services integrated into employer benefit plans. Comparable to Collective Health on the navigation/advocacy and digital point-solution layers for self-funded employers.
• Accolade: Accolade is a personalized advocacy and navigation platform for employer health benefits, combining AI-driven member guidance with human healthcare assistants. Closely comparable to Collective Health's Navigation & Advocacy offering, although Accolade historically has partnered with TPBs rather than operating its own claims administration platform.

Broad incumbents

• Virgin Pulse (Personify Health): Personify Health (formerly Virgin Pulse) is a comprehensive employer wellbeing, navigation, and benefits engagement platform serving large employers globally. Adjacent to Collective Health's navigation/advocacy offering, with broader wellness and international footprint but weaker claims-administration depth.
• Elevance Health (Anthem): Elevance Health is one of the largest US health insurers with significant ASO/TPA capabilities and a national Blue Cross Blue Shield footprint. Competes head-to-head with Collective Health for self-funded employer accounts via its captive TPA and Carelon services platform.
• Cigna Group (Evernorth): Cigna operates a major commercial health business and Evernorth services platform including PBM, specialty pharmacy, and benefits administration. Competes with Collective Health for self-funded employer RFPs and offers bundled stop-loss and care services.
• UnitedHealth Group (Optum): UnitedHealth Group is the largest US health insurer with deeply integrated Optum services across PBM, care delivery, and benefits administration. The structural incumbent competitor for self-funded employer plans via UMR and other captive TPA subsidiaries.

Others

• Premise Health: Premise Health operates on-site and near-site primary care clinics for large self-funded employers and health systems. Comparable to Collective Health's clinical partnership layer (e.g., One Medical integration) and a potential ecosystem partner for care navigation.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xtwitter.com/Collective
• YouTubeyoutube.com/channel/UCoBFDclYuCtGgUVmA2XBHxg
• Facebookfacebook.com/CollectiveHealthInc
• LinkedInlinkedin.com/company/collectivehealth

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles20 records

Funding overview

Funding rounds6 records

Investors31 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 Collective Health