Peach State Health Plan
Peach State Health Plan is a Centene subsidiary administering Medicaid, Ambetter Marketplace, and Wellcare Medicare Advantage plans across all 149 Georgia counties, serving low-income families, children, pregnant women, working adults, and seniors as one of two state-contracted Medicaid MCOs.
- Company typePrivate
- Founded2006
- HeadquartersAtlanta, United States
- Headcount501–1,000
- GTM typeB2C
- OfferingServices
What Peach State Health Plan does
Peach State Health Plan is a Georgia-based managed care organization and wholly-owned subsidiary of Centene Corporation (NYSE: CNC), founded in 2006 and headquartered in Atlanta. The company administers Medicaid (Georgia Families, PeachCare for Kids, Planning for Healthy Babies, Georgia Pathways to Coverage), Health Insurance Marketplace (Ambetter), and Medicare Advantage (Wellcare of Georgia) products for Georgia residents, covering all 149 counties in the state. As one of only two Georgia Medicaid managed care organizations contracted with the Georgia Department of Community Health (alongside CareSource), the company operates in a structurally concentrated duopoly for government-sponsored coverage.
Revenue is generated through capitated per-member-per-month premiums from Medicaid, premium revenue from Ambetter Marketplace plans (Bronze, Silver, Gold, and Select tiers, including off-exchange ICHRA-compatible plans), and Medicare Advantage premiums under the Wellcare brand. Distribution combines direct enrollment via the Georgia Access state-based ACA Marketplace, a licensed broker channel, field sales for enterprise ICHRA and state Medicaid relationships, and digital enrollment through web and mobile platforms. The company has 501-1,000 employees and is led by Plan President and CEO Clyde White.
The technology stack is largely an integration layer atop Centene enterprise platforms: PaySpan Health for provider EFT/ERA, Availity for eligibility and authorization, Express Scripts for mail-order pharmacy, Walgreens for retail pharmacy, Evolut/TurningPoint/CareCentrix for specialty prior authorization, and a broad telehealth stack (MDLive, Teladoc, Brightside Health, Grow Therapy, Rula Health, Great Speech). Member-facing tools include the Wellframe digital care app and the My Health Pays rewards program (up to $500 annually). Value-added benefits span mental health apps, grocery allowances, childcare assistance, summer camp, and wellness rewards. A pending 20% reduction in Medicaid reimbursement for pediatric therapy, effective May 15, 2026, is the most significant near-term unit economics event.
Peach State Health Plan firmographics
Firmographics- Name
- Peach State Health Plan
- Legal name
- Ambetter of Peach State Inc.
- Website
- https://pshpgeorgia.com
- Company type
- Private
- Founded year
- 2006
- Operating status
- Operating
- Headcount range
- 501–1,000 employees
- Short description
- Peach State Health Plan is a Centene subsidiary administering Medicaid, Ambetter Marketplace, and Wellcare Medicare Advantage plans across all 149 Georgia counties, serving low-income families, children, pregnant women, working adults, and seniors as one of two state-contracted Medicaid MCOs.
- Ownership category
- akta.pro rank
Peach State Health Plan industry classification
Industry- Product category
- Managed Health Care Insurance
- NAICS
- Direct Health and Medical Insurance Carriers (524114), Direct Life, Health, and Medical Insurance Carriers (52411)
- SIC
- Accident & Health Insurance (6321), Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- TANF/CHIP Managed Care Plans (HLAEAEAA)
- akta.pro secondary industries
- Medicare Quality, Risk Adjustment & Stars Analytics/Services (FSAIAGAJ), Fully Insured Small Group Plans (HLAEAAAB)
Keywords
Where Peach State Health Plan is headquartered
LocationHeadquarters
- HQ city
- Atlanta
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Peach State Health Plan business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- Medicaid Managed Care Premiums: Capitated premium payments from Georgia Department of Community Health for administering Georgia Families Medicaid, PeachCare for Kids, Planning for Healthy Babies, and Georgia Pathways programs. Revenue based on per-member-per-month (PMPM) capitation rates.
- Health Insurance Marketplace (Ambetter): Premium revenue from individual/family plans sold through ACA Marketplace (Georgia Access). Members may receive premium tax credits based on income. Open enrollment November 1 - January 15 annually.
- Medicare Advantage Premiums: Part C Medicare Advantage plans (Wellcare brand) providing hospital, medical, and prescription drug coverage to Medicare-eligible individuals.
- Ambetter Health Solutions (ICHRA): Off-exchange individual health insurance plans compatible with Individual Coverage Health Reimbursement Arrangements, supporting employers adopting ICHRA reimbursement models.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Ambetter Health Marketplace plans with Bronze, Silver, Gold, and Select tier options available in 149 Georgia counties for 2026 plan year. |
Go-to-market motion2 records
Distribution channels5 records
Marketing channels5 records
Peach State Health Plan product offering
Product offeringCore offering
Peach State Health Plan is a managed care organization that administers government-sponsored and commercial health insurance products to Georgia residents. It delivers Medicaid coverage (Georgia Families, PeachCare for Kids, Planning for Healthy Babies, Georgia Pathways), Health Insurance Marketplace Qualified Health Plans under the Ambetter brand, and Medicare Advantage plans under the Wellcare brand. Core operations include provider network management, claims administration, care management, and member services supported by integrated digital portals and partner-driven telehealth, pharmacy, and transportation services.
Product overview
Peach State Health Plan operates as a Medicaid managed care organization and Health Insurance Marketplace insurer in Georgia, offering a multi-product portfolio under the Centene Corporation umbrella. The core offerings include Georgia Families Medicaid, Georgia Families PeachCare for Kids, Planning for Healthy Babies, Georgia Pathways to Coverage Program, and Medicare Advantage (Wellcare) plans. The Ambetter brand serves Marketplace customers with Bronze, Silver, Gold, and Select plans across 149 Georgia counties. Value-added services include Virtual 24/7 Care telehealth, My Health Pays Rewards (up to $500/year), Ambetter Perks discounts, Care Management Services, Nurse Advice Line, Health Management Programs for chronic conditions, Start Smart for Your Baby maternity program, Non-Emergency Medical Transportation, Partnerships in Care behavioral health program, and the Wellframe digital care app. All products integrate with third-party providers including PaySpan Health for payments, Express Scripts for pharmacy, Walgreens for retail pharmacy, and various telehealth providers (MDLive, Teladoc, Brightside Health, Grow Therapy, Rula Health, Great Speech).
Differentiator
Problem solved
Functional benefit
Brands
- Ambetter Health: Health Insurance Marketplace product offering affordable health insurance plans in Georgia, including bronze, silver, gold, and select tier plans with benefits such as preventive care, mental health, and prescription coverage.
- Wellcare
Products and services
- Georgia Families Medicaid Medicaid managed care program providing health coverage for eligible Georgia residents including preventive care, hospitalizations, prescriptions, mental health services, and maternity care for low-income families, children, pregnant women, and individuals with disabilities.
- PeachCare for Kids Georgia's Children's Health Insurance Program (CHIP) administered by Peach State Health Plan, providing comprehensive health coverage including doctor visits, dental, vision, and prescription drugs for uninsured children in families with incomes above Medicaid limits but below 200% FPL.
- Planning for Healthy Babies Family planning program providing inter-pregnancy care services, family planning, and Resource Mother support for Georgia women who have had a previous very low birth weight baby, addressing infant mortality through family planning and interconception care.
- Georgia Pathways to Coverage Program State Medicaid expansion program helping eligible working Georgia residents aged 19-64 with incomes below 100% FPL gain health coverage through community engagement and qualifying activities.
- Ambetter from Peach State Health Plan (Health Insurance Marketplace Plans) Qualified Health Plan offered through the Georgia Access ACA Marketplace for individuals and families not covered by employer or government programs, providing Bronze, Silver, Gold, and Select tier plans with essential health benefits, preventive care, mental health coverage, prescription drug coverage, and optional dental and vision across 149 Georgia counties.
- Ambetter Select Plans Network-specific Ambetter Marketplace plan variants including Select Wellstar, Select Plus, Select St. Joseph's Candler, and Gwinnett Plans, providing tailored provider networks within the broader Ambetter Marketplace product line.
- Ambetter Health Solutions (ICHRA) Off-exchange marketplace business providing individual health insurance plans compatible with Individual Coverage Health Reimbursement Arrangements (ICHRAs), supporting employers adopting ICHRA reimbursement models for workforce coverage.
- Wellcare of Georgia Medicare Advantage Plans Medicare Advantage (Part C) and Medicare Prescription Drug Plans offered under the Wellcare brand in Georgia, providing hospital, medical, and prescription drug coverage with additional benefits beyond Original Medicare, distributed through licensed agents, brokers, and direct enrollment.
Quantifiable outcome
- Rewards program offers up to $500 for healthy activities including wellness visits, health screenings, and online challenges
Companies that use Peach State Health Plan
Customer profileNamed customers1 record
Segments6 records
Ideal customer profiles4 records
Peach State Health Plan technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration13 records
Feature4 records
Peach State Health Plan partnerships and signals
Strategic signalPartnerships
15 partnerships are on record, tiered minor and core.
- Big Brothers Big Sisters of AmericaminorPeach State Health Plan participated in the 2026 Big Brothers Big Sisters of America National Conference in Atlanta, Georgia, reinforcing its commitment to community engagement through mentorship programs. The conference brought together affiliates, corporate partners, and youth development leaders to discuss best practices and expansion of mentoring relationships.
- VeridacoreVerida provides Non-Emergency Medical Transportation (NEMT) services for Peach State Health Plan members across five Georgia regions: Atlanta (404-209-4000), Central (1-888-224-7981), Southwest (1-888-224-7985), North (1-866-388-9844), and Southeast/East (1-888-224-7988).
- PaySpan HealthcorePaySpan Health provides innovative web-based Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) solutions for providers at no cost. Enables HIPAA 835 electronic remittance file downloads and practice management system integration.
- WalgreenscoreWalgreens partnership provides Ambetter members 20% off Walgreens brand health and wellness products, prescription access, pharmacy clinical services including Pharmacy Chat (24/7), COVID-19/flu testing, vaccinations, and Same Day Prescription Delivery. Available at over 8,600 locations.
- MDLive (Telehealth)coreMDLive provides virtual urgent care services available to members of all ages, virtual mental health services for members 10 years and older, and virtual dermatology for members 12 years and older as part of Ambetter Telehealth 24/7 Care program.
- Teladoc (Telehealth)coreTeladoc provides virtual urgent care and virtual mental health services for members 13 years and older through Ambetter Telehealth 24/7 Care program.
- Brightside HealthcoreBrightside Health provides virtual mental health services including therapy and psychiatry for members 13 years and older, addressing anxiety, depression, addiction, ADHD, grief, stress, trauma, and PTSD.
- Evolent (Medical and Radiation Oncology)coreEvolent provides prior authorization management for medical and radiation oncology services, biopharmacy drugs, complex imaging (MRA, MRI, PET, CT scans), musculoskeletal services, pain management, and spinal cord stimulator services for Ambetter from Peach State Health Plan.
- TurningPoint HealthcarecoreTurningPoint Healthcare manages prior authorization for cardiac and Ear, Nose and Throat (ENT) services for Ambetter from Peach State Health Plan members.
- CareCentrixcoreCareCentrix manages prior authorization for post-acute facility services including Skilled Nursing Facilities (SNF), Inpatient Rehabilitation Facilities (IRF), and Long-Term Acute Care (LTAC) for Ambetter members.
- Centene Vision ServicescoreCentene Vision Services handles vision service verification and authorization for Ambetter from Peach State Health Plan members.
- Centene Dental ServicescoreCentene Dental Services manages dental service verification and authorization for Ambetter from Peach State Health Plan members.
- Express Scripts PharmacycoreExpress Scripts Pharmacy provides mail-order pharmacy services for Ambetter members, offering 90-day prescription supplies with free delivery to home, workplace, or any chosen address.
- WellframecoreWellframe app connects members with care managers, sends medication reminders, and enables progress tracking for care management services.
- Centene CorporationcoreCentene Corporation (NYSE: CNC) is the parent company of Peach State Health Plan. A leading healthcare enterprise providing insurance to under-insured and uninsured populations through Health Insurance Marketplace and government programs.
Scale indicators3 records
Recent moves6 records
Expansion highlights5 records
Peach State Health Plan competitors and assessment
Company assessmentDirect peers
- Molina Healthcare: Molina is a government-sponsored managed care specialist focused on Medicaid and Marketplace plans across multiple states — a direct peer given its similar product mix, premium-based revenue model, and Medicaid contract orientation.
- Oscar Health: Oscar Health is an individual Marketplace-focused carrier operating on ACA exchanges — directly comparable to Peach State's Ambetter individual Marketplace product with similar technology-led member engagement approach.
- CareSource: CareSource is the only other Georgia Medicaid managed care organization alongside Peach State, directly comparable in Medicaid product mix, state contract model, and Georgia-only service area.
- Anthem Blue Cross Blue Shield of Georgia: Anthem offers Ambetter's primary Marketplace competitor on Georgia Access plus Medicare Advantage and commercial plans in Georgia — directly comparable to Peach State's Ambetter, Wellcare, and commercial offerings across the same state.
- Humana: Humana is a major Medicare Advantage carrier with growing Georgia MA presence — directly comparable to Peach State's Wellcare Medicare Advantage product line in the same state.
- UnitedHealthcare Georgia: UnitedHealthcare offers Medicaid, Medicare Advantage, and individual Marketplace plans in Georgia, making it a direct multi-line competitor to Peach State across all three of its core product segments.
Others
- Ambetter from Peach State Health Plan (within Centene): Peach State's Ambetter brand sits within Centene's national Ambetter franchise — comparable state-level sister plans such as Ambetter from Sunshine Health or Ambetter from Superior HealthPlan operate identical Marketplace product templates in their respective states.
Broad incumbents
- Aetna (CVS Health): Aetna offers Medicare Advantage and individual Marketplace plans in Georgia as part of CVS Health's broader portfolio — comparable to Peach State's MA and Marketplace offerings but operating as part of a much larger diversified healthcare enterprise.
Emerging players
- Alignment Healthcare: Alignment Healthcare is a tech-forward Medicare Advantage insurer — comparable to Peach State's Wellcare MA line in product category but operating as a smaller, emerging player with technology-driven care management focus.
Regional players
- Kaiser Permanente Georgia: Kaiser Permanente competes in Georgia on the Marketplace and offers integrated care delivery — comparable to Peach State's Ambetter Marketplace product but operates a different integrated provider-network model.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks5 records
Key highlights6 records
Customer concentration
Peach State Health Plan social profiles
Digital presencePeach State Health Plan financial estimates
Financial estimateRevenue estimate
Valuation estimate
Peach State Health Plan leadership team
Management profileNumber of profiles
Profiles1 record
Peach State Health Plan subsidiaries and ownership
Company hierarchySubsidiaries2 records
Peach State Health Plan funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Peach State Health Plan M&A and investment
M&A and investmentM&A
Investments1 record
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Peach State Health Plan
What does Peach State Health Plan do?
Peach State Health Plan is a managed care organization that administers government-sponsored and commercial health insurance products to Georgia residents. It delivers Medicaid coverage (Georgia Families, PeachCare for Kids, Planning for Healthy Babies, Georgia Pathways), Health Insurance Marketplace Qualified Health Plans under the Ambetter brand, and Medicare Advantage plans under the Wellcare brand. Core operations include provider network management, claims administration, care management, and member services supported by integrated digital portals and partner-driven telehealth, pharmacy, and transportation services.
Is Peach State Health Plan a public or private company?
Peach State Health Plan is a private company. It is classified as corporate owned and is currently operating.
When was Peach State Health Plan founded?
Peach State Health Plan was founded in 2006. It employs 501 to 1,000 people.
Where is Peach State Health Plan based?
Peach State Health Plan is headquartered in Atlanta, United States, in the North America region.
How does Peach State Health Plan make money?
Four revenue lines are on record. Medicaid Managed Care Premiums are the primary driver. The others are health Insurance Marketplace (Ambetter), medicare Advantage Premiums and ambetter Health Solutions (ICHRA).
Who are Peach State Health Plan's main competitors?
Direct peers on record are Molina Healthcare, Oscar Health, CareSource, Anthem Blue Cross Blue Shield of Georgia, Humana and UnitedHealthcare Georgia. Ambetter from Peach State Health Plan (within Centene) is listed as an others. Aetna (CVS Health) is listed as a broad incumbent. Alignment Healthcare is listed as an emerging player. Kaiser Permanente Georgia is listed as a regional player.
Does Peach State Health Plan have an API?
No public API is recorded for Peach State Health Plan.
What industry is Peach State Health Plan in?
Peach State Health Plan's product category is Managed Health Care Insurance. Its primary akta.pro industry code is HLAEAEAA, TANF/CHIP Managed Care Plans, with a secondary code of FSAIAGAJ, Medicare Quality, Risk Adjustment & Stars Analytics/Services. Its NAICS code is 524114 and its SIC code is 6321.