HealthPlanOne

What HealthPlanOne does

HealthPlanOne, operating commercially as HPOne and through consumer sub-brands ClearMatch Medicare and ClearMatch Insurance Agency, is a privately held digital health distribution and engagement company founded in 2006 and headquartered in Shelton, Connecticut. The company focuses on the U.S. Medicare-eligible 65+ population as its primary segment, with secondary reach into under-65 individual and family health insurance. It is licensed to operate in all 50 states and maintains appointment relationships with more than 80 insurance carriers, including Humana, Anthem/WellPoint, United Healthcare, Aetna, Cigna, and Blue Cross and Blue Shield plans. A retiree health exchange line of business extends the company's reach into employer-sponsored retiree benefits through partnerships with benefits administrators such as bswift and The Segal Group.

The core technology stack is a proprietary insurance shopping and enrollment platform that combines quote generation, plan comparison, enrollment processing, CRM, and consumer matching analytics. The platform is delivered through three primary channels: (1) direct-to-consumer digital properties including ClearMatchMedicare.com and the broker-facing quoting tools, (2) licensed-agent contact center operations located in Shelton, CT; Tampa and Orlando/Lake Mary, FL; Phoenix and Gilbert, AZ; and San Antonio, TX, and (3) lead generation and broker distribution services that supply qualified Medicare prospects to independent agents and benefits partners. The company also licenses elements of its technology and contact center capabilities to carrier and benefits administration partners.

Revenue is generated primarily through carrier commissions on Medicare Advantage, Medicare Supplement, Part D, and individual health policies sold or enrolled through the platform, supplemented by lead generation fees charged to independent agents and brokers, and by technology licensing and contact center services provided to carriers and benefits administrators. HealthPlanOne is private equity-backed, with Peloton Equity acquiring a majority stake in December 2014 and Lightyear Capital co-leading a growth recapitalization in June 2020. Leadership transitioned in July 2022 when Benjamin Pajak was appointed CEO, succeeding founder Bill Stapleton, who remains Executive Chairman.

Name

HealthPlanOne

Legal name

HealthPlanOne, LLC

Website

https://hpone.com

Company type

Private

Founded year

2006

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

HealthPlanOne (dba HPOne) is a private, PE-backed digital health insurance distribution platform founded in 2006 and licensed in all 50 U.S. states. It sells Medicare Advantage, Medicare Supplement, Part D, and individual health insurance through proprietary technology, licensed agents, contact centers, and the ClearMatch Medicare consumer brand.

Ownership category

akta.pro rank

Product category

Health Insurance Distribution and Brokerage (Medicare and Individual Health Plans)

NAICS

Agencies, Brokerages, and Other Insurance Related Activities (5242), Insurance Agencies and Brokerages (524210)

SIC

Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Medicare Plan Distribution & Brokerage (Captive, Independent, FMOs) (FSAIAGAH)

akta.pro secondary industries

Medigap Marketing, Lead Gen & Compliance (CMS/Do-Not-Call/TPMO) (HLAEADAE), Medicare Quality, Risk Adjustment & Stars Analytics/Services (FSAIAGAJ), Medigap Member Support & Care Navigation (Advocacy/Concierge) (HLAEADAH)

Keywords

• Medicare insurance distribution
• Health insurance brokerage
• Medicare Advantage enrollment
• Lead generation services
• Retiree health exchange

Headquarters

HQ city

Trumbull

HQ country

United States

HQ region

North America

Offices3 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

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

Revenue model

1. Insurance Sales Commissions: HealthPlanOne earns commissions from insurance carriers for each policy sold through its licensed agent force. The company has relationships with over 80 insurance carriers including Humana, Anthem/WellPoint, United Healthcare, Aetna, Cigna, and Blue Cross plans.
2. Lead Generation Services: Provides lead generation services to independent insurance brokers and agents, generating leads for Medicare and health insurance products for a fee
3. Technology Licensing and Services: Licensing of proprietary technology platform and contact center services to insurance carriers and benefits administration partners

Pricing tiers

Go-to-market motion3 records

Distribution channels5 records

Marketing channels5 records

Core offering

HealthPlanOne is a licensed insurance broker and digital distribution platform that sells Medicare Advantage, Medicare Supplement, Part D prescription drug plans, and individual/family health insurance to consumers through its ClearMatch Medicare consumer brand, an in-house licensed agent contact center, and a proprietary quoting and enrollment platform. It also generates and sells exclusive leads and white-label technology to independent insurance agents, brokers, and insurance carriers, and operates a private retiree health exchange for employers through partnerships with bswift and The Segal Group.

Product overview

HealthPlanOne operates as a digital health distribution platform and engagement company focused on the 65+ Medicare market and under-65 individual health insurance segments. The company offers a unified platform combining proprietary technology, digital marketing, lead generation, and licensed agent services. Core offerings include the HPOne Platform (digital marketing and member acquisition), ClearMatch Medicare (consumer-facing Medicare enrollment brand), Broker Quoting Tools (white-label technology for agents), Private Health Exchange for Retirees (employer-sponsored defined contribution solution), Contact Center Services, Lead Generation, and Performance Marketing programs. The company is appointed with 80+ carriers and holds licenses in all 50 states.

Differentiator

Problem solved

Functional benefit

Products and services

• HPOne Platform Proprietary digital platform combining lead generation, private health insurance exchange, broker/carrier tools, and contact center capabilities for the Medicare and individual health insurance markets; used by HPOne's in-house agents and licensed partner brokers.
• ClearMatch Medicare / ClearMatch Consumer Brand and Website Consumer-facing Medicare brand and ecommerce site providing easy-to-understand Medicare resources, plan comparisons, and enrollment for Medicare Advantage and Prescription Drug Plans, targeted at the 65+ Medicare-eligible population across all 50 U.S. states.
• Broker Quoting Tools (White-label Medicare Quoting Platform) White-label technology platform with a Medicare quoting tool offering customized mobile-friendly interface, integrated Rx drug pricing, instant accurate quotes, applications, summary of benefits, underwriting guides, and side-by-side plan comparisons; sold to independent insurance agents and brokers.
• Private Health Exchange for Retirees Online private exchange platform enabling retirees to view plan details, compare individual plans, utilize decision support tools, and access over 4,000 insurance plans from 80+ carriers nationally; used by employers transitioning retirees from group medical plans.
• Contact Center Services U.S.-based contact center services with expert agent teams, custom-built technology, IVR systems, call routing, and reporting for optimal sales performance during Medicare enrollment periods; sold to insurance carriers and benefit partners needing outsourced member acquisition.
• Lead Generation for Brokers and Agents Digitally generated exclusive Medicare and individual/family health insurance leads with verification, validation, and high close rates; sold to independent insurance agents and brokers.
• Performance Marketing for Health Plans No-risk performance marketing program where HPOne collaborates with health plans to establish enrollment and cost-per-acquisition targets, leveraging proprietary marketing, lead nurturing, and licensed agents to guarantee results; sold to insurance carriers seeking member acquisition.
• ClearChoice Exchange (Employer Retiree Health Exchange) Employer-facing healthcare exchange solution for managing retiree health care costs while enhancing flexibility, choice, and value for retirees; built around a defined contribution approach with plan comparison and decision support.
• Employer Solutions Private healthcare exchange offering for employers transitioning retirees from traditional group medical plans to a defined contribution approach, including enhanced communication materials, decision-making tools, HRA administration services, and reporting.
• Stars Solutions (Medicare Advantage Quality Program) Program supporting Medicare Advantage plans in improving quality of care as reflected in CMS Star Ratings; sold to Medicare Advantage carriers seeking to improve member outcomes and ratings.

Quantifiable outcome

• Over $1.5 billion in written premiums generated

Named customers6 records

Segments4 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

Nine partnerships are on record, tiered core.

• The Segal GroupcoreStrategic or Co-development Partner · 1 January 2014HealthPlanOne was selected by The Segal Group, a benefits consulting firm, to provide retiree health solutions as part of Segal's benefits offerings to their employer clients. This partnership positioned HealthPlanOne as a recommended retiree health solution for Segal's extensive corporate client base.
• bswiftcoreStrategic or Co-development Partner · 1 January 2013HealthPlanOne partnered with bswift to develop and deliver a retiree health exchange solution, combining HealthPlanOne's Medicare expertise and carrier relationships with bswift's benefits administration platform for employer retiree health benefits.
• CMS (Centers for Medicare and Medicaid Services)coreOthers · 1 January 2013HealthPlanOne entered into a Web Broker Entity Agreement with CMS, enabling the company to offer Medicare plan information and enrollment capabilities through its digital platform in compliance with federal health insurance marketplace requirements.
• HumanacoreGTM or Marketing PartnerHumana is a major insurance carrier partner whose Medicare and health insurance products are distributed through HealthPlanOne's sales platform and agent network across all 50 states.
• Anthem/WellPointcoreGTM or Marketing PartnerAnthem/WellPoint is an insurance carrier partner whose health insurance products are distributed through HealthPlanOne's sales platform and agent network.
• United HealthcarecoreGTM or Marketing PartnerUnited Healthcare is a major insurance carrier partner whose Medicare and health insurance products are distributed through HealthPlanOne's sales platform and agent network.
• AetnacoreGTM or Marketing PartnerAetna is an insurance carrier partner whose health insurance products are distributed through HealthPlanOne's sales platform and agent network.
• CignacoreGTM or Marketing PartnerCigna is an insurance carrier partner whose health insurance products are distributed through HealthPlanOne's sales platform and agent network.
• Blue Cross and Blue Shield PlanscoreGTM or Marketing PartnerRegional Blue Cross and Blue Shield insurance carriers are partner companies whose health insurance products are distributed through HealthPlanOne's sales platform and agent network across various states.

Scale indicators4 records

Recent moves12 records

Expansion highlights5 records

Direct peers

• eHealth: eHealth operates a leading online Medicare and individual health insurance marketplace with licensed agents across all 50 states, directly competing with HPOne in digital Medicare enrollment, lead generation, and carrier distribution. Both monetize via commissions from major carriers and offer multi-carrier comparison.
• GoHealth: GoHealth operates a Medicare-focused online insurance marketplace with proprietary technology and a large licensed-agent sales force, directly competing with HPOne in digital Medicare acquisition and multi-carrier distribution. Its technology-led marketplace model closely mirrors HPOne's HPOne Platform approach.
• SelectQuote: SelectQuote is a publicly traded senior-focused insurance distributor that uses a comparable inside-sales contact-center model to sell Medicare Advantage, Medicare Supplement, and life insurance products. It is one of the closest scaled comparables to HPOne's licensed-agent Medicare distribution motion.

Emerging players

• Quotacy: Quotacy is a digital life and Medicare insurance brokerage with online quoting and licensed-agent support. It overlaps with HPOne's individual life and Medicare distribution but at a meaningfully smaller scale.
• Medicareful (by MediaAlpha): Medicareful is a Medicare comparison and enrollment platform operating inside MediaAlpha's performance-marketing ecosystem, competing with HPOne in both consumer enrollment and broker lead generation. Its narrower scale makes it an emerging rather than direct peer.
• Chapter: Chapter is an emerging Medicare advisory platform that helps seniors navigate Medicare Advantage and Medigap options, using licensed advisors and technology. It competes with HPOne's ClearMatch Medicare brand for the same 65+ consumer, though with a higher-touch advisory model.

Broad incumbents

• Aetna (CVS Health): Aetna is a major HPOne carrier partner for Medicare and individual health, while also distributing through its own captive channels as part of CVS Health. It overlaps with HPOne's distribution footprint but competes as a vertically integrated payer.
• UnitedHealthcare (Optum): UnitedHealthcare is the largest Medicare Advantage carrier and a key HPOne distribution partner, but also operates its own AARP-branded direct-to-consumer enrollment and agent channels that compete with HPOne for the same senior consumer.
• Humana: Humana is both a major HPOne carrier partner and a broad incumbent in Medicare Advantage with growing direct-to-consumer distribution. It overlaps with HPOne in the Medicare consumer market but competes at the carrier level with its own agent and digital channels.

Others

• bswift: bswift is an HPOne strategic partner in retiree health exchange solutions and a broader benefits administration platform. They are economically aligned in serving employer retiree health, but bswift operates primarily in benefits technology and exchange infrastructure while HPOne drives the consumer Medicare enrollment.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/HealthPlanOne

Revenue estimate

Valuation estimate

Number of profiles

Profiles11 records

Funding overview

Funding rounds1 record

Investors3 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 HealthPlanOne