Benecon Group

What Benecon Group does

Benecon Group is a Pennsylvania-based financial and insurance services company that develops and manages self-funded health benefit programs for small and mid-sized employers and public sector entities across all 50 US states. Founded in 1991 by Samuel N. Lombardo, the company administers plans covering approximately 80,000 members with $80 billion in health plan assets under management across 14 self-funded programs, including the VERIS Benefits Consortium and several state-licensed government cooperatives (PA Municipal, PA Counties, Intergovernmental, LGIT Health). The core offering pools stop-loss purchasing power and provides employer-owned claim funds with rate caps, guaranteed renewals, and no new lasers at renewal — features unavailable to standalone small-group buyers facing standard fully insured or stand-alone self-funded arrangements.

Name

Benecon Group

Legal name

The Benecon Group, LLC

Website

https://benecon.com

Company type

Private

Founded year

1991

Operating status

Operating

Headcount range

101–250 employees

Short description

Benecon Group administers self-funded health benefit programs through its VERIS Benefits Consortium for small and mid-sized employers and public sector entities across all 50 US states, serving roughly 80,000 members and $80 billion in health plan assets under management.

Ownership category

akta.pro rank

Product category

Self-Funded Health Benefits Administration

NAICS

Health and Welfare Funds (525120), Other Insurance Funds (525190), Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Insurance Agents, Brokers & Service (6411), Hospital & Medical Service Plans (6324), Services-Management Consulting Services (8742)

akta.pro primary industry

Self-Funded (ERISA) Employer Plans (HLAEAAAC)

akta.pro secondary industries

Self-Funded (ASO) Group Health Plans & Stop-Loss (FSAIAFAB), Flexible Benefits Administration (FSA/HSA/HRA) (HLAEALAK), Association & PEO Group Health Plans (AHP/PEO-Sponsored) (FSAIAFAH)

Keywords

• Self-funded health benefits
• Benefits consortium management
• Stop-loss insurance purchasing
• Health benefits administration
• Actuarial services consulting

Headquarters

HQ city

Lititz

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Self-Funded Plan Administration: Benecon generates revenue by administering self-funded health benefit plans for employer groups through the VERIS consortium and other programs. Revenue comes from administrative fees, stop-loss premium equivalents, and consortium management fees based on plan size and complexity.
2. VERIS Consortium Fees: Revenue from managing the VERIS Benefits Consortium, including stop-loss purchasing, actuarial services, compliance support, and claim fund management for member employers.
3. Ancillary Services: Additional revenue streams from CDH products (HSA, HRA, FSA administration), COBRA administration, general agency services, and ancillary benefit products including life, disability, dental, and vision.

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels8 records

Core offering

Benecon Group develops and administers self-funded health benefit programs for employers, primarily small and mid-sized businesses and public sector entities. The company's flagship VERIS Benefits Consortium pools employer purchasing power for stop-loss coverage while delivering guaranteed renewals, rate caps, no new lasers, and employer-owned claim funds. Supporting offerings include Benecon Analytics claims reporting, Benecon360° consultant portal, CDH product administration, COBRA administration, ConnectCare3 cost containment, and ancillary benefits.

Product overview

Benecon Group operates a multi-platform architecture centered on the VERIS Benefits Consortium for self-funded health benefits. The core VERIS platform provides pooled purchasing power and transparent claims management, while Benecon360° serves as the consultant-facing portal for quotes, renewals, and account management. Supporting modules include Benecon Analytics (claims reporting), CDH Products (HSA/HRA/FSA administration), COBRA Administration, ConnectCare3 (cost containment), Nurse Navigation, Diabetes Education, and Ancillary Services. The company pioneered Self-Funding as a Service (SFaaS), combining proprietary actuarial modeling with web-based platforms to deliver turnkey self-funding solutions for small and mid-sized businesses.

Differentiator

Problem solved

Functional benefit

Brands

• VERIS: Benecon's industry-leading benefits consortium platform providing consultant-driven solutions for creating and managing group benefits programs for self-funded employers.

Products and services

• VERIS Benefits Consortium Employer health benefits consortium enabling small and mid-sized businesses to self-fund healthcare through pooled purchasing power. Delivers guaranteed renewals, no new lasers, rate caps, and full claims transparency, with independent actuarial pricing not driven by carrier profit margins.
• Self-Funding as a Service (SFaaS) Tech-enabled turnkey self-funding platform for employers, providing proprietary actuarial modeling, claims analytics, wellness platform, plan performance reporting, and data-driven cost savings in a packaged offering.
• Benecon Analytics Claims analytics platform that consolidates medical and pharmacy data from TPA/PBM sources, delivering financial reporting, chronic condition gap analysis, preventive care insights, and actionable cost-containment recommendations for employer plans.
• Benecon360° Consultant Portal Interactive consultant portal providing real-time group information, renewal management, online quoting, implementation tracking, RFP status, and 5500 filing capabilities for broker and consultant partners.
• CDH Products (HSA/HRA/FSA Administration) Consumer Directed Healthcare administration including HSA, HRA, FSA, DCAP, QSEHRA, commuter benefits, educational reimbursements, and LSA, delivered via a 24/7 web-based platform with employer and participant portals and the Benecon Benefits Card.
• COBRA Administration Full-service COBRA administration covering federal and Pennsylvania state compliance, with an online platform offering 24/7 portals, payment processing, detailed reporting, and a dedicated client service team.
• ConnectCare3 Cost Containment Cost containment solution integrated with VERIS that provides nurse navigation, diabetes education, wellness incentive tracking, and clinical support services to reduce unnecessary spend while improving outcomes.
• Ancillary Services Full range of ancillary benefit solutions including group life/AD&D, short- and long-term disability, dental, vision, worksite benefits, and voluntary programs, with RFP implementation, renewal governance, and contract review for employer groups.
• General Agency Services General Agency back-office services for independent broker and producer partners, providing quoting tools, commission support, monthly educational webinars, and ongoing renewal assistance for selling VERIS and ancillary services to employer clients.

Quantifiable outcome

• 27% savings in healthcare costs vs. fully insured alternatives over 5 years
• +8 more outcomes

Named customers8 records

Segments4 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration3 records

AI capability2 records

Feature5 records

Partnerships

Two partnerships are on record, tiered core.

• ConnectCare3coreTechnology or IntegrationConnectCare3 provides integrated cost containment services including nurse navigation, diabetes education, wellness programs, and clinical services as a fully-integrated component of the VERIS plan offering.
• Independent ActuariescoreStrategic or Co-development PartnerBenecon uses independent actuaries to set rates and claim fund projections, ensuring fairness and avoiding carrier-driven pricing that prioritizes financial returns over employer benefit.

Scale indicators8 records

Recent moves6 records

Expansion highlights6 records

Broad incumbents

• Unum Group: Major provider of group disability, life, and supplemental health benefits to US employers. Overlaps with Benecon's ancillary benefits and stop-loss-adjacent offerings, particularly for SMB and mid-market employer segments.
• UnitedHealthcare (UnitedHealth Group): Largest US health insurer offering fully insured and self-funded products plus stop-loss through Optum. Competes with Benecon for SMB self-funded business and provides network access that Benecon depends on as a carrier partner.
• Sun Life Financial: Large group benefits carrier offering stop-loss, group life, disability, and dental products to US employers. Comparable to Benecon in the group benefits and stop-loss space but as a diversified incumbent with broader product portfolio and owned distribution.
• Cigna Group: Major national health carrier with significant employer-sponsored and stop-less businesses serving SMB and mid-market. Comparable as a large incumbent competing for the same self-funded employer segment Benecon targets via VERIS.
• Voya Financial: Diversified financial services firm with significant employer-sponsored benefits administration, stop-loss, and CDH capabilities. Overlaps with Benecon in self-funded administration, stop-loss, and FSA/HSA products serving mid-market employers.
• Aetna (CVS Health): National health insurer with self-funded and stop-loss offerings for US employers. Functions as both a Benecon carrier partner and a competitor for self-funded employer business across multiple regions.

Emerging players

• PlanSource Benefits: Cloud-based benefits administration and enrollment platform serving SMB and mid-market employers and brokers. Comparable to Benecon's Benecon360 consultant portal as a broker/employer-facing benefits technology platform.

Direct peers

• HealthEquity: Leading HSA and consumer-directed healthcare (CDH) administrator serving US employers and health plans. Direct competitor in Benecon's CDH Products (HSA/HRA/FSA) line and a comparable benefits-administration platform for employer-sponsored plans.
• The Phia Group: Specialized stop-loss, claims management, and cost-containment consulting firm serving self-funded employer plans and TPAs. Closely comparable to Benecon's stop-loss purchasing, claims advocacy, and renewal governance services for self-funded groups.
• Sentinel Group: Independent benefits, insurance, and wealth management firm offering self-funded plan administration, stop-loss, and consulting for employers and municipalities. Directly comparable to Benecon in serving public-sector cooperatives and mid-market employers with self-funded solutions.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xtwitter.com/thebenecongroup
• YouTubevimeo.com/benecon
• Facebookfacebook.com/Benecon
• LinkedInlinkedin.com/company/benecon-group

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles15 records

Funding overview

Funding rounds2 records

Investors2 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 Benecon Group