MotivHealth

What MotivHealth does

MotivHealth Insurance Company is a privately held health insurer founded in 2015 and headquartered in South Jordan, Utah. It underwrites and administers HSA-based health insurance plans, level-funded employer plans, and Administrative Services Only (ASO) arrangements for self-funded employer groups of 10+ employees, operating across Utah, Arizona, Colorado, Nevada, Texas, Georgia, Wisconsin, and Indiana. The company pairs these plans with in-house HSA administration and a proprietary integrated HSA investing platform (launched 2020) that offers real-time fractional share investing in mutual funds and ETFs above a $2,000 balance threshold.

The platform architecture combines three external-facing portals — member (member.motivhealth.com), employer/broker (employer.motivhealth.com), and provider (provider.motivhealth.com) — with a suite of cost-containment and engagement modules branded under the MotivAdvantage umbrella: MotivRx (prescription assistance eliminating out-of-pocket costs above $200/month), SmartPay (procedure cost savings of $250-$3,000), Steps Program ($1/day HSA rewards for 8,000+ steps up to 20 days/month), MotivU (five-module education with $50 HSA completion reward), and the Personal Health Assistant (PHA) concierge service available 6am-10pm. Integrated vendor partners include First Stop Health (telehealth), Azova (birth doulas), RecoveryOne (virtual PT/MSK), DecisionRx (pharmacogenomics), and IMS (cross-border Mexican network), with mobile apps on iOS and Android and step-data sync via Garmin, Fitbit, Apple Health, and Google Health Connect.

MotivHealth generates revenue primarily through recurring insurance premiums on level-funded plans (with reported average annual renewal increases under 8% versus an industry average of 20%+), ASO administrative fees on self-funded plans, and broker commissions structured as $40 per employee per month for 1-25 employee groups, $35 PEPM for 26-50, 5% PEPM for 51-100, and 3% PEPM for 100+. Distribution is broker-led for small and mid-market employers, with direct sales for enterprise accounts. An independent actuarial study in October 2025 validated 17% total medical and pharmacy cost savings for employers using MotivRx and SmartPay, supporting a member-engagement-driven cost differentiation thesis across more than 50,000 covered lives.

Name

MotivHealth

Legal name

MotivHealth Insurance Company

Website

https://motivhealth.com

Company type

Private

Founded year

2015

Operating status

Operating

Headcount range

51–100 employees

Short description

MotivHealth is a Utah-based, privately held health insurer offering HSA-based, level-funded, and self-funded (ASO) plans to employer groups of 10+ employees across eight states, paired with in-house HSA investing and cost-containment modules including MotivRx, SmartPay, and Personal Health Assistant concierge support.

Ownership category

akta.pro rank

Product category

Employer Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114), Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

High-Deductible Health Plans (HDHP) with HSA-Eligible Coverage (FSAIAFAM)

akta.pro secondary industries

Self-Funded (ASO) Group Health Plans & Stop-Loss (FSAIAFAB), Level-Funded Group Health Plans (FSAIAFAC), Eligibility, Enrollment & Benefits Administration (HLAEALAH), Flexible Benefits Administration (FSA/HSA/HRA) (HLAEALAK)

Keywords

• Employer health insurance
• HSA administration
• Level-funded plans
• Self-funded ASO
• Prescription assistance

Headquarters

HQ city

South Jordan

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Health Insurance Premiums: MotivHealth generates revenue through insurance premiums from level-funded and self-funded employer health plans. Premiums are collected monthly from employer groups with 10+ employees. The company has demonstrated average premium renewal increases of less than 8%, compared to industry average of 20%+.
2. Third-Party Administrator (TPA) Services: ASO (Administrative Services Only) fees for managing self-funded employer plans, handling plan management, streamlined enrollment and claims, and expert employee support. Stop-loss protection options available.
3. Broker Commissions: Commissions paid to insurance brokers/agents for writing commercial fully insured, level-funded, and self-funded business. Payment begins ~45 days after enrollment, then monthly by 15th of following month.

Pricing tiers

Go-to-market motion3 records

Distribution channels5 records

Marketing channels7 records

Core offering

MotivHealth sells HSA-based health insurance plans—primarily level-funded and self-funded (ASO) employer plans for groups of 10+ employees—paired with in-house HSA administration and an integrated HSA investment platform. Around the core plan, the company bundles cost-containment and engagement modules including MotivRx prescription assistance, SmartPay procedure savings, the Steps wellness incentive, MotivU education, MotivNet provider network, telemedicine, birth doulas, dental/vision, and concierge Personal Health Assistants. Distribution is led by appointed insurance brokers with direct employer sales supplementing the channel.

Product overview

MotivHealth is a Utah-based health insurance company offering HSA-based insurance plans as its core product, complemented by a comprehensive suite of cost-containment and member engagement modules. The company's portfolio includes level-funded and self-funded (ASO) employer plans, proprietary programs like MotivRx (prescription assistance), SmartPay (procedure cost savings), Steps Program (wellness incentives), MotivU (education), and MotivNet (provider network). The platform integrates in-house HSA administration with investment capabilities, supported by concierge Personal Health Assistant services and digital portals (member, employer, provider). The architecture combines a core insurance platform with modular add-on services including dental/vision, telemedicine, birth doulas, and price transparency tools, all designed to reduce healthcare costs while improving member outcomes.

Differentiator

Problem solved

Functional benefit

Brands

• MotivRx: Prescription assistance program that helps lower or eliminate out-of-pocket prescription drug costs for members taking medications costing more than $200 per month.
• SmartPay
• MotivU
• MotivNet
• Steps Program
• MotivHSA
• MotivMagazine
• MotivHealth App
• MotivAdvantage

Products and services

• HSA-Based Health Insurance Plans Core HSA-qualified health insurance plans that pair high-deductible health protection with a tax-advantaged Health Savings Account, designed for employer groups of 10+ employees and (via StartHealth partnership) individuals.
• Level-Funded Employer Health Plans Self-funded employer health plans for groups of 10+ employees offering the protection of fully insured plans with the flexibility of self-insurance, including stop-loss protection and the potential for annual refunds based on claims experience.
• ASO (Administrative Services Only) / Third-Party Administrator Services Third-Party Administrator services handling plan management, streamlined enrollment and claims, and expert employee support for self-funded companies, including stop-loss protection options and MotivAdvantage cost-containment programs.
• HSA Administration and Investment Platform In-house HSA administration platform allowing members to manage contributions, view balances, pay qualified medical expenses, and—once the account reaches a $2,000 minimum—invest HSA funds in mutual funds and ETFs with real-time fractional share investing across three investment path options.
• MotivRx Prescription Assistance Prescription assistance program that helps members lower or eliminate out-of-pocket prescription costs for medications over $200 per month, including insulin, with formulary lookup, pharmacy search, and prescription management through the SGRX Health portal.
• SmartPay Procedure Savings Program Cost-savings program connecting members with Personal Health Assistants to compare provider prices and access Prompt Pay participating facilities for planned medical procedures, with savings ranging from $250 to $3,000 per procedure.
• Steps Incentive Program Wellness incentive program that pays members $1 per day for walking 8,000+ steps (up to 20 days per month), deposited into their HSA, with spouse participation doubling earnings; integrates with Garmin, Fitbit, Apple Health, and Google Health Connect via the MotivHealth app.
• MotivU Member Education Platform Educational platform with five courses teaching members about health insurance and the healthcare system, with a $50 HSA reward upon completing all courses; over 4,000 MotivU graduates have earned the reward.
• MotivNet Provider Network Provider network offering access to contracted medical, dental, and vision providers across multiple states, with a provider portal for eligibility checks, claims status, and prior authorization submission; covers more than 50,000 lives.
• Dental and Vision Coverage Comprehensive dental and vision coverage bundled with health plans, with cost-effective coverage options accessible through the all-in-one member portal.
• Telemedicine (First Stop Health) 24/7 access to unlimited virtual urgent care and unlimited virtual mental health services delivered through partner First Stop Health, reducing low-acuity ED utilization and total cost of care for acute episodes.
• Birth Doulas (Azova) Maternal benefits program providing birth doulas for prenatal, delivery, and postpartum support, plus lactation support and breastfeeding supplies, delivered through partner Azova.
• Personal Health Assistants (PHA) Concierge Service Concierge support service staffed by real human assistants available 6am–10pm daily via phone and email to help members schedule appointments, answer questions, and find the best care at the best price; reported 97% satisfaction among members who have used the service.
• PBM Carve-Out (Pharmacy Benefit Management) Standalone pharmacy benefit management carve-out solution providing transparent pricing and tailored PBM services for self-funded employers seeking to reduce prescription drug costs.
• RecoveryOne Virtual Physical Therapy Virtual physical therapy program providing expert PT guidance online, licensed PT oversight, PT supplies, and health coaching for musculoskeletal surgical avoidance and post-surgery rehab compliance, delivered through partner RecoveryOne.

Quantifiable outcome

• 17% total medical and pharmacy cost savings per independent actuarial study
• +5 more outcomes

Named customers6 records

Segments3 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration5 records

Feature13 records

Partnerships

Six partnerships are on record, tiered core.

• First Stop HealthcoreTechnology or IntegrationTelehealth partner providing 24/7 access to unlimited virtual urgent care services and unlimited virtual mental health. Improves access to timely care, optimizes low-acuity ED utilization, and lowers total cost of care for acute episodes.
• AzovacoreTechnology or IntegrationMaternal benefits partner offering Birth Doulas (prenatal, delivery, and postpartum), lactation support, and breastfeeding supplies. Aims to reduce C-section rates, NICU stays/birth complications, and lower cost of care for delivery and postpartum.
• RecoveryOnecoreTechnology or IntegrationPT & MSK Support partner providing virtual physical therapy, licensed PT oversight, PT supplies, and health coaching. Focuses on MSK surgical avoidance, improved post-surgery rehab compliance, and lowered overall MSK related medical spend.
• DecisionRxcoreTechnology or IntegrationPharma-cogenomics partner offering personalized medication management relative to unique member DNA and medical history. Reduces prescription drug complications and reduces inpatient and ER admits.
• StartHealthcoreGTM or Marketing PartnerIndividual coverage partnership offering self-employed and small business coverage through StartHealth's reimbursement model. Members can see any doctor with no networks, HSA-Qualified plans, and comprehensive coverage.
• MotivRxcoreTechnology or IntegrationProprietary prescription assistance program lowering or eliminating out-of-pocket prescription costs for members spending $200+/month, including insulin. Available as carve-out standalone solution for self-funded employers.

Scale indicators11 records

Recent moves5 records

Expansion highlights5 records

Broad incumbents

• Cigna Group: Major national carrier in commercial group, individual, and stop-loss markets and current former employer of MotivHealth's CEO; comparable as a large incumbent whose Evernorth PBM and stop-loss divisions compete directly with MotivHealth's TPA and MotivRx offerings.
• Elevance Health: Blue Cross Blue Shield licensee with broad commercial group, ASO, and individual coverage plus Carelon services — comparable as a large incumbent competing for the same mid-market and self-funded employer RFPs.
• UnitedHealthcare (Optum): Largest US health insurer and benefits administrator offering fully insured, level-funded, ASO, HSA, and ancillary programs across all 50 states — sets the broker commission and renewal benchmark that MotivHealth positions against.

Emerging players

• Collective Health: Tech-enabled employer self-funded health benefits platform serving mid-market and enterprise employers with integrated plan administration and cost management — directly comparable TPA-as-a-service and member-experience proposition.
• Lucent Health: Third-party administrator focused on self-funded employer health plans for mid-market and small employer groups with stop-loss and care management — closely comparable to MotivHealth's ASO/TPA core motion.
• Oscar Health: Technology-led health insurer targeting individual and small-group ACA and employer markets with consumer-engagement features; comparable as a digital-first challenger carrier competing on member experience rather than network scale.
• Bright Health Group: Narrow-network, value-based health plan that scaled rapidly through technology-driven product design and clinical partnerships — relevant comparable for a private, technology-led health insurer pursuing multi-state expansion.

Direct peers

• SelectHealth: Intermountain Health-owned regional health plan offering employer-sponsored coverage including level-funded and self-funded plans in Utah and surrounding Mountain West states — the same primary geographies and product mix as MotivHealth.
• HealthEquity: NASDAQ-listed HSA custodian and consumer-directed benefit administrator. Most comparable peer: MotivHealth's founder Dave Hall co-founded HealthEquity, and MotivHealth's HSA investing platform directly competes with HealthEquity's core HSA investment offering, while MotivHealth also acts as the underlying health plan.

Regional players

• PacificSource Health Plans: Mutual regional health plan offering employer-sponsored, self-funded, and individual coverage across the Pacific Northwest and Mountain West — directly comparable size, geographic posture, and product breadth to MotivHealth.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/MotivHealth
• Facebookfacebook.com/motivhealth
• LinkedInlinkedin.com/company/motivhealth
• Instagraminstagram.com/motivhealth

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles8 records

Funding overview

Funding rounds

Investors

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 MotivHealth