SimplePay Health
SimplePay Health is a Minnesota-based third-party administrator offering a price-transparent, self-insured health plan for employers with 100+ employees, featuring advance cost estimates, 0% statement financing, and a Health Valet concierge.
- Company typePrivate
- Founded-
- HeadquartersDallas, United States
- Headcount11–50
- GTM typeB2B
- OfferingServices
What SimplePay Health does
SimplePay Health, LLC is a Minnesota-based third-party administrator that offers an alternative, price-transparent health plan design for self-insured commercial employers with 100 or more employees. The company restructures the member experience around advance out-of-pocket cost disclosure, a single consolidated monthly statement, 0% financing on outstanding balances (or a 1.5% credit-back for paying in full), and a Health Valet concierge service for provider selection and care navigation. On the provider side, SimplePay pays contracted rates in full and eliminates patient-balance collection, materially simplifying the administrative burden of traditional health plan participation.
The product is delivered through a cloud-based health plan administration platform integrated with the Aetna Choice POS II network via Meritain Health, and surfaced to members through a web-based portal (member.simplepayhealth.com) and a mobile app on iOS and Android. Distribution is anchored by a broker channel targeting benefits advisors who serve self-insured employers, supplemented by direct enterprise sales. Revenue is generated from third-party administrator / administrative fees charged to employer groups and from the float on member-financed statement balances. The company is privately held, headquartered in Dallas with operations in Eagan, Minnesota, and operates exclusively in the United States under HIPAA Business Associate compliance.
The company is small (11-50 employees) and at an early commercial stage, with public-facing signals indicating active product development through 2024 (portal, app, broker program) and continued regulatory housekeeping (Terms of Use refresh in January 2025). No funding rounds, acquisitions, or named employer customers are publicly disclosed, which limits visibility into scale and growth velocity.
SimplePay Health firmographics
Firmographics- Name
- SimplePay Health
- Legal name
- SimplePay Health, LLC
- Website
- https://simplepayhealth.com
- Company type
- Private
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Short description
- SimplePay Health is a Minnesota-based third-party administrator offering a price-transparent, self-insured health plan for employers with 100+ employees, featuring advance cost estimates, 0% statement financing, and a Health Valet concierge.
- Ownership category
- akta.pro rank
SimplePay Health industry classification
Industry- Product category
- Health Plan Administration
- NAICS
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)
- SIC
- Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Self-Funded Employer Plan TPA (ASO Administration) (HLAEALAA)
- akta.pro secondary industry
- Compliance, Reporting & Regulatory Administration (ERISA/ACA/No Surprises) (HLAEALAJ)
Keywords
Where SimplePay Health is headquartered
LocationHeadquarters
- HQ city
- Dallas
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
SimplePay Health business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- Administrative/Third-Party Administrator Fees: SimplePay Health functions as an alternative health plan administrator or third-party administrator (TPA) for self-insured employers. Revenue is generated through administrative fees charged to employer groups for managing their health plan, processing claims, and providing the financing feature.
- Financing Interest / Credit Revenue: The 0% financing feature extended to members generates revenue through the float on the financed balances. Members can pay statements over time at 0% financing or pay in full to receive 1.5% credit back. The company benefits from the time value of money on outstanding balances.
Go-to-market motion3 records
Distribution channels3 records
Marketing channels7 records
SimplePay Health product offering
Product offeringCore offering
SimplePay Health is an alternative third-party administrator (TPA) for self-insured commercial employers, providing a redesigned health plan that delivers price certainty to members, eliminates upfront deductible payments, and consolidates multiple provider bills into a single monthly statement. The company operates the SimplePay Member Portal and Mobile App for member self-service, supports a Health Valet concierge team, and pays healthcare providers their contracted rates in full.
Product overview
SimplePay Health is a single unified health plan offering built around price transparency and financial simplicity. The core SimplePay Health Plan integrates with the Member Portal and Mobile App for member-facing functionality, while the Health Valet Service provides personalized concierge support. Additional service modules include Provider Services (simplified claims administration) and Broker Services (partner support for insurance brokers).
Differentiator
Problem solved
Functional benefit
Products and services
- SimplePay Health Plan Alternative self-insured health plan design that shows members their out-of-pocket cost for any medical service in advance, removes the upfront deductible payment burden, consolidates provider bills and EOBs into a single monthly statement, and offers 0% financing to pay over time or 1.5% credit back for paying in full.
- SimplePay Member Portal Cloud-based web portal at member.simplepayhealth.com that lets members search for providers, compare out-of-pocket prices across services, view benefits, access their monthly statement, and choose between 0% installment financing or full payment with a 1.5% credit-back incentive.
- SimplePay Health Mobile App Mobile application on Apple App Store and Google Play that delivers the same functionality as the Member Portal — provider search, price comparison, benefits viewing, statement access, and payment management — for members accessing their health plan from a smartphone.
- Health Valet Service Concierge support service staffed by healthcare professionals and available to SimplePay members via email and phone (1-800-606-3564 / [email protected]) to help locate high-quality, low-cost providers, compare costs, understand plan details, navigate specialist referrals, and access prescription assistance.
Quantifiable outcome
- Members who chose high-quality, low-cost providers doubled within the first year after implementing SimplePay.
- +2 more outcomes
Companies that use SimplePay Health
Customer profileSegments4 records
Ideal customer profiles2 records
SimplePay Health technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature5 records
SimplePay Health partnerships and signals
Strategic signalScale indicators4 records
Recent moves6 records
Expansion highlights5 records
SimplePay Health competitors and assessment
Company assessmentEmerging players
- Transcarent: Transcarent provides an employer- and health-plan-facing experience platform that aggregates navigation, virtual care, and cost transparency. It intersects with SimplePay Health's transparency and concierge positioning but operates as an overlay rather than a TPA.
- Included Health: Included Health combines virtual primary care, behavioral health, and benefits navigation for employer-sponsored populations. Its concierge and cost-navigation features overlap with SimplePay's Health Valet and member portal but it does not underwrite or administer the health plan itself.
Direct peers
- Thatch: Thatch provides modern health benefits infrastructure including ICHRA-focused plans for employers, with a tech-led, broker-enabled distribution motion that competes with SimplePay Health for the same self-funded employer buyer.
- Decent: Decent offers self-funded health plans for small businesses with cost-transparency features and broker distribution, addressing the same buyer (small/mid self-funded employer) as SimplePay Health with a comparable alternative-TPA model.
- Gravie: Gravie offers an alternative health benefits marketplace for employers and employees, including self-funded plan designs with cost-comparison tools and concierge support that overlap directly with SimplePay Health's transparency- and service-led value proposition.
- Sana Benefits: Sana Benefits provides alternative self-funded health plans for small and mid-sized employers with a similar broker-led distribution model and a focus on price transparency and simplified member experience, directly comparable to SimplePay Health's core offering.
- Vitable: Vitable delivers alternative health benefit plans targeted at small and mid-sized employers with a focus on price transparency and a simplified member experience, making it a closely comparable peer in the self-funded employer space.
- Sedera Health: Sedera offers medical cost-sharing communities positioned as an alternative to traditional health insurance for employer-sponsored groups, competing for similar self-funded and alternative-plan employer buyers with comparable broker-led distribution.
Broad incumbents
- Justworks: Justworks is a PEO that administers health benefits (among other HR services) for small and mid-sized employers. While broader in scope, it competes for the same self-funded / level-funded employer segment that SimplePay Health targets.
- Elevance Health: Elevance Health (parent of Anthem and several TPAs/administrators) is a major incumbent in self-funded plan administration, providing ASO services, provider networks, and stop-loss coverage that compete broadly with SimplePay Health's positioning for mid-market and large self-funded employers.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat4 records
Key risks6 records
Key highlights7 records
Customer concentration
SimplePay Health social profiles
Digital presenceSimplePay Health compliance and trust
Trust signalCompliance1 record
SimplePay Health financial estimates
Financial estimateRevenue estimate
Valuation estimate
SimplePay Health leadership team
Management profileNumber of profiles
Profiles2 records
SimplePay Health funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
SimplePay Health M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about SimplePay Health
What does SimplePay Health do?
SimplePay Health is an alternative third-party administrator (TPA) for self-insured commercial employers, providing a redesigned health plan that delivers price certainty to members, eliminates upfront deductible payments, and consolidates multiple provider bills into a single monthly statement. The company operates the SimplePay Member Portal and Mobile App for member self-service, supports a Health Valet concierge team, and pays healthcare providers their contracted rates in full.
Is SimplePay Health a public or private company?
SimplePay Health is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was SimplePay Health founded?
SimplePay Health was founded in -1. It employs 11 to 50 people.
Where is SimplePay Health based?
SimplePay Health is headquartered in Dallas, United States, in the North America region.
How does SimplePay Health make money?
Two revenue lines are on record. Administrative/Third-Party Administrator Fees are the primary driver. The others are financing Interest / Credit Revenue.
Who are SimplePay Health's main competitors?
Emerging players on record are Transcarent and Included Health. Direct peers are Thatch, Decent, Gravie, Sana Benefits, Vitable and Sedera Health. Broad incumbents are Justworks and Elevance Health.
Does SimplePay Health have an API?
No public API is recorded for SimplePay Health.
What industry is SimplePay Health in?
SimplePay Health's product category is Health Plan Administration. Its primary akta.pro industry code is HLAEALAA, Self-Funded Employer Plan TPA (ASO Administration), with a secondary code of HLAEALAJ, Compliance, Reporting & Regulatory Administration (ERISA/ACA/No Surprises). Its NAICS code is 524292 and its SIC code is 6324.