PacificSource

What PacificSource does

PacificSource Health Plans is a nonprofit, privately-held health insurance company founded in 1933 by 13 physicians as a cooperative and headquartered in Bend, Oregon. The company provides a comprehensive portfolio of health insurance products across four states — Idaho, Montana, Oregon, and Washington — including individual and family plans, small group (1-50 employees) and large group (51+) employer plans, self-funded employer plans, Medicare Advantage and D-SNP plans, Medicaid managed care through the Oregon Health Plan, standalone dental coverage, and the Program of All-Inclusive Care for the Elderly (PACE). Operating subsidiaries include PacificSource Community Solutions (Medicaid), PacificSource Community Health Plans (Medicare Advantage and OHP), PacificSource Administrators, Inc. (TPA services), and PacificSource PACE, LLC.

The company's technology stack centers on the InTouch member portal, the myPacificSource mobile application (iOS and Android), the InTouch for Providers portal for healthcare provider administration, and interoperability APIs supporting CMS-mandated data exchange and transparency requirements. Telehealth services are delivered through partner Teladoc. Recent product initiatives include a tech-enabled dementia management program with Ceresti Health for Medicare Advantage and D-SNP members, leveraging caregiver tablets, personalized education, and dedicated coaching. PacificSource has also adopted the Databricks Data Intelligence Platform for data infrastructure. Distribution is multi-channel: direct-to-consumer via website and call center, employer group sales, government-facilitated Medicare and Medicaid enrollment, and licensed insurance producers/brokers.

Revenue is generated primarily through recurring monthly health insurance premiums collected from individuals, families, employers, and government programs. Pricing is quote-based and varies by plan type, coverage level, geography, age, and risk profile; specific rates are not publicly disclosed. The company employs 501-1,000 people. In 2026, PacificSource announced exits from Montana's marketplace, Oregon's individual market, and the ACA Marketplaces for plan year 2027, citing rising healthcare costs and industry headwinds. AM Best withdrew PacificSource Health Plans' credit ratings in October 2025 at the company's request, noting weak risk-adjusted capitalization despite earnings improvements. The company was also fined $100,000 by the Washington state Insurance Commissioner for incorrectly processing claims resulting in over $85,000 in improper consumer co-payments.

Name

PacificSource

Legal name

PacificSource Health Plans

Website

https://pacificsource.com

Company type

Private

Founded year

1933

Operating status

Operating

Headcount range

501–1,000 employees

Short description

PacificSource Health Plans is a nonprofit, cooperative health insurer founded in 1933, providing individual, employer, Medicare, Medicaid, dental, and PACE plans across Idaho, Montana, Oregon, and Washington, with roughly 501-1,000 employees.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Health and Welfare Funds (525120), Nursing and Residential Care Facilities (623)

SIC

Hospital & Medical Service Plans (6324), Services-Health Services (8000)

akta.pro primary industry

Compliance, Reporting & Regulatory Administration (ERISA/ACA/No Surprises) (HLAEALAJ)

Keywords

• Health insurance plans
• Medicare Advantage coverage
• Employer group benefits
• Medicaid managed care
• Dental insurance products

Headquarters

HQ city

Springfield

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

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

Revenue model

1. Health Insurance Premiums: PacificSource generates revenue primarily through collecting premiums from individuals, families, employers, and government programs (Medicare, Medicaid) in exchange for health coverage. Premiums are collected on a monthly basis and cover medical services, prescription drugs, and preventive care.

Go-to-market motion1 record

Distribution channels5 records

Marketing channels5 records

Core offering

PacificSource is a nonprofit health insurance company that underwrites and administers medical, dental, Medicare Advantage, Medicaid, and PACE health plans for individuals, families, employers, and government program participants in Oregon, Idaho, Montana, and Washington. The company collects recurring monthly premiums and provides members with access to multi-state provider networks, telehealth, behavioral health, prescription drug coverage, and digital self-service through the InTouch portal and myPacificSource mobile app.

Product overview

PacificSource offers a comprehensive health insurance portfolio consisting of Individual & Family Plans, Small Group and Large Group employer plans (including self-funded options), Medicare Advantage and D-SNP plans, Medicaid plans through the Oregon Health Plan, Dental coverage, and PACE (Program of All-Inclusive Care for the Elderly). The company's digital ecosystem includes the InTouch member portal and myPacificSource mobile app for member self-service, the InTouch for Providers portal for healthcare providers, and telehealth services including Teladoc. These products are supported by interoperability APIs and data transparency resources, with recent expansion into tech-enabled care management through partnerships like Ceresti Health for dementia care.

Differentiator

Problem solved

Functional benefit

Brands

• InTouch: Member and employer online portal for managing health insurance accounts, viewing claims, and accessing plan information
• myPacificSource

Products and services

• Individual & Family Plans
• Small Group Plans
• Large Group Plans
• Self-Funded Plans
• Medicare Plans
• Medicaid Plans
• Dental Plans
• PACE (Program of All-Inclusive Care for the Elderly)

Quantifiable outcome

• 42% reduction in medical costs for Medicare Advantage members with dementia in Ceresti partnership
• +1 more outcomes

Named customers1 record

Segments6 records

Ideal customer profiles5 records

Technology focussed No

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

AI capability2 records

Feature4 records

Partnerships

Two partnerships are on record, tiered notable.

• Ceresti HealthnotableStrategic or Co-development Partner · 21 April 2026Dementia management partnership demonstrating significant cost savings with 42% reduction in medical costs and $523 per member per month savings for 444 enrolled Medicare Advantage and D-SNP members. The tech-enabled program activates family caregivers through tablets, personalized education, and dedicated coaching to reduce preventable emergency visits and hospitalizations.
• Summit HealthnotableStrategic or Co-development Partner · 24 August 2023Collaboration with physician-led, patient-centric healthcare network with more than 170 providers and ten locations in Central Oregon to create new models for quality improvement. Partnership reflects PacificSource's founding cooperative vision dating back 90 years.

Scale indicators7 records

Recent moves9 records

Expansion highlights5 records

Direct peers

• Providence Health Plan: Oregon-based nonprofit health plan and direct competitor that PacificSource is co-exiting the Oregon individual market with at end-2026. Operates commercial, Medicare Advantage and Medicaid lines in the same Pacific Northwest footprint.
• Moda Health: Oregon-headquartered regional health plan offering individual, group, Medicare and Medicaid products across the Pacific Northwest. One of the four carriers remaining in Oregon's individual market after PacificSource exits.
• Blue Cross of Idaho: Idaho-domiciled nonprofit health plan serving individual, employer, Medicare and Medicaid markets — one of the few remaining regional carriers competing with PacificSource in Idaho post-Montana exit.
• CareOregon: Oregon-focused nonprofit Medicaid managed care plan and one of four remaining carriers in Oregon's individual market. Directly comparable Oregon Health Plan partner/contributor alongside PacificSource Community Solutions.
• Regence BlueCross BlueShield of Oregon: Regence/Cambia is a Pacific Northwest Blue plan serving Oregon, Idaho, Utah and Washington with commercial, Medicare and Medicaid products, directly competing for the same employer and individual accounts as PacificSource.

Broad incumbents

• Cigna Healthcare: National carrier exiting ACA Marketplaces for 2027 alongside PacificSource; competes in the same national-employer and stop-loss segments that PacificSource Administrators serves.
• Kaiser Permanente Northwest: Integrated payer-provider system operating in Oregon and Washington with commercial, Medicare and Medicaid plans. Differentiated by owned-clinic delivery model but competes directly for group and individual enrollment in PacificSource's core footprint.

Others

• Summit Health: Central Oregon physician-led provider network with 170+ providers across ten locations; PacificSource's announced quality-improvement partner. Included as an ecosystem/partner comparable rather than a plan competitor.

Regional players

• Premera Blue Cross: Washington/Alaska-based nonprofit Blue plan offering commercial and Medicare products; competes with PacificSource in the Washington employer group and Medicare Advantage segments.
• Health Net (Oregon): Centene-owned health plan offering commercial and Medicaid products in Oregon, competing for the same employer and Medicaid contracts as PacificSource in the Pacific Northwest.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• YouTubeyoutube.com/user/pacificsource
• Facebookfacebook.com/PacificSource
• LinkedInlinkedin.com/company/pacificsource-health-plans
• Instagraminstagram.com/pacificsourcehealthplans/?hl=en
• Xx.com/pacificsource

Revenue estimate

Valuation estimate

Number of profiles

Profiles7 records

Subsidiaries4 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 PacificSource