MagnaCare Holdings

Name

MagnaCare Holdings

Legal name

MagnaCare

Website

https://magnacare.com

Company type

Private

Founded year

1994

Operating status

Operating

Headcount range

101–250 employees

Ownership category

akta.pro rank

Product category

Healthcare Benefits Third Party Administration

NAICS

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

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Taft-Hartley / Union Multiemployer Group Health Plans (FSAIAFAG)

akta.pro secondary industries

Ancillary Benefits TPA (Dental/Vision/Life/Accident/Critical Illness) (HLAEALAN), Compliance, Reporting & Regulatory Administration (ERISA/ACA/No Surprises) (HLAEALAJ)

Keywords

• Third party administration
• Health plan administration
• Taft-Hartley fund services
• Workers compensation management
• Provider network solutions

Headquarters

HQ city

New York

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. TPA Administration Fees: MagnaCare generates revenue through Third Party Administration fees charged to Labor organizations (Taft-Hartley Funds, multiemployer plans), employers, and self-insured plans for comprehensive benefits administration services including claims processing, eligibility management, network access, and compliance reporting
2. Network Rental: Revenue from leasing portions of the MagnaCare provider network to other TPAs, employers, and organizations seeking network access without building their own
3. Medical Management Services: Fees for medical management programs including utilization review, case management, telemedicine, and population health services
4. MEC Plan Offerings: Revenue from Minimal Essential Coverage (MEC) plan administration including MyMEC Basic, Enhanced, and Premier tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels5 records

Core offering

MagnaCare Holdings operates as a Third Party Administrator (TPA) providing comprehensive healthcare benefits administration for Labor organizations, Taft-Hartley Funds, self-insured employers, brokers, and commercial plans. Its core services include claims processing, eligibility and enrollment management, provider network access (including network rental), medical management programs (utilization review, case management, telemedicine), workers' compensation/casualty solutions, and Minimal Essential Coverage (MEC) plans delivered through its proprietary Create® Technology platform.

Product overview

MagnaCare Holdings operates as a Third Party Administrator (TPA) providing a comprehensive suite of health benefits administration services. The company offers Create® Technology, a unified benefits administration platform that integrates claims processing, member self-service portals, employer administration tools, and provider network access. The core service portfolio includes Health Plan Administration, TPA Services for Labor (Taft-Hartley Funds), Network Solutions, Medical Management, and MyMEC (Minimal Essential Coverage) plans with three tiers. Additional offerings encompass ancillary benefits administration, workers' compensation/casualty solutions, telemedicine, and a price transparency tool. The platform supports member-facing features including a Mobile App, Member Portal, Employer Portal, Benefits Enrollment system, and Provider Locator. Services are designed for self-insured employers, labor organizations, Taft-Hartley multiemployer funds, brokers, and providers across all 50 states.

Differentiator

Problem solved

Functional benefit

Brands

• Create® Technology: Best-in-class technology platform that brings benefits technology, health insurance technology, and HR platform together seamlessly for employers, admins and members.
• MyMEC Plans

Products and services

• Create® Technology Platform A unified benefits administration platform that combines claims processing, enrollment, member management, employer administration tools, compliance-ready reporting, and provider access, including branded member self-service and employer management portals.
• Health Plan Administration Full-service third-party administration for self-insured health plans, including claims processing, eligibility management, ID card coordination, HR administration, and plan compliance handling.
• TPA Services for Labor Comprehensive TPA services designed for Labor organizations and Taft-Hartley Funds, including trust fund administration, health and welfare funds, retirement funds, contribution accounting, and eligibility and enrollment management.
• Network Solutions Provider network access solutions including provider solutions, network rental (leasing portions of the MagnaCare network), casualty solutions for workers' compensation, and specialized networks for various healthcare needs.
• Medical Management Comprehensive medical management programs covering population health, complex case management, telemedicine, and price transparency tools to ensure quality patient care based on medical needs.
• MyMEC Plans Minimal Essential Coverage plans offering preventive wellness services in three tiers: MyMEC Basic (preventive visits, prescription discounts, optional COBRA/vision/telemedicine), MyMEC Enhanced (Basic plus primary care, specialist visits, urgent care, outpatient X-rays), and MyMEC Premier (Enhanced plus prescription drug services).
• Ancillary Benefits Supplemental benefit administration services including dental, vision, and other ancillary coverage options integrated with the core health plan administration platform.
• Casualty and Workers' Compensation Integrated workers' compensation solutions including case triage, nurse case management, utilization review, formulary review, care scheduling, and concierge care management to get injured workers back to their jobs.

Quantifiable outcome

• 99% customer retention rate demonstrates strong satisfaction and ongoing partnerships
• +2 more outcomes

Named customers3 records

Segments4 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature6 records

Partnerships

One partnership is on record.

• Brighton Health Plan Solutions, LLCcoreTechnology or IntegrationBrighton Health Plan Solutions, LLC is the parent company powering MagnaCare's operations. The company is accredited by URAC for Health Utilization Management and provides the technological and operational infrastructure underlying MagnaCare's TPA services. MagnaCare is powered by Brighton Health Plan Solutions' technology and operational framework.

Scale indicators3 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Amalgamated Life Insurance Company: Amalgamated Life is a union-affiliated insurer and benefits administrator that provides third-party administration and stop-loss coverage specifically to multiemployer and Taft-Hartley funds, mirroring MagnaCare's core Labor segment and benefits administration focus.
• HealthComp Holdings: HealthComp is a third-party administrator focused on self-funded employer health plans with integrated medical management and consumer-driven health administration tools, closely matching MagnaCare's employer-side TPA offering and technology-enabled service model.
• Sedgwick: Sedgwick is a leading third-party administrator of workers' compensation, disability, and integrated casualty claims programs, directly comparable to MagnaCare's Casualty/Workers' Compensation line of business and shared TPA distribution model.
• Trustmark Companies: Trustmark provides group health, voluntary benefits, and third-party administration tailored to labor unions, public employers, and Taft-Hartley plans, competing head-to-head with MagnaCare in the multiemployer/Labor segment.
• York Risk Services Group: York provides third-party claims administration and managed care services for workers' compensation and casualty exposures, directly comparable to MagnaCare's integrated workers' comp and utilization review offering.

Broad incumbents

• UMR (UnitedHealthcare): UMR is the largest TPA in the United States and a UnitedHealthcare subsidiary offering self-funded claims administration, network access, and stop-loss, serving the same self-insured employer segment that MagnaCare addresses with materially greater scale.
• Meritain Health (CVS Health/Aetna): Meritain Health is the Aetna-affiliated TPA serving self-insured employers with claims administration, network solutions, and integrated medical management, comparable to MagnaCare's employer TPA bundle but delivered as part of a much larger carrier ecosystem.

Emerging players

• WEX Inc. WEX operates a benefits administration platform (HSAs, FSAs, HRAs, COBRA) that overlaps with MagnaCare's flexible benefits enrollment technology, addressing similar employer and broker segments via a SaaS-led model.
• Alegeus Technologies: Alegeus provides consumer-directed benefit administration technology (HSA, FSA, HRA, commuter) used by health plans, TPAs, and employers, overlapping with MagnaCare's enrollment and employer portal capabilities within the broader benefits administration stack.

Others

• Trustmark Stop Loss (StarLine/Hylant-adjacent stop-loss distributors operating with large TPAs): Stop-loss carriers and the specialty brokers who pair coverage with third-party administration are adjacent ecosystem peers who influence the self-funded employer buying decision alongside TPAs like MagnaCare.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/magnacare
• Facebookfacebook.com/magnacare
• LinkedInlinkedin.com/company/magnacare

Compliance4 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

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 MagnaCare Holdings