Banner|Aetna
Banner|Aetna is an Arizona-based joint venture health insurer between Banner Health and Aetna (CVS Health), offering HMO, PPO, Open Access, and self-funded employer health plans to Arizona employers, with integrated virtual care, diabetes reversal, and clinical decision support.
- Company typePrivate
- Founded2017
- HeadquartersPhoenix, United States
- Headcount51–100
- GTM typeB2B
- OfferingServices
What Banner|Aetna does
Banner|Aetna is an Arizona-based joint venture health insurance company established in 2017 between Banner Health, a regional healthcare delivery system, and Aetna (a CVS Health company). The company offers a comprehensive portfolio of health plans in Arizona, including HMO, PPO, Open Access EPO Plus, Open Access POS II, Open Access Managed Plus, fully insured employer plans, and ERISA-governed self-funded administrative services contracts. Banner|Aetna distributes through direct enterprise sales to employers of all sizes and through a licensed producer/broker network (via the Producer World platform), with member self-service available through the MyPlanPortal member portal (transitioning to the Aetna Health portal).
The company's underlying technology is the CareEngine clinical decision support platform developed by ActiveHealth Management (an Aetna subsidiary), which continuously analyzes claims and clinical data against evidence-based best practices to identify care gaps and clinical inconsistencies. Banner|Aetna layers value-added clinical services on top of its core insurance products, including 24/7/365 text-based virtual primary care through 98point6 by Transcarent, a Type 2 Diabetes Reversal Program through Virta Health, a Mental Wellbeing Resource Center, a multi-disciplinary Care Advocate Team, a 24/7 Nurse On-Call line, and online appointment scheduling. Pharmacy benefits are administered through CVS Caremark mail service and Aetna Specialty Pharmacy; dental and vision benefits are provided through Aetna administrators.
Banner|Aetna generates revenue primarily through recurring health insurance premiums on fully insured plans and managed-services fees on self-funded employer plans. Its four primary customer segments are employers (small and large groups), employee/member covered lives, healthcare professionals participating in the Banner|Aetna provider network, and licensed producers/brokers. Notable named customers include the Town of Gilbert (municipal government), the Pima County Sheriff's Department, and the Arizona Interscholastic Association. As of January 1, 2026, the company exited the individual and family Marketplace segment, refocusing exclusively on employer-sponsored business in Arizona. The company has approximately 51-100 employees and is headquartered in Phoenix, Arizona.
Banner|Aetna firmographics
Firmographics- Name
- Banner|Aetna
- Legal name
- Banner Health and Aetna Health Insurance Company and Banner Health and Aetna Health Plan Inc.
- Website
- https://banneraetna.com
- Company type
- Private
- Founded year
- 2017
- Operating status
- Operating
- Headcount range
- 51–100 employees
- Short description
- Banner|Aetna is an Arizona-based joint venture health insurer between Banner Health and Aetna (CVS Health), offering HMO, PPO, Open Access, and self-funded employer health plans to Arizona employers, with integrated virtual care, diabetes reversal, and clinical decision support.
- Ownership category
- akta.pro rank
Banner|Aetna industry classification
Industry- Product category
- Health Insurance
- NAICS
- Direct Health and Medical Insurance Carriers (524114), Agencies, Brokerages, and Other Insurance Related Activities (5242)
- SIC
- Services-Health Services (8000), Insurance Agents, Brokers & Service (6411)
- akta.pro primary industry
- Chronic Condition Medication Programs (e.g., diabetes, hypertension) with Integrated Prescribing (HLALAIAH)
- akta.pro secondary industry
- Pharmacy/Medication Management & Virtual MTM (Payer-Sponsored) (HLALACAK)
Keywords
Where Banner|Aetna is headquartered
LocationHeadquarters
- HQ city
- Phoenix
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Banner|Aetna business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Operations, Personnel, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- Health Insurance Premiums: Banner|Aetna generates revenue through fully insured health benefit plans where the company bears insurance risk and collects premiums from employers and individuals to cover claims and administrative costs.
- Administrative Services for Self-Funded Plans: Banner|Aetna provides administrative services for self-insured employer plans, earning fees for claims processing, network access, and care management without bearing insurance risk.
- Pharmacy Benefits Management: Pharmacy benefits administered by Aetna/CVS Health, including mail order pharmacy (CVS Caremark) and specialty pharmacy services, with rebates from drug manufacturers factored into drug list decisions.
- Dental and Vision Benefits: Dental benefits provided by Aetna as an administrator of dental insurance plans. Vision benefits available as part of medical plans or through Aetna Vision Preferred.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Fully Insured Employer Plans |
| Subscription | Monthly | Self-Insured Employer Plans |
| Subscription | Monthly | Individual and Family Plans (Discontinued) |
Go-to-market motion2 records
Distribution channels4 records
Marketing channels6 records
Banner|Aetna product offering
Product offeringCore offering
Banner|Aetna is an Arizona-based joint venture health insurer that offers fully insured and self-funded employer health plans (HMO, PPO, Open Access EPO Plus, Open Access POS II, Open Access Managed Plus) paired with integrated care programs including the CareEngine clinical decision support system, virtual primary care through 98point6 by Transcarent, and the Virta Health Type 2 Diabetes Reversal Program. The company combines Banner Health's local provider network with Aetna/CVS Health's national insurance and pharmacy infrastructure to deliver payvider-style coverage to Arizona employers and their members.
Product overview
Banner|Aetna is a joint venture health insurer between Banner Health and Aetna (a CVS Health company) offering a comprehensive portfolio of health insurance products and integrated healthcare services in Arizona. The core offering consists of HMO, PPO, Open Access, and EPO health plans for employers and individuals. The company differentiates through integrated care programs including the Type 2 Diabetes Reversal Program through Virta Health, virtual care via 98point6 by Transcarent, a Mental Wellbeing Resource Center, and a Care Advocate Team for personalized care management. Additional services include Nurse On-Call 24/7 support, online appointment scheduling, dental benefits through Aetna Dental, vision benefits through Aetna Vision Preferred, and pharmacy benefits administered by CVS Caremark and Aetna Specialty Pharmacy. The company also operates the CareEngine system for care gap identification.
Differentiator
Problem solved
Functional benefit
Brands
- 98point6 by Transcarent: Virtual care solution providing 24/7/365 text-based primary care through a mobile application partnership with Transcarent.
- Virta Health Diabetes Reversal Program
Products and services
- Banner|Aetna Health Insurance Plans Comprehensive health insurance plans offered to Arizona employers and their employees, available in HMO, PPO, Open Access EPO Plus, Open Access POS II, and Open Access Managed Plus formats with both fully insured and self-funded (ERISA) options.
- Virtual Care through 98point6 by Transcarent
Quantifiable outcome
- 1.4% A1C reduction and 11% average weight loss for Type 2 diabetes reversal program participants
- +2 more outcomes
Companies that use Banner|Aetna
Customer profileNamed customers3 records
Segments4 records
Ideal customer profiles2 records
Banner|Aetna technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration6 records
AI capability4 records
Feature4 records
Banner|Aetna partnerships and signals
Strategic signalPartnerships
Eight partnerships are on record, tiered flagship, core and major.
- Arizona Interscholastic Association (AIA)flagshipBanner|Aetna named exclusive health insurance partner of the Arizona Interscholastic Association (AIA). The partnership involves sponsoring high school athletic events, hosting community activities such as food drives, and emphasizing health and wellness initiatives for Arizona's student-athletes. CEO Victoria Coley serves as AIA's Official Health Insurance Partner.
- American Heart AssociationflagshipBanner|Aetna participates in the annual Phoenix Heart Walk organized by the American Heart Association to raise funds for cardiovascular research, education, and disease prevention. Since 2020, Banner|Aetna has ranked among the event's top five fundraisers, contributing to campaigns raising more than $1 million annually. CFO Dan Keller serves on the event's Executive Leadership Team.
- Banner HealthcoreBanner|Aetna is a joint venture health insurer formed through partnership between Banner Health (healthcare delivery system) and Aetna (health insurance, part of CVS Health). Banner Health provides the local provider network and clinical expertise, while Aetna provides insurance expertise, technology, and national scale. Each insurer has sole financial responsibility for its own products.
- Aetna (CVS Health)coreAetna, a CVS Health company, partners with Banner Health to operate Banner|Aetna. Aetna provides management services including claims processing, customer service, pharmacy benefits management through CVS Caremark, and access to the CareEngine clinical decision support system. Aetna and its affiliates provide certain management services to Banner|Aetna.
- 98point6 by TranscarentcoreBanner|Aetna partners with Transcarent (which acquired 98point6) to provide 24/7/365 text-based virtual primary care to members through a mobile app. Members can connect with physicians via text messaging for primary care services.
- Virta HealthcoreBanner|Aetna partners with Virta Health to offer a Type 2 Diabetes Reversal Program. The clinically-proven program helps members reverse Type 2 diabetes through metabolic health improvement, achieving outcomes including 1.4% A1C reduction and 11% average weight loss. Three years of partnership success with thousands of members achieving diabetes reversal.
- AvailitycoreBanner|Aetna uses Availity as its provider portal platform, allowing health care professionals to access provider websites, manage claims, and conduct administrative tasks related to Banner|Aetna membership.
- Phoenix Children's HospitalmajorPhoenix Children's Hospital was highlighted alongside Banner|Aetna as a Modern Healthcare 2023 Top Innovator, indicating collaborative innovation in pediatric healthcare services and outcomes.
Scale indicators5 records
Recent moves8 records
Expansion highlights5 records
Banner|Aetna competitors and assessment
Company assessmentDirect peers
- Humana: Humana's Arizona commercial and Medicare Advantage plans overlap with Banner|Aetna on employer-sponsored and senior segments, and share a focus on integrated care management.
- Health Net (Centene subsidiary): Health Net sells commercial and government-sponsored plans in the western U.S. and competes with Banner|Aetna on employer group and individual products in adjacent states.
- UnitedHealthcare Arizona: UnitedHealth Group's Arizona commercial and Medicare business competes head-to-head with Banner|Aetna on large-group employer accounts and provider network breadth, with significantly greater national scale.
- Blue Cross Blue Shield of Arizona: Arizona's incumbent not-for-profit health plan and the most direct in-state competitor, serving employer groups with overlapping HMO/PPO products across the same geography and customer base.
- Cigna Healthcare Arizona: Cigna's Arizona employer and individual plans compete with Banner|Aetna on commercial group accounts and increasingly on integrated care and pharmacy benefit offerings.
Regional players
- Priority Health: Michigan-based regional non-profit health plan that competes on integrated employer-group products and value-based care, providing a comparable regional-carrier peer with similar employer-centric GTM.
Emerging players
- Alignment Health: Tech-enabled Medicare Advantage plan operating in select western states, including Arizona, that competes on integrated care and chronic-disease management — overlapping with Banner|Aetna's Medicare-eligible and chronic-condition segments.
- Oscar Health: Technology-forward ACA Marketplace and small-group insurer focused on consumer experience and virtual care — a comparable emerging playbook to Banner|Aetna's 98point6 integration, though primarily individual rather than employer-focused.
Broad incumbents
- Kaiser Permanente: Kaiser Permanente operates the most established integrated payer-provider model in the U.S. — the same 'payvider' positioning Banner|Aetna is pursuing — providing the reference architecture for the JV's strategic bet.
- Aetna (CVS Health): Banner|Aetna's joint-venture partner and parent provides claims, CareEngine, and pharmacy infrastructure; Aetna's directly-branded commercial plans also overlap with Banner|Aetna's Arizona employer book.
Market position
Strengths4 records
Weaknesses4 records
Competitive moat6 records
Key risks6 records
Key highlights7 records
Customer concentration
Banner|Aetna social profiles
Digital presenceBanner|Aetna compliance and trust
Trust signalCompliance7 records
Banner|Aetna financial estimates
Financial estimateRevenue estimate
Valuation estimate
Banner|Aetna leadership team
Management profileNumber of profiles
Profiles3 records
Banner|Aetna funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Banner|Aetna 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 Banner|Aetna
What does Banner|Aetna do?
Banner|Aetna is an Arizona-based joint venture health insurer that offers fully insured and self-funded employer health plans (HMO, PPO, Open Access EPO Plus, Open Access POS II, Open Access Managed Plus) paired with integrated care programs including the CareEngine clinical decision support system, virtual primary care through 98point6 by Transcarent, and the Virta Health Type 2 Diabetes Reversal Program. The company combines Banner Health's local provider network with Aetna/CVS Health's national insurance and pharmacy infrastructure to deliver payvider-style coverage to Arizona employers and their members.
Is Banner|Aetna a public or private company?
Banner|Aetna is a private company. It is classified as corporate owned and is currently operating.
When was Banner|Aetna founded?
Banner|Aetna was founded in 2017. It employs 51 to 100 people.
Where is Banner|Aetna based?
Banner|Aetna is headquartered in Phoenix, United States, in the North America region.
How does Banner|Aetna make money?
Four revenue lines are on record. Health Insurance Premiums are the primary driver. The others are administrative Services for Self-Funded Plans, pharmacy Benefits Management and dental and Vision Benefits.
Who are Banner|Aetna's main competitors?
Direct peers on record are Humana, Health Net (Centene subsidiary), UnitedHealthcare Arizona, Blue Cross Blue Shield of Arizona and Cigna Healthcare Arizona. Priority Health is listed as a regional player. Emerging players are Alignment Health and Oscar Health. Broad incumbents are Kaiser Permanente and Aetna (CVS Health).
Does Banner|Aetna have an API?
No public API is recorded for Banner|Aetna.
What industry is Banner|Aetna in?
Banner|Aetna's product category is Health Insurance. Its primary akta.pro industry code is HLALAIAH, Chronic Condition Medication Programs (e.g., diabetes, hypertension) with Integrated Prescribing, with a secondary code of HLALACAK, Pharmacy/Medication Management & Virtual MTM (Payer-Sponsored). Its NAICS code is 524114 and its SIC code is 8000.