Community First Health Plans

What Community First Health Plans does

Community First Health Plans is a nonprofit, community-focused health insurance company headquartered in San Antonio, Texas, founded in 1995 by University Health to provide health coverage to residents of Bexar County and seven surrounding counties. The plan offers a multi-segment product portfolio spanning Texas Medicaid managed care programs (STAR, STAR Kids, STAR+PLUS, CHIP, CHIP Perinate), Medicare Advantage (Medicare Advantage Alamo HMO and a Dual-Eligible Special Needs Plan), Marketplace off-exchange individual coverage (University Community Care Plan), and commercial HMO products (University Family Care Plan and Commercial HMO).

The company's operating model relies on government capitation payments as the primary revenue stream, supplemented by commercial and individual-market premiums. Its technology stack is built around HealthTrio Connect, which powers the member portal and provider portal for eligibility, claims, and benefits administration, with an Interoperability API supporting data exchange with healthcare partners. In December 2025, Community First expanded its product surface by adopting Softheon's ICHRA Connector Cloud to enter the off-exchange individual insurance market via employer-sponsored Individual Coverage Health Reimbursement Arrangements.

Go-to-market combines direct member enrollment through the member portal, provider referrals, healthcare marketplace exchanges, employer group sales for commercial plans, and a network of 90+ community partner organizations including universities, chambers of commerce, food banks, and local nonprofits. The plan holds multiple NCQA accreditations and distinctions (Health Plan Accreditation, Health Outcomes Accreditation, Community-Focused Care Accreditation, LTSS Distinction) and reinvests a portion of proceeds into community health programs, food pantry operations, and scholarships. The organization employs 251-500 staff and has cumulatively served over 3 million individuals across its three-decade operating history.

Name

Community First Health Plans

Legal name

Community First Health Plans, Inc.

Website

https://cfhp.com

Company type

Private

Founded year

1995

Operating status

Operating

Headcount range

251–500 employees

Short description

Community First Health Plans is a nonprofit, San Antonio-based health plan founded in 1995 by University Health, offering Medicaid, Medicare, Marketplace, and commercial HMO products to residents of Bexar County and seven surrounding Texas counties.

Ownership category

akta.pro rank

Product category

Managed Care Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114), Direct Life, Health, and Medical Insurance Carriers (52411)

SIC

Accident & Health Insurance (6321), Hospital & Medical Service Plans (6324)

akta.pro primary industry

Medicaid Expansion (ACA Adult) Managed Care Plans (HLAEAEAB)

akta.pro secondary industries

Integrated Physical-Behavioral-Social Care (Whole-Person) Medicaid Plans (HLAEAEAI), CO-OP / Nonprofit Individual Market Plans (HLAEABAH), Fully Insured Small Group Plans (HLAEAAAB)

Keywords

• Managed health care plans
• Medicaid managed care
• Medicare Advantage plans
• Community health insurance
• Individual coverage HRA

Headquarters

HQ city

San Antonio

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

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

Revenue model

1. Insurance Premiums - Medicaid: Revenue from Medicaid managed care contracts including STAR Medicaid, STAR Kids, STAR+PLUS, CHIP, and CHIP Perinate programs serving low-income families, children, expectant mothers, and individuals with special needs in Bexar County and surrounding counties.
2. Insurance Premiums - Medicare: Revenue from Medicare Advantage plans including Medicare Advantage Alamo (HMO) and Medicare D-SNP (HMO) products for seniors and individuals with special needs.
3. Insurance Premiums - Marketplace: Revenue from Marketplace/Exchange plans including University Community Care Plan (UCCP) offered through health insurance exchanges.
4. Insurance Premiums - Commercial: Revenue from commercial health plans including University Family Care Plan (UFCP) and Commercial HMO products for employer groups and families.

Go-to-market motion1 record

Distribution channels5 records

Marketing channels5 records

Core offering

Community First Health Plans is a nonprofit managed care organization that sells government-sponsored and commercial health insurance products to individuals and families in the San Antonio / Bexar County region. Its portfolio spans Texas Medicaid programs (STAR, STAR Kids, STAR+PLUS, CHIP, CHIP Perinate), Medicare Advantage (Medicare Advantage Alamo HMO and Medicare D-SNP HMO), an off-exchange Marketplace plan (University Community Care Plan), and Commercial HMO plans (University Family Care Plan and Commercial HMO), now augmented by Individual Coverage HRA (ICHRA) options via Softheon's Connector Cloud.

Product overview

Community First Health Plans operates as a nonprofit, community-focused health plan offering a multi-product portfolio across government-sponsored and commercial insurance segments. The core offering spans four program areas: Medicaid (STAR, STAR Kids, STAR+PLUS, CHIP, CHIP Perinate for low-income families, children, expectant mothers, and individuals with special needs); Medicare (Medicare Advantage Alamo HMO and Dual-Eligible Special Needs Plan); Marketplace (University Community Care Plan for off-exchange individual coverage); and Commercial (University Family Care Plan and Commercial HMO for employer groups). The plan was established in 1995 by University Health to serve Bexar County and seven surrounding counties. Recent expansion includes adoption of Softheon's ICHRA Connector Cloud to enable Individual Coverage HRA options for employers and employees. Members and providers access plan services through HealthTrio Connect-powered portals.

Differentiator

Problem solved

Functional benefit

Brands

• University Community Care Plan (UCCP): Marketplace health plan offering.
• University Family Care Plan (UFCP)

Products and services

• STAR Medicaid Texas STAR Medicaid managed care plan providing health coverage for low-income families and individuals in Bexar County and seven surrounding counties.
• STAR Kids Texas STAR Kids Medicaid plan providing coverage for children and adults with special needs.
• STAR+PLUS Texas STAR+PLUS integrated Medicaid plan combining healthcare and long-term services and supports for adults with chronic conditions or disabilities.
• CHIP Texas Children's Health Insurance Program (CHIP) providing coverage for children in families that earn too much for Medicaid but cannot afford private coverage.
• CHIP Perinate Texas CHIP Perinate program providing prenatal coverage for unborn children of pregnant women who do not qualify for Medicaid.
• Medicare Advantage Alamo (HMO) Medicare Advantage HMO plan providing Medicare coverage for seniors and eligible individuals in the Alamo region.
• Medicare D-SNP (HMO) Medicare Dual-Eligible Special Needs Plan (D-SNP) HMO designed for individuals eligible for both Medicare and Medicaid.
• University Community Care Plan (UCCP) Off-exchange Marketplace health insurance plan offered to individuals and families.
• University Family Care Plan (UFCP) Commercial health maintenance organization (HMO) plan for families and individuals in the commercial market.
• Commercial HMO Standard commercial HMO health plan offering coverage for employer groups and their employees.
• Softheon ICHRA Connector Cloud offering Individual Coverage Health Reimbursement Arrangement (ICHRA)-enabled off-exchange individual health insurance options for local employers and employees in Bexar County and surrounding areas.

Quantifiable outcome

• Touched the lives of over 3 million individuals since 1995
• +1 more outcomes

Named customers1 record

Segments4 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

Feature1 record

Partnerships

Eleven partnerships are on record, tiered core, flagship and minor.

• SoftheoncoreTechnology or Integration · 2 December 2025Community First Health Plans has adopted Softheon's ICHRA Connector Cloud to expand off-exchange individual health insurance options for local employers and employees. This partnership enables the nonprofit health plan to offer flexible, cost-effective ICHRA-based coverage options.
• University HealthflagshipStrategic or Co-development PartnerUniversity Health established Community First Health Plans in 1995 specifically to provide health care coverage to citizens of Bexar and surrounding counties. This founding relationship represents a deep strategic partnership between the healthcare system and the health plan.
• Texas A&M University San AntoniominorGTM or Marketing PartnerCommunity partner supporting educational initiatives and community health programs.
• Texas Public RadiominorGTM or Marketing PartnerCommunity partner for health education and awareness initiatives.
• United WayminorGTM or Marketing PartnerCommunity partner supporting social services and community health improvement programs.
• YMCA of Greater San AntoniominorGTM or Marketing PartnerCommunity partner supporting health and wellness initiatives in the San Antonio area.
• San Antonio Food BankminorGTM or Marketing PartnerCommunity partner addressing food insecurity and supporting community health.
• Health CollaborativeminorGTM or Marketing PartnerCommunity partner supporting collaborative health initiatives in the region.
• San Antonio Hispanic Chamber of CommerceminorGTM or Marketing PartnerCommunity partner supporting Hispanic business community and health initiatives.
• San Antonio LGBT Chamber of CommerceminorGTM or Marketing PartnerCommunity partner supporting LGBTQ+ community health initiatives.
• San Antonio FCminorGTM or Marketing PartnerCommunity partner and sponsor supporting local sports and health awareness.

Scale indicators3 records

Recent moves6 records

Expansion highlights4 records

Direct peers

• Superior HealthPlan (Centene): Centene's Texas Medicaid managed care subsidiary, operating STAR, STAR+PLUS, STAR Kids, and CHIP across multiple Texas service areas including Bexar County. Most direct competitor given overlapping product portfolio and government program focus.
• Molina Healthcare of Texas: National Medicaid MCO operating STAR, STAR+PLUS, CHIP, and Medicare D-SNP in Texas. Closely comparable business model focused exclusively on government-sponsored health coverage for low-income and dual-eligible populations.
• Parkland Community Health Plan: Texas nonprofit Medicaid MCO serving Dallas County and surrounding areas with STAR, CHIP, and Marketplace plans. Operates as a hospital-system-affiliated nonprofit regional health plan—structurally analogous to CFHP.
• Cook Children's Health Plan: Texas nonprofit Medicaid and CHIP MCO serving the Tarrant County service area, affiliated with Cook Children's Health Care System. Directly comparable as a regional nonprofit, hospital-system-affiliated Medicaid plan.
• Driscoll Health Plan: Texas nonprofit Medicaid and CHIP MCO serving the Coastal Bend and Rio Grande Valley, affiliated with Driscoll Children's Hospital. Comparable as a regional nonprofit Medicaid plan with hospital system backing.
• Sendero Health Plans: Austin-based nonprofit health plan offering STAR, CHIP, and Marketplace products in Central Texas. Closely comparable mission and structure as a Texas regional nonprofit MCO serving low-income populations.

Broad incumbents

• UnitedHealthcare Community & State of Texas: UnitedHealth Group's Medicaid division offering STAR, STAR+PLUS, and Medicare D-SNP products across Texas. Larger, better-capitalized competitor with national Medicaid scale and integrated UnitedHealthcare Medicare Advantage platform.
• Aetna Better Health of Texas (CVS Health): CVS Health's Medicaid MCO offering STAR, STAR+PLUS, and CHIP in Texas. National incumbent competing in same Medicaid programs with greater parent-company resources (CVS retail, Caremark PBM).
• Blue Cross and Blue Shield of Texas: Largest Texas health insurer offering individual Marketplace, commercial group, and Medicare plans in the San Antonio market. Competes with CFHP's Marketplace (UCCP) and Commercial (UFCP, HMO) product lines.
• Humana (Texas): Major Medicare Advantage insurer in Texas with growing D-SNP presence. Directly competes with CFHP's Medicare Advantage Alamo HMO and D-SNP products, especially for dual-eligible seniors in Bexar County.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat4 records

Key risks6 records

Key highlights6 records

Customer concentration

• Xx.com/cfhealthplans
• YouTubeyoutube.com/user/communityfirsthp
• Facebookfacebook.com/communityfirsthealthplans
• Instagraminstagram.com/cfhealthplans/?hl=en

Compliance6 records

Revenue estimate

Valuation estimate

Number of profiles

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 Community First Health Plans