Medical Risk Managers

What Medical Risk Managers does

Medical Risk Managers, Inc. (MRM) is a privately held stop loss insurance services firm founded in 1984 and headquartered in East Hartford, Connecticut. The company operates as a service partner to health plans, reinsurers, and stop loss carriers — not as a risk-bearing carrier — providing three core service lines: Private Label Services (acting as the backroom for BUCAs and other major insurance carriers, handling rating, underwriting, clinical review, actuarial/pricing, policy issuance, financial accounting, claim adjudication, producer licensing validation, and reporting); Consulting Projects (advisory work for carriers, regional health plans, providers, captives, TPAs, brokers, and reinsurers on network analysis, underwriting guidelines, pricing, catastrophic claims review, regulatory filings, and reinsurance structure); and Employer Stop Loss (competitive quoting of specific and aggregate stop loss coverage for self-funded employer groups using A/A+ rated carriers, supported by TPAs, brokers, and ASO channels).

MRM's underlying technology stack is a proprietary Stop Loss pricing model maintained by an in-house Actuarial department, supplemented by network evaluation tools covering more than 400 provider networks nationwide and a comprehensive administration system spanning new business opportunity tracking, active case listings, persistency, claim reports, premium bordereaux, and incurred loss ratio reporting. The company holds SOC 2 Type 2 certification aligned with COSO 2013 and operates in a HIPAA-compliant posture.

MRM earns revenue through fee-for-service and commission-based structures across private-label service contracts with insurance carriers, consulting engagements, and stop loss quoting/broker fee arrangements. Customer segments are weighted heavily toward enterprise B2B — large insurance carriers (BUCAs and direct carriers), reinsurers, regional and provider-owned health plans, captives, TPAs, and brokers — with self-funded employers accessed indirectly through these intermediaries. The company is led by President Chris Rice (since January 2023) and Chairman Mike McLean (a Fellow of the Society of Actuaries), and operates as a privately held corporation with no disclosed external investors or parent company.

Name

Medical Risk Managers

Legal name

Medical Risk Managers, Inc.

Website

https://mrmstoploss.com

Company type

Private

Founded year

1984

Operating status

Operating

Headcount range

11–50 employees

Short description

Medical Risk Managers is a privately held stop loss insurance services firm founded in 1984 and headquartered in East Hartford, Connecticut. It provides private-label underwriting, claims, and actuarial backroom services to major insurance carriers and reinsurers, plus consulting and direct stop loss coverage for self-funded employers accessed via brokers, TPAs, and ASO carriers.

Ownership category

akta.pro rank

Headquarters

HQ city

South Windsor

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Private Label Stop Loss Services: MRM provides private labeling services for insurance carriers, acting as expert underwriter, claims adjudicator, actuarial analyst, or marketing strategist on behalf of clients. Revenue is generated through service fees for underwriting, claims, actuarial, and administrative services provided to carriers and health plans.
2. Stop Loss Quoting and Broker Services: MRM provides competitive stop loss quotes to brokers, TPAs, and ASO carriers using A/A+ carriers, earning fees or commissions for facilitating stop loss coverage placement.
3. Consulting Services: MRM consults to stop loss carriers, regional health plans, providers, captives, TPAs, brokers, and other entities seeking to understand catastrophic claims. Services include network analysis, underwriting guidelines review, pricing evaluation, catastrophic claims assessment, regulatory compliance, and reinsurance advisory.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels4 records

Core offering

Medical Risk Managers (MRM) provides stop loss insurance services, acting as a service partner to health plans, reinsurers, and stop loss carriers. The company delivers private label/backroom operations (underwriting, claims adjudication, actuarial analysis, policy issuance), consulting/advisory services (network analysis, pricing evaluation, catastrophic claims review, regulatory compliance, reinsurance advisory), and direct employer stop loss coverage for self-funded plans.

Product overview

Medical Risk Managers (MRM) is a stop loss insurance services company offering a unified portfolio of three core service offerings: Private Label Services, Consulting Projects, and Employer Stop Loss. The company operates as a service partner to health plans, reinsurers, and stop loss carriers rather than as a software product company. The Private Label Services division provides end-to-end backroom operations including rating, underwriting & clinical services, actuarial/pricing, policy issuance, financial accounting, claim adjudication, producer licensing validation, and reporting. Consulting Projects delivers advisory services for network analysis, underwriting guidelines, pricing, catastrophic claims review, regulatory compliance, and reinsurance. Employer Stop Loss provides direct stop loss coverage for self-funded employers. All services leverage MRM's proprietary pricing models and network evaluation expertise developed over 35+ years.

Differentiator

Problem solved

Functional benefit

Named customers7 records

Segments5 records

Ideal customer profiles5 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

One partnership is on record.

• BUCAs (Blue Cross Blue Shield and Major Health Plans)coreOEM/ Whitelabel/ Licensing PartnerMRM has been private labeling stop loss services for some of the largest Insurance carriers in the country for over 35 years. BUCAs trust MRM to underwrite and place business on their paper. MRM serves as expert underwriter, claims adjudicator, actuarial analyst, or marketing strategist on behalf of carrier partners, operating as their 'backroom' while partners maintain their brand identity and customer relationships.

Scale indicators8 records

Recent moves8 records

Expansion highlights5 records

Direct peers

• HM Insurance Group: HM Insurance Group is a specialty stop loss insurance carrier offering specific and aggregate stop loss coverage to self-funded employers, brokers, and TPAs — directly comparable to MRM's employer stop loss and underwriting capabilities.
• Tokio Marine HCC (HCC Life): Tokio Marine HCC's stop loss division underwrites specific and aggregate coverage and offers MGU-style services to brokers and TPAs, directly competing with MRM's private-label and consulting offerings.
• Companion Life: Companion Life specializes in stop loss insurance for self-funded employer plans distributed through brokers and TPAs — comparable product, distribution model, and customer base to MRM.
• BCS Financial Corporation: BCS Financial provides stop loss insurance and reinsurance products to Blue Cross Blue Shield plans and other carriers, with a service-partner model analogous to MRM's BUCA private-label positioning.
• Voya Employee Benefits (Stop Loss): Voya's stop loss center provides specific and aggregate stop loss coverage to mid-size employers through brokers and TPAs — overlapping target market, distribution channels, and underwriting services with MRM.
• RGA Reinsurance Company: RGA is a major reinsurer with stop loss quota share expertise; MRM's President previously led stop loss underwriting at RGA. RGA competes directly with MRM's reinsurance advisory and underwriting capabilities.

Broad incumbents

• Sun Life Financial (Stop Loss): Sun Life U.S. offers stop loss insurance as part of a broader group benefits portfolio — broader incumbent with overlapping product set but serves as a carrier rather than MRM's MGU-style service-partner model.
• Cigna (Stop Loss): Cigna offers stop loss coverage to self-funded employers and brokers as part of its larger group benefits franchise — broad incumbent with overlapping stop loss capabilities and significant scale advantages.
• UnitedHealthcare / Optum Stop Loss: Optum's stop loss division (noted as a previous employer of MRM's President) underwrites stop loss for self-funded employers — a large incumbent that competes on scale and analytics with MRM's pricing expertise.

Emerging players

• Pareto Intelligence: Pareto Intelligence provides analytics, reporting, and clinical risk management services to stop loss carriers and TPAs — an emerging technology-enabled competitor to MRM's consulting and analytics offerings.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights7 records

Customer concentration

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles11 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 Medical Risk Managers