Community Health Plan
Community Health Plan of Washington is a not-for-profit managed care organization founded in 1992 by Washington's community health centers, offering Apple Health (Medicaid), Medicare Advantage, and Individual & Family Cascade Select plans exclusively to Washington State residents.
- Company typePrivate
- Founded1992
- HeadquartersSeattle, United States
- Headcount501–1,000
- GTM typeB2C
- OfferingServices
What Community Health Plan does
Community Health Plan of Washington (CHPW) is a not-for-profit managed care organization founded in 1992 by Washington's community health centers, headquartered in Seattle with 501-1,000 employees. The company offers four core insurance products: Apple Health (Medicaid managed care), Medicare Advantage (including a Dual Eligible Special Needs Plan), and Individual & Family Cascade Select plans sold through Washington's state marketplace. Its service territory is exclusively Washington State.
CHPW's technology stack consists of administrative and engagement platforms rather than a proprietary care-delivery engine. This includes the myCHPW member portal (benefit access, ID card, coverage management), the HealthMAPS provider portal (eligibility, prior authorization, care coordination), a Virtual Care telehealth service, and an Interoperability Developer Portal supporting payer-to-payer data exchange and prior authorization APIs in compliance with federal interoperability mandates. Value-added programs include Benefits+ (free eyeglasses, alternative treatments, ride benefits), MemberFirst Rewards, ChildrenFirst, behavioral health services, and a Diabetes Care Program. Multilingual support spans eight or more languages aligned with Washington's immigrant populations.
The business model is capitated managed care: CHPW receives per-member-per-month premiums from Washington State's Apple Health program, from CMS for Medicare Advantage, and from individuals purchasing Cascade Select marketplace plans. Go-to-market is community-led, relying on referrals from the founding community health centers, supplemented by direct website and phone enrollment, provider office assisted enrollment, and a multilingual outreach program. Revenue is not publicly disclosed, consistent with non-profit status.
Community Health Plan firmographics
Firmographics- Name
- Community Health Plan
- Legal name
- Community Health Plan of Washington
- Website
- https://chpw.com
- Company type
- Private
- Founded year
- 1992
- Operating status
- Operating
- Headcount range
- 501–1,000 employees
- Short description
- Community Health Plan of Washington is a not-for-profit managed care organization founded in 1992 by Washington's community health centers, offering Apple Health (Medicaid), Medicare Advantage, and Individual & Family Cascade Select plans exclusively to Washington State residents.
- Ownership category
- akta.pro rank
Community Health Plan industry classification
Industry- Product category
- Managed Care Health Insurance
- NAICS
- Direct Health and Medical Insurance Carriers (524114)
- SIC
- Accident & Health Insurance (6321)
- akta.pro primary industry
- Group HMO Plans (FSAIAFAK)
Keywords
Where Community Health Plan is headquartered
LocationHeadquarters
- HQ city
- Seattle
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Community Health Plan business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Operations, Personnel, Infrastructure, Marketing or Sales, Technology or R&D
Revenue model
- Medicaid Premium Revenue: Capitated premium payments from Washington State Apple Health (Medicaid) program for managed care coverage of eligible low-income individuals and families.
- Medicare Advantage Premium Revenue: Premium revenue from Medicare Advantage plans for seniors and individuals with disabilities, including dual-eligible special needs plans (D-SNP).
- Individual & Family Plan Premiums: Premium payments from individuals and families enrolled in Cascade Select plans through Washington's health insurance marketplace.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Others | Apple Health (Medicaid) - No cost to eligible members |
| Subscription | Monthly | Medicare Advantage Plans - Monthly premiums vary by plan |
| Subscription | Monthly | Individual & Family Plans (Cascade Select) - Market-based pricing |
Go-to-market motion1 record
Distribution channels4 records
Marketing channels5 records
Community Health Plan product offering
Product offeringCore offering
Community Health Plan of Washington (CHPW) is a not-for-profit managed care organization that sells government-sponsored and marketplace health insurance plans to Washington State residents. Its portfolio includes Apple Health (Medicaid) managed care, Medicare Advantage, Dual Eligible Special Needs Plans (D-SNP), and Individual & Family Cascade Select marketplace plans, delivered through a network of community health centers and providers.
Product overview
Community Health Plan of Washington (CHPW) operates as a multi-product health insurance organization founded in 1992 by Washington's community health centers. Its portfolio consists of four core insurance products — Apple Health (Medicaid) Plan (its foundational managed Medicaid offering), Medicare Advantage Plans, Individual & Family Cascade Select Plans, and the CHPW Dual Plan (D-SNP) for dual-eligible beneficiaries — supported by a suite of member-facing digital tools and value-added programs. These include myCHPW Member Portal and HealthMAPS Provider Portal for administrative management, CHPW Virtual Care for telehealth, and Benefits+ (with sub-programs MemberFirst™ Rewards and ChildrenFirst™) offering supplemental benefits such as free eyeglasses, alternative treatments, and reward incentives for preventive care. Behavioral health services, a Diabetes Care Program, and an Interoperability Developer Portal further round out its offerings.
Differentiator
Problem solved
Functional benefit
Products and services
- Apple Health (Medicaid) Plan CHPW's core Medicaid managed care plan offering comprehensive health coverage to eligible Washington state residents, including doctor visits, hospital care, prescription drugs, and behavioral health services.
- Medicare Advantage Plans
Quantifiable outcome
- Over 280,000 members served across Washington's individual market
- +1 more outcomes
Companies that use Community Health Plan
Customer profileNamed customers1 record
Segments4 records
Ideal customer profiles3 records
Community Health Plan technology and API
TechnologyTechnology focussed No
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
Feature4 records
Community Health Plan partnerships and signals
Strategic signalPartnerships
One partnership is on record.
- Dermatology PartnerscoreDermatology Partners announced a new provider agreement with Community Health Plan, expanding access to dermatologic care for CHPW members across Southeastern Pennsylvania. The partnership started May 1 and serves patients at multiple office locations throughout Pennsylvania, addressing gaps in specialty dermatology care for underserved communities.
Scale indicators3 records
Recent moves4 records
Expansion highlights5 records
Community Health Plan competitors and assessment
Company assessmentBroad incumbents
- UnitedHealthcare: Largest national health insurer with Medicare Advantage and Medicaid presence in Washington; competes with CHPW especially in Dual-Eligible and Medicare segments with much broader resources.
- Premera Blue Cross: Washington-based health insurer offering Individual, Medicare Advantage, and administrative services; broader portfolio than CHPW but shares geography and Individual market overlap via Cascade Select.
- Humana: National Medicare Advantage and D-SNP leader; comparable to CHPW in Medicare Advantage and Dual-Eligible Special Needs Plan offerings in Washington.
- Amerigroup (Elevance Health): Elevance-affiliated Medicaid managed care plan with Washington presence; comparable government-program-focused model competing for similar Medicaid populations.
Direct peers
- Kaiser Permanente Washington: Integrated managed care plan offering Medicaid, Medicare Advantage, and Individual/Family plans in Washington; competes head-to-head with CHPW across product lines using an integrated provider-payor model.
- Molina Healthcare: National Medicaid managed care organization with substantial presence in Washington State; directly competes with CHPW for Apple Health contracts and shares a similar government-program-centric model.
- CareOregon: Non-profit community-focused Medicaid and D-SNP plan in Oregon with a similar cooperative model serving low-income populations; highly comparable on structure, mission, and product mix.
- Coordinated Care (Centene): Centene's Washington Medicaid managed care plan, directly competing with CHPW in the Apple Health program with a comparable member demographic and provider network model.
- Keystone First: Pennsylvania Medicaid managed care plan cited as a CHPW partner; comparable Medicaid-focused MCO model with similar member population and regulatory environment.
Regional players
- Health Alliance Plan: Michigan-based non-profit health plan offering Medicaid, Medicare Advantage, and Individual products; comparable non-profit cooperative governance and product breadth though serving a different geography.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat4 records
Key risks5 records
Key highlights6 records
Customer concentration
Community Health Plan social profiles
Digital presenceCommunity Health Plan compliance and trust
Trust signalCompliance1 record
Community Health Plan financial estimates
Financial estimateRevenue estimate
Valuation estimate
Community Health Plan leadership team
Management profileNumber of profiles
Community Health Plan funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Community Health Plan 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 Community Health Plan
What does Community Health Plan do?
Community Health Plan of Washington (CHPW) is a not-for-profit managed care organization that sells government-sponsored and marketplace health insurance plans to Washington State residents. Its portfolio includes Apple Health (Medicaid) managed care, Medicare Advantage, Dual Eligible Special Needs Plans (D-SNP), and Individual & Family Cascade Select marketplace plans, delivered through a network of community health centers and providers.
Is Community Health Plan a public or private company?
Community Health Plan is a private company. It is classified as nonprofit foundation owned and is currently operating.
When was Community Health Plan founded?
Community Health Plan was founded in 1992. It employs 501 to 1,000 people.
Where is Community Health Plan based?
Community Health Plan is headquartered in Seattle, United States, in the North America region.
How does Community Health Plan make money?
Three revenue lines are on record. Medicaid Premium Revenue is the primary driver. The others are medicare Advantage Premium Revenue and individual & Family Plan Premiums.
Who are Community Health Plan's main competitors?
Broad incumbents on record are UnitedHealthcare, Premera Blue Cross, Humana and Amerigroup (Elevance Health). Direct peers are Kaiser Permanente Washington, Molina Healthcare, CareOregon, Coordinated Care (Centene) and Keystone First. Health Alliance Plan is listed as a regional player.
Does Community Health Plan have an API?
Yes. CHPW operates an Interoperability Developer Portal and supports payer-to-payer data exchange under interoperability standards. The portal provides information on prior authorization APIs and payer-to-payer data sharing (Interoperability Payer-to-Payer). No specific API standard (e.g., FHIR, REST), auth method, rate limits, or versioning details were stated in the available source material.
What industry is Community Health Plan in?
Community Health Plan's product category is Managed Care Health Insurance. Its primary akta.pro industry code is FSAIAFAK, Group HMO Plans. Its NAICS code is 524114 and its SIC code is 6321.