Employer Driven Insurance Services

What Employer Driven Insurance Services does

Employer Driven Insurance Services, Inc. (E.D.I.S.) is a Visalia, California-based third-party administrator (TPA) founded in 2014 that administers self-funded, level-funded, and fully insured group health plans on behalf of employer clients and the brokers who serve them. The company serves more than 1,200 employer groups spanning approximately 60,000 covered lives and is licensed across 11 states/territories concentrated in the Western United States, with additional operational presence in Tyler, Texas. Its core offerings include ERISA-compliant HRA plans, level-funded Medical Expense Reimbursement Plans (MERP), Individual Coverage HRAs, the trademarked EDHP Excess Loss Level Funded Stop Loss Plans portfolio, and an ACA-compliant Minimum Essential Coverage (MEC) plan suite, supplemented by ancillary dental, vision, life, disability, and EAP products marketed under the SecureCare Group Insurance sub-brand.

E.D.I.S. monetizes through third-party administration fees charged to employer groups, stop loss administration, and plan design and compliance services, with quote-based pricing and monthly billing across three primary tiers: fully insured plans for groups of 2+, partially self-insured stop loss for groups of 10+, and self-insured ASO services for groups of 200+. Its technology stack centers on the proprietary YourBenPortal web portal and the OCA360 debit card portal, which provide members, employers, brokers, and providers with mobile access to benefits, claims, billing, eligibility, enrollment, and ID cards. Distribution is primarily broker-led, supported by direct inside sales and online quoting. In May 2025, E.D.I.S. was acquired by OCA Insurance Services, under whose ownership it now operates as a strategic subsidiary with enhanced technology and geographic reach.

Name

Employer Driven Insurance Services

Legal name

Employer Driven Insurance Services, Inc.

Website

https://employerdriven.com

Company type

Private

Founded year

2014

Operating status

Acquired

Headcount range

101–250 employees

Short description

Employer Driven Insurance Services (E.D.I.S.) is a California-based third-party administrator that administers self-funded, level-funded, and fully insured group health plans for 1,200+ employer groups across 11 states, serving approximately 60,000 covered lives through its EDHP stop loss, HRA/MERP, and SecureCare ancillary product lines.

Ownership category

akta.pro rank

Product category

Third-Party Health Plan Administration

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Hospital & Medical Service Plans (6324), Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Self-Funded Employer Plan TPA (ASO Administration) (HLAEALAA)

akta.pro secondary industries

Compliance, Reporting & Regulatory Administration (ERISA/ACA/No Surprises) (HLAEALAJ), Eligibility, Enrollment & Benefits Administration (HLAEALAH), Flexible Benefits Administration (FSA/HSA/HRA) (HLAEALAK), Dental & Vision Third-Party Administration (TPA) (FSAIAHAL), Group Life Administration/Enrollment Platforms (TPA & Benefits Admin) (FSAIADAJ)

Keywords

• Third party administration
• Group health benefits
• Stop loss insurance
• Self-funded health plans
• Benefits administration services

Headquarters

HQ city

Visalia

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Third-Party Administration Fees: Administrative fees charged to employer groups for managing self-funded, level-funded, and fully insured health plans including claims administration, customer service, eligibility, renewal, underwriting, and billing.
2. Stop Loss Administration: Excess loss administration services for employers with stop loss coverage, including EDHP™ level funded stop loss plans.
3. Plan Design and Compliance Services: Services including HRA plan design, MERP administration, ERISA document creation and maintenance, and ACA compliance reporting.

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels4 records

Core offering

E.D.I.S. operates as a third-party administrator (TPA) that administers self-funded, level-funded, and fully insured group health plans for employer groups ranging from 2 to 1,200+ covered lives. Core services include plan design and enrollment across 18+ medical, dental, and vision plans, claims administration, eligibility management, renewal and underwriting, billing and collection, stop loss and excess loss administration under the EDHP™ Portfolio, and compliance support for HIPAA, CMS, and ACA regulations. The firm supplements administration with branded ancillary products (SecureCare dental, vision, life, disability, EAP), proprietary online portals, and broker-channel distribution across 11 Western U.S. states/territories.

Product overview

E.D.I.S. (Employer Driven Insurance Services) operates as a third-party administrator (TPA) offering a modular, multi-tier benefits administration platform. The core portfolio is organized around three main product lines: (1) ERISA Compliant HRA Plans — including Level-Funded MERP and Individual Coverage HRA — which form the foundational reimbursement arrangement layer; (2) Excess Loss Level Funded Stop Loss Plans under the EDHP™ brand, which provide stop loss protection for self-insured employers; and (3) an ACA Compliant MEC Portfolio spanning MEC Plan, MEC Value, MEC+, MVP Next Gen, Hybrid Plan, Buy Up Stop Loss RBP, and Buy Up Stop Loss PPO variants. These are supplemented by the SecureCare Group Insurance sub-brand covering dental, vision, life, disability, and EAP products (underwritten by American National Life Insurance Company of Texas and American United Life Insurance Company), as well as ancillary dental and vision plans through various network arrangements. Add-on service modules include the proprietary YourBenPortal online web portal, OCA360 debit card portal, ERISA document services, ACA employer mandate reporting, PCORI fee filing, and Medicare Part D notice administration. The company serves employer groups of 2+ for fully insured plans, 10+ for partially self-insured stop loss, and 200+ for self-insured ASO services, licensed across Arizona, California, Colorado, Kansas, Michigan, Nevada, Oregon, South Carolina, Texas, and Washington D.C.

Differentiator

Problem solved

Functional benefit

Brands

• EDHP: Excess Loss Level Funded Stop Loss Plans portfolio, including member co-pays for office visits and prescriptions.
• EDHPâ„¢ Portfolio
• YourBenPortal
• OCA360
• SecureCare Group Insurance
• Concierge Service

Products and services

• ERISA Compliant HRA Plans Health Reimbursement Arrangement plans designed to be fully compliant with ERISA regulations, enabling employers to reimburse employees for eligible medical expenses on a tax-advantaged basis. Available to employer groups of 2+.
• Excess Loss Level Funded Stop Loss Plans (EDHP™) Trademarked stop loss insurance product that protects self-insured employers from catastrophic claims under the EDHP™ Portfolio brand. Available for employer groups of 10 or more and supports multiple funding types including level-funded stop loss plans. Returns 100% of unused claims funds to employers and 100% of pharmacy rebates to clients.
• ACA Compliant MEC Portfolio Minimum Essential Coverage plan portfolio compliant with the Affordable Care Act, offering MEC Plan, MEC Value, MEC+, MVP Next Gen, Hybrid Plan, Buy Up Stop Loss RBP, and Buy Up Stop Loss PPO variants for employer-sponsored health coverage.
• SecureCare Group Insurance Branded ancillary insurance product line from E.D.I.S. covering dental, vision, life, short-term and long-term disability, and employee assistance programs. Dental and vision plans are underwritten by American National Life Insurance Company of Texas; life and disability plans are underwritten by American United Life Insurance Company (OneAmerica).
• Telemedicine Telehealth services offered as an ancillary benefit, providing employees with remote access to medical consultations and care as part of employer-sponsored health benefits.
• ERISA Document Services Creation and maintenance of required ERISA documents including Summary Plan Description, Plan Document, Summary of Benefits & Coverage, Notice of Material Modification, and ACA-required notices, provided free for E.D.I.S. clients and available for purchase to non-clients.
• ACA Employer Mandate Reporting (1094-C/1095-C) Compliance reporting service handling IRS Transmittal Form 1094-C and employee 1095-C statements to fulfill ACA employer shared responsibility reporting requirements.
• COBRA Administration Continuation coverage administration service for employers, managing COBRA notifications and compliance for employees losing employer-sponsored coverage.
• Section 125 / FSA Administration Pre-tax benefit administration under IRC Section 125, including Flexible Spending Account management for qualified medical and dependent care expenses as part of employer-sponsored benefits.
• PCORI Fee Filing Patient-Centered Outcomes Research Institute fee filing assistance and calculation for self-funded and fully insured plans, including IRS Form 720 preparation support.

Quantifiable outcome

• Returned more than $2 million in unused claims funds to clients in 2017
• +2 more outcomes

Named customers4 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

Integration24 records

Feature4 records

Partnerships

Twelve partnerships are on record, tiered core and minor.

• American National Life Insurance Company of TexascoreOthersUnderwriter for SecureCare Group Insurance dental and vision plans. Based in Galveston, Texas.
• American United Life Insurance Company (AUL)coreOthersOneAmerica company that underwrites Life, Short Term Disability and Long Term Disability Insurance for SecureCare Group Insurance plans.
• AetnaminorOthersMedical network provider partner listed on provider search page.
• Anthem Blue CrossminorOthersMedical network provider partner listed on provider search page.
• Blue ShieldminorOthersMedical network provider partner listed on provider search page.
• CignaminorOthersMedical network provider partner listed on provider search page, including LocalPlus network and PPO network.
• United HealthcareminorOthersMedical network provider partner listed on provider search page.
• Kaiser PermanenteminorOthersMedical network provider partner listed on provider search page.
• MultiPlan/PHCSminorOthersNetwork provider partner for EDHP plans listed on provider search page.
• First Dental HealthminorOthersDental network provider for self-funded dental plans listed on provider search page.
• DenteMaxminorOthersDental network provider for self-funded dental plans listed on provider search page.
• MedImpactminorOthersPharmacy benefit manager partner listed on provider search page.

Scale indicators7 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Key Benefit Administrators: Third-party administrator providing health, dental, vision, and FSA/HRA administration for self-funded employer plans. Comparable to E.D.I.S.'s modular benefits administration stack and ancillary bundling.
• Meritain Health: Third-party administrator for self-funded employer health plans, offering ASO, stop-loss, and ancillary administration. Direct competitor to E.D.I.S. in the small/mid-market self-funded segment, with a larger national footprint.
• Employee Benefit Corporation: TPA offering self-funded, level-funded, and fully insured plan administration with stop-loss products for small and mid-sized employers. Direct overlap with E.D.I.S.'s funding-tier product structure.
• HealthScope Benefits: Mid-market TPA specializing in self-funded and level-funded employer health plans with stop-loss administration. Closely mirrors E.D.I.S.'s product positioning around small-group level-funded solutions.
• Boon-Chapman: Third-party administrator for self-funded employer health plans and ancillary benefits, with regional concentration in the South/Central U.S. Direct competitor in the small and mid-market employer space.

Broad incumbents

• UnitedHealthcare (Optum Health): Largest U.S. health insurer with TPA, stop-loss, and ancillary capabilities. E.D.I.S. lists United Healthcare as a network partner, but the firm is also a competitor for self-funded and ASO employer accounts at scale.
• Sun Life Financial (U.S.): Major stop-loss carrier and group benefits provider serving self-funded employers. Comparable to E.D.I.S. through its stop-loss and group benefits administration products, though Sun Life is an underwriter/carrier at much greater scale.
• Cigna Group / Evernorth: National carrier and benefits services giant with TPA, stop-loss, PBM, and ancillary capabilities through Evernorth. Indirect overlap with E.D.I.S. via employer stop-loss and ancillary partnerships (Cigna networks listed as E.D.I.S. providers).
• Arthur J. Gallagher & Co. Global insurance brokerage and risk management firm with growing TPA and benefits administration capabilities. Competes with E.D.I.S. for broker-led employer relationships and offers scale advantages in large accounts.
• Lockton Companies: Largest independent insurance brokerage globally, with benefits consulting and TPA-adjacent services. Competes with E.D.I.S. for broker-led employer mandates, particularly in mid-market and upper mid-market segments.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/employerdriven
• Facebookfacebook.com/employerdriveninsuranceservices
• LinkedInlinkedin.com/company/12955014

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles8 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 Employer Driven Insurance Services