Preferred Health Care
Preferred Health Care is a private, Lancaster, PA-based PPO network and benefits consulting firm serving self-funded and insured employers, carriers, TPAs, brokers, and government agencies across four Pennsylvania counties with credentialed provider access, URAC/NCQA-compliant medical management, and self-funded plan products.
- Company typePrivate
- Founded1986
- HeadquartersLancaster, United States
- Headcount11–50
- GTM typeB2B
- OfferingServices
What Preferred Health Care does
Preferred Health Care (PHC) is a private, licensed Preferred Provider Organization founded in 1986 and headquartered in Lancaster, Pennsylvania. The company operates a credentialed network of thousands of healthcare providers across Lancaster, Chester, York, and Lebanon Counties (the latter via the UNITY reciprocal agreement with Lebanon Valley Health Net), and serves self-funded employers, fully insured employers, insurance carriers, third-party administrators, brokers, healthcare coalitions, government agencies, non-profits, and a specialized Old Order Group (Amish and Mennonite) segment. PHC's core products include its PPO network access, PHC Consulting (benefits advisory offering self-funded and fully insured plans through Aetna, Capital Blue Cross, Highmark, and United Healthcare), Eliance Health Solutions (self-funded group health with wellness and occupational medicine), wellness programs delivered in partnership with Penn Medicine Lancaster General Health, and medical management and large case management services.
PHC generates revenue through PPO network access fees paid by self-funded employers, insurance carriers, and TPAs, alongside broker commissions and consulting fees earned through PHC Consulting and Eliance Health Solutions. Its medical management program has been a Pennsylvania Department of Health Certified Utilization Review Entity since 1999 and operates URAC- and NCQA-compliant utilization review, credentialing, and quality management programs that have passed annual payor audits. Distribution is primarily B2B direct sales to employers and via an established broker channel, with an additional online quote request funnel.
The company employs 11-50 people across sales, client services, IT, claims administration, provider relations/credentialing, and clinical case management functions. PHC Consulting was voted the #1 Insurance Agency for Businesses in Central PA in the Central Penn Business Journal 2023 Reader Rankings, and the broader PHC organization has 35-38 years of continuous operation in the region. No external funding, private equity involvement, or material M&A activity is disclosed in the available information.
Preferred Health Care firmographics
Firmographics- Name
- Preferred Health Care
- Legal name
- Preferred Health Care
- Website
- https://phcunity.com
- Company type
- Private
- Founded year
- 1986
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Short description
- Preferred Health Care is a private, Lancaster, PA-based PPO network and benefits consulting firm serving self-funded and insured employers, carriers, TPAs, brokers, and government agencies across four Pennsylvania counties with credentialed provider access, URAC/NCQA-compliant medical management, and self-funded plan products.
- Ownership category
- akta.pro rank
Preferred Health Care industry classification
Industry- Product category
- Healthcare PPO Network Services
- NAICS
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)
- SIC
- Insurance Agents, Brokers & Service (6411), Hospital & Medical Service Plans (6324), Services-Health Services (8000)
- akta.pro primary industry
- Regional & Local PPO Networks (HLAEANAB)
- akta.pro secondary industries
- Direct Contracting / Narrow Network PPOs (HLAEANAK), Multi-Specialty PPO Provider Networks (HLAEANAC)
Keywords
Where Preferred Health Care is headquartered
LocationHeadquarters
- HQ city
- Lancaster
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Preferred Health Care business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- PPO Network Administration Fees: PHC generates revenue as a licensed PPO by providing network access and discounted rates to self-funded employers, insurance companies, TPAs, and other payors. PHC applies network discounts to provider charges and forwards claims to the TPA for benefit determination and payment.
- Benefits Consulting (PHC Consulting): PHC Consulting provides objective benefits advisory services to businesses, offering self-funded and fully insured quotes through various carriers (Aetna, Capital Blue Cross, Highmark, United Healthcare), ancillary coverage quotes (vision, dental, life, disability), and wellness solutions, earning broker fees and commissions.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Multi-year contract | Custom group health plans are quoted based on employer requirements |
Go-to-market motion2 records
Distribution channels4 records
Marketing channels4 records
Preferred Health Care product offering
Product offeringCore offering
Preferred Health Care is a licensed Preferred Provider Organization (PPO) operating in Lancaster, Chester, York, and Lebanon Counties, Pennsylvania, providing access to a credentialed network of thousands of healthcare providers for employer-sponsored health plans. Through its PHC Consulting arm, the company delivers self-funded and fully insured benefits advisory, stop loss coverage, and ancillary coverage quotes with major carriers. PHC also offers NCQA/URAC-compliant utilization review, case management for chronic and catastrophic illness, and corporate wellness programs in partnership with Penn Medicine Lancaster General Health.
Product overview
Preferred Health Care operates as a licensed Preferred Provider Organization (PPO) offering a comprehensive suite of healthcare services. The core PHC network is supplemented by PHC Consulting for benefits advisory services, the UNITY program for multi-county provider access across Central and Eastern Pennsylvania, and Eliance Health Solutions for self-funded group health insurance and wellness programs. The company provides Medical Management and Precert services including utilization review, case management, and large case management for chronic or catastrophic conditions. Wellness Programs are offered in partnership with Penn Medicine Lancaster General Health. All services are supported by a credentialed network of thousands of healthcare providers across Lancaster, Chester, York, and Lebanon Counties.
Differentiator
Problem solved
Functional benefit
Brands
- UNITY: A reciprocal agreement between Central and Eastern Pennsylvania contracting PPOs, designed to benefit members who may live in one PPO area and work in another.
Products and services
- Preferred Health Care (PHC) PPO Network A licensed Preferred Provider Organization operating in Lancaster, Chester, and York Counties that provides access to a credentialed network of thousands of healthcare providers for members covered by employer-sponsored health plans, TPAs, and insurance carriers.
- PHC Consulting
Quantifiable outcome
- Network of thousands of healthcare providers across Lancaster, Chester, York and Lebanon Counties
- +2 more outcomes
Companies that use Preferred Health Care
Customer profileNamed customers7 records
Segments4 records
Ideal customer profiles3 records
Preferred Health Care technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature3 records
Preferred Health Care partnerships and signals
Strategic signalPartnerships
Five partnerships are on record, tiered core and major.
- Eliance Health SolutionscoreEliance Health Solutions is supported by PHC and provides businesses in Lancaster County with self-funded group health insurance, corporate wellness, and occupational medicine services. PHC's President references this as an innovative product offering and the health plan is designed to save employers money and keep employees healthy.
- Lebanon Valley Health Net (LVHN)coreLVHN is the partner PPO in the UNITY reciprocal agreement, covering members living and working in Lancaster, Chester, York and Lebanon Counties. The UNITY joint venture enables cross-county provider access with a single ID card.
- Penn Medicine Lancaster General Health — Corporate Wellness DepartmentcorePHC partners with Penn Medicine Lancaster General Health's Corporate Wellness Department to provide comprehensive wellness programs in support of an employer's health plan. Services include program management, awareness and prevention, education, at-risk behavior change programs, on-site biometric screenings, flu shots, and member health-coaching.
- Regional and National Insurers (CHIP, Medicaid, Medicare Advantage)majorPHC's Medical Management program has been selected by large, well-known regional and national insurers to perform utilization management in Lancaster County for Commercial, CHIP, Medicaid and Medicare Advantage members. The program meets URAC and NCQA Accreditation Standards.
- Insurance Carriers (Aetna, Capital Blue Cross, Highmark, United Healthcare)majorPHC Consulting offers self-funded and fully insured options through Aetna, Capital Blue Cross, Highmark, and United Healthcare in addition to its own Eliance Health Solutions product. PHC acts as a benefits advisor bringing employers together with these carriers.
Scale indicators6 records
Recent moves1 record
Expansion highlights6 records
Preferred Health Care competitors and assessment
Company assessmentBroad incumbents
- Highmark: Highmark is a major regional health insurer and PPO network operator serving Pennsylvania and surrounding states through Blue Cross Blue Shield plans. It is a direct competitor and partner of PHC, providing overlapping PPO network access in the Central PA market.
- First Health (Cigna): First Health is a national PPO network owned by The Cigna Group serving employers, payors and TPAs with discounted provider access. Comparable to PHC as a PPO network product, though operating at national scale and owned by a major carrier.
- MultiPlan: MultiPlan is the largest independent PPO network in the US, providing network access, utilization management and analytics to payors and employers. It is the closest broad incumbent to PHC, operating PPO networks at vastly greater scale across all US geographies.
- Capital Blue Cross: Capital Blue Cross is a Pennsylvania-based health insurer operating PPO and HMO plans across Central PA. It is a direct competitor to PHC's PPO network in the same Lancaster/Harrisburg geography and one of PHC's carrier partners through PHC Consulting.
- HealthLink: HealthLink is a UnitedHealth Group-owned PPO network serving employers and payors across multiple US regions. It competes in the same PPO network access category as PHC, though with the backing of a national carrier and broader geographic reach.
Direct peers
- Three Rivers Provider Network: Three Rivers Provider Network operates regional PPO networks for payors, employers and TPAs, providing credentialed provider access and network management. Comparable to PHC as a regional PPO network operator serving self-funded employer markets.
- USA Managed Care Organization: USA Managed Care Organization provides PPO and managed care network solutions to payors, employers, and government programs. Comparable to PHC in the PPO network access and management services category with similar carrier and TPA partnerships.
- Devon Health: Devon Health operates regional PPO networks and managed care services in the Mid-Atlantic region, providing network access and utilization management. It is a direct peer to PHC in the regional PPO market, with overlapping Mid-Atlantic geography.
- Stratose: Stratose is a PPO network offering regional and national network access, cost containment and claims management. It is a direct peer to PHC in the PPO network and provider access category, with similar multi-carrier, multi-TPA distribution model.
- National Preferred Provider Network (NPPN): NPPN is a PPO network serving payors, employers and third-party administrators with provider access and network management services. Comparable to PHC in the PPO network category with a focus on TPA and employer distribution channels.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat6 records
Key risks6 records
Key highlights7 records
Customer concentration
Preferred Health Care social profiles
Digital presencePreferred Health Care compliance and trust
Trust signalCompliance3 records
Preferred Health Care financial estimates
Financial estimateRevenue estimate
Valuation estimate
Preferred Health Care leadership team
Management profileNumber of profiles
Profiles9 records
Preferred Health Care funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Preferred Health Care 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 Preferred Health Care
What does Preferred Health Care do?
Preferred Health Care is a licensed Preferred Provider Organization (PPO) operating in Lancaster, Chester, York, and Lebanon Counties, Pennsylvania, providing access to a credentialed network of thousands of healthcare providers for employer-sponsored health plans. Through its PHC Consulting arm, the company delivers self-funded and fully insured benefits advisory, stop loss coverage, and ancillary coverage quotes with major carriers. PHC also offers NCQA/URAC-compliant utilization review, case management for chronic and catastrophic illness, and corporate wellness programs in partnership with Penn Medicine Lancaster General Health.
Is Preferred Health Care a public or private company?
Preferred Health Care is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was Preferred Health Care founded?
Preferred Health Care was founded in 1986. It employs 11 to 50 people.
Where is Preferred Health Care based?
Preferred Health Care is headquartered in Lancaster, United States, in the North America region.
How does Preferred Health Care make money?
Two revenue lines are on record. PPO Network Administration Fees are the primary driver. The others are benefits Consulting (PHC Consulting).
Who are Preferred Health Care's main competitors?
Broad incumbents on record are Highmark, First Health (Cigna), MultiPlan, Capital Blue Cross and HealthLink. Direct peers are Three Rivers Provider Network, USA Managed Care Organization, Devon Health, Stratose and National Preferred Provider Network (NPPN).
Does Preferred Health Care have an API?
No public API is recorded for Preferred Health Care.
What industry is Preferred Health Care in?
Preferred Health Care's product category is Healthcare PPO Network Services. Its primary akta.pro industry code is HLAEANAB, Regional & Local PPO Networks, with a secondary code of HLAEANAK, Direct Contracting / Narrow Network PPOs. Its NAICS code is 524292 and its SIC code is 6411.