Regional Care

What Regional Care does

Regional Care Inc (RCI), operating as RCI Group II, LLC, is an independent third-party administrator (TPA) that administers self-funded health benefit plans on behalf of self-insured employers. Founded in 1992 in Scottsbluff, Nebraska, the company operates from a single headquarters (905 W. 27th Street) with approximately 47 employees and serves 300+ employer clients with members in 48 contiguous states, covering 25,000+ members and processing over 300,000 claims annually. RCI is embedded within the Regional West Health Services umbrella and was originated in the basement of Regional West Medical Center.

Name

Regional Care

Legal name

RCI Group II, LLC

Website

https://regionalcare.com

Company type

Private

Founded year

1992

Operating status

Operating

Headcount range

51–100 employees

Short description

Regional Care Inc (RCI) is an independent third-party administrator providing health benefits administration, claims processing, and COBRA/HSA/FSA/HRA management for 300+ self-insured employer clients with 25,000+ members across 48 contiguous states, operating from Scottsbluff, Nebraska.

Ownership category

akta.pro rank

Headquarters

HQ city

Scottsbluff

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Third-Party Administration Services: RCI operates as a third-party administrator (TPA) providing claims processing, benefits administration, and cost management services for self-insured employers. Revenue is generated through administrative fees charged to employer clients for managing their health benefit plans.

Go-to-market motion2 records

Distribution channels3 records

Marketing channels4 records

Core offering

Regional Care (RCI) is an independent third-party administrator (TPA) that administers self-funded health benefit plans for U.S. employers. The company processes medical, dental, vision, and pharmacy claims; manages HSA/HRA/FSA, COBRA, level-funded, MEC, wellness, disease management, and compliance programs; and provides member and employer web portals for benefits access and account management. RCI sells these services primarily through insurance brokers to self-insured employers ranging from 5 to 1,200 employees across 48 contiguous states.

Product overview

RCI operates as a third-party administrator (TPA) offering a comprehensive, one-stop-shop portfolio of health benefits administration products and services for self-insured companies. The core platform consists of claims administration and member/employer portal technology (Health Portal, Flex Portal for Members and Employers), supported by a suite of benefit management modules including Medical, Dental, Vision, and Pharmacy benefit administration, along with administrative services such as COBRA, HSA/HRA/FSA, Level-Funded Programs, MEC Administration, Wellness Programs, Disease Management, and Compliance Assistance. RCI also provides access to telemedicine, care management, and transparency tools like Healthcare Bluebook through partnerships. The company was acquired by CGS Health in 2025.

Differentiator

Problem solved

Functional benefit

Products and services

• Medical Benefit Administration Third-party administration of medical benefit plans for self-insured employers, including claims processing, network access (proprietary and national PPO networks), and benefit coordination. Offered to U.S. self-insured employers and accessed via insurance brokers.
• Dental Benefit Administration Administration of dental benefit plans as part of comprehensive employer benefit packages for self-insured employers.
• Vision Benefit Administration
• Pharmacy Benefit Management
• COBRA Administration
• HSA/HRA/FSA Administration Administration of Health Savings Accounts (HSA), Health Reimbursement Arrangements (HRA), and Flexible Spending Accounts (FSA) for employer-sponsored plans.
• Level-Funded Programs Level-funded health benefit programs that combine stop-loss coverage with administrative services, designed for self-insured employers.
• MEC Administration
• Wellness Programs
• Disease Management
• Compliance Assistance Compliance support services for employer health plans, addressing healthcare regulatory requirements; delivered through RCI's partnership with PHIA.
• Health Portal
• Flex Portal (Member) Member-facing web portal for managing flexible spending accounts, including claims submission and account balance tracking for FSA, HSA, and HRA.
• Flex Portal (Employer) Employer-facing web portal for administering and managing employee flexible spending accounts under self-insured benefit plans.

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration1 record

Feature4 records

Partnerships

Nine partnerships are on record, tiered major, supporting and core.

• CGS HealthmajorStrategic or Co-development Partner · 1 January 2025Regional Care Inc announced asset sale to CGS Health in 2025, connecting RCI's service with CGS Health's resources, broader capabilities and new tools to deliver value and savings for every client.
• PHIAsupportingImplementation/ SI/ Consulting Partner · 1 January 2016RCI contracted with PHIA, the industry standard in legal advice, to provide compliance support for healthcare regulations.
• Midlands ChoicecoreTechnology or Integration · 1 January 1996Began working with Midlands Choice in 1996 to help expand their network in western Nebraska. This partnership helped develop their PPO network presence.
• Rural Health OrganizationssupportingStrategic or Co-development Partner · 1 January 1995Received a $500k rural health grant over three years in 1995 to work with network development, expanding access to healthcare services in rural areas.
• Healthcare BluebooksupportingTechnology or IntegrationRCI partners with Healthcare Bluebook to provide transparency tools for members to understand healthcare costs and quality.
• Regional West Health ServicescoreStrategic or Co-development PartnerRCI resides under the umbrella of Regional West Health Services, western Nebraska's largest provider of health care services. The company originated in the basement of Regional West Medical Center in 1992.
• PPO NetworkscoreTechnology or IntegrationRCI has teamed up with best-in-class PPO networks in each geographic area to provide access to healthcare providers across multiple regions.
• Care Management CompaniessupportingTechnology or IntegrationPartnership with care management companies to provide comprehensive health benefit administration and cost management services.
• Telemedicine ProviderssupportingTechnology or IntegrationIntegration with telemedicine providers to offer virtual healthcare access as part of their benefit portfolio.

Scale indicators7 records

Recent moves9 records

Expansion highlights5 records

Broad incumbents

• ADP TotalSource: National PEO offering payroll, benefits administration (including self-funded medical, dental, vision), HR, and compliance to small and mid-sized businesses — competes for the same small/mid-employer wallet but bundles PEO services.
• WEX Health: Larger benefits administration platform offering HSA, HRA, FSA, COBRA, and consumer-directed benefit technology to TPAs, employers, and banks — overlaps with RCI's CDH/FSA administration but operates as a technology provider and administrator at greater scale.
• Lockton: Large independent insurance brokerage offering self-funded plan design, benefits administration, and consulting to mid- and large employers — overlaps with RCI on self-funded administration but operates at far greater scale with broader consulting services.
• Paychex: Large PEO and HR/benefits administrator offering health benefits administration, retirement, and insurance services to SMBs — comparable in serving small/mid-employer self-funded benefit needs via a broker/partner channel.
• Sun Life Financial (U.S. Group Benefits): Large insurer with significant group benefits and stop-loss / TPA-adjacent capabilities for self-funded employers — relevant incumbent competing for self-funded plan administration and stop-loss relationships that intersect with RCI's product set.

Direct peers

• BenefitMall: Broker-focused benefits distributor and administrator offering payroll, HR, and benefits administration products through a national broker channel — comparable in broker-led distribution and small/mid-employer focus.
• TASC (Total Administrative Services Corporation): Independent third-party administrator offering self-funded plan administration, COBRA, FSA/HRA, and compliance services to mid-market employers through brokers — closely comparable in business model, product scope, and broker-led GTM.
• Holmes Murphy & Associates: Independent insurance brokerage and benefits firm with dedicated TPA and self-funded plan administration capabilities for employers — comparable in combining broker relationships with in-house administration of self-funded plans.
• HealthEZ: Self-funded TPA focused on small and mid-sized employers with medical, dental, vision, HSA/FSA, and level-funded programs sold through brokers — directly comparable in target segment, product mix, and broker distribution.
• AmeriFlex: Independent TPA specializing in consumer-directed benefits (HSA, HRA, FSA), COBRA, and compliance administration for self-funded employers — comparable in scale, TPA-only model, and broker channel.

Market position

Strengths4 records

Weaknesses5 records

Competitive moat5 records

Key risks7 records

Key highlights7 records

Customer concentration

Compliance2 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 Regional Care