Paramount Health Care

What Paramount Health Care does

Paramount Health Care, founded in 1988 and headquartered in Toledo, Ohio (corporate offices also in Maumee and Cincinnati, Ohio, and Monroe, Michigan), is a regional health insurance company offering Medicare Advantage, Individual ACA Marketplace, employer group, short-term, and dental plans to approximately 77,000 health plan members and 308,000 dental plan members across Ohio, Michigan, and four additional Midwest states. The product portfolio centers on the Paramount Elite Medicare Advantage suite (HMO, HMO-POS, and PPO) with a layered set of supplemental benefits — dental, vision, hearing, OTC allowances, transportation through SafeRide, SilverSneakers fitness, wellness rewards, and post-discharge meals — alongside fully insured and self-funded employer plans and ACA Marketplace individual and family coverage. The underlying technology stack includes the MyParamount member portal, a CMS-mandated HL7 FHIR interoperability API platform (Patient Access, Provider Directory, Formulary, Claims, Clinical) built on Aidbox with SMART on FHIR authorization, and an integrated vendor ecosystem spanning CVS Caremark for PBM, Prime Therapeutics for Part B review, and multiple value-added benefit partners.

Name

Paramount Health Care

Legal name

Paramount Care, Inc.

Website

https://paramounthealthcare.com

Company type

Private

Founded year

1988

Operating status

Operating

Headcount range

501–1,000 employees

Short description

Paramount Health Care is a regional health insurer offering Medicare Advantage, ACA Marketplace, employer group, and dental plans to 77,000+ health and 308,000 dental members across Ohio, Michigan, and the broader Midwest, operating as a Medical Mutual subsidiary since May 2024.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114)

SIC

Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Medicare Advantage (MA) Plans (FSAIAGAA)

akta.pro secondary industries

ACA Marketplace (On-Exchange) Individual Plans (FSAIAEAA), Taft-Hartley / Union Multiemployer Group Health Plans (FSAIAFAG), Medicare Dental & Vision (MA Embedded & Supplemental) (FSAIAHAJ), MA Chronic Condition Management & Supplemental Benefits (SSBCI) (HLAEACAI)

Keywords

• Medicare Advantage plans
• Individual health insurance
• Employer group coverage
• HMO PPO plans
• Dental insurance benefits

Headquarters

HQ city

Maumee

HQ country

United States

HQ region

North America

Offices4 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Supply Chain, Marketing or Sales, Infrastructure, Others

Revenue model

1. Medicare Advantage Premiums: Paramount Elite Medicare Advantage plans (HMO, HMO-POS, PPO) generate revenue through Medicare contracts. The company receives capitation payments from CMS based on enrolled member demographics and risk scores, plus member premiums and cost-sharing.
2. Commercial Group Health Insurance: Fully insured employer health plans (HMO, PPO, CDHP) across Ohio and Michigan. Revenue from employer group premiums based on employee count and plan selection.
3. Individual and Family Plans: Marketplace (ACA) plans sold through healthcare.gov for individuals and families. Includes Gold, Silver, and Bronze tier options with subsidies for eligible enrollees.
4. Short-term Health Insurance: Bridge gap coverage plans for individuals between coverage periods.
5. Dental Plans: Standalone dental plans serving over 308,000 dental plan members.

Pricing tiers

Go-to-market motion3 records

Distribution channels4 records

Marketing channels8 records

Core offering

Paramount Health Care sells a portfolio of health insurance products, including Paramount Elite Medicare Advantage plans (HMO, HMO-POS, PPO), Individual and Family Marketplace plans in Gold/Silver/Bronze tiers, short-term health insurance, and fully insured or self-funded employer group plans (HMO, PPO, CDHP, POS) across Ohio and Michigan. It also administers standalone dental plans (serving ~308,000 members) and supplemental benefits such as dental, vision, hearing, OTC allowances, transportation, and wellness rewards, all accessed through the MyParamount member portal and supported by FHIR-based Interoperability APIs.

Product overview

Paramount Health Care is a health insurance company offering a portfolio of insurance products structured as a platform with multiple plan types and add-on modules. The core offerings include Paramount Elite Medicare Advantage Plans (HMO, HMO-POS, and PPO) which provide comprehensive medical coverage with optional supplemental benefits including dental, vision, hearing, OTC benefits, transportation services, and wellness rewards; Individual and Family Health Plans offered through the Health Insurance Marketplace in Gold, Silver, and Bronze tiers with various cost-sharing structures; and Employer Health Plans including HMO, POS, CDHP, and PPO options for businesses in Ohio and Michigan. These core products are supported by the MyParamount member portal platform, Interoperability APIs enabling third-party application integration via FHIR standards, and various vendor partnerships for specialized services including prescription drug management (CVS Caremark), transportation (SafeRide), vision (EyeMed), fitness (SilverSneakers), hearing (TruHearing), and telehealth assessments. The company operates as part of the Medical Mutual family of companies following acquisition in May 2024.

Differentiator

Problem solved

Functional benefit

Products and services

• Paramount Elite Medicare Advantage Plans Medicare Advantage plans (HMO, HMO-POS, and PPO) with a Medicare contract, offering hospital, medical, and Part D prescription drug coverage plus optional supplemental benefits including dental, vision, hearing, OTC allowances, transportation, and wellness programs, sold to Medicare-eligible individuals across Ohio and Michigan.
• Individual and Family Marketplace Health Plans ACA Marketplace health insurance plans sold to individuals and families outside of employer coverage across Ohio and Michigan, available on-exchange through healthcare.gov and off-exchange, with Gold, Silver, and Bronze tier options and cost-sharing reduction subsidies on Silver plans for income-eligible enrollees.
• Short-term Health Insurance Plans Short-term health insurance plans designed to bridge gaps in major medical coverage for individuals between major medical coverage periods.
• Employer Health Plans Fully insured and self-funded group health insurance plans for businesses in Ohio and Michigan, offering HMO, POS, CDHP, and PPO options, with small group plans sold through brokers (under 50 employees) and large group plans (50+ employees) handled by direct account managers.
• MyParamount Member Portal Secure online member portal for enrolled Paramount members to access claims, authorizations, benefit summaries, prescription coverage information, send email to Paramount, and use the discount shopping network.
• Paramount Interoperability APIs HL7 FHIR-based developer APIs exposing Provider Directory (Organization, Practitioner, Location, Healthcare Service), Patient Access (via SMART on FHIR), Drug Formulary, Claims, and clinical data resources, running on the Aidbox platform with sandbox and production environments, enabling third-party applications to integrate with Paramount member data with member consent.
• Standalone Dental Plans Standalone dental insurance plans serving approximately 308,000 dental plan members, offered in connection with Paramount's core health insurance product lines.

Quantifiable outcome

• 94.6% of standard prior authorization requests approved for Medicare Advantage members in 2025
• +3 more outcomes

Segments3 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration13 records

Feature3 records

Partnerships

Nine partnerships are on record, tiered flagship and core.

• Medical MutualflagshipStrategic or Co-development Partner · 1 May 2024Medical Mutual acquired Paramount Health Insurance (Commercial and Medicare) from ProMedica. Transaction closed May 1, 2024. Paramount continues operating under the Paramount name as part of Medical Mutual family of companies. Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio (founded 1934), serving over 1.2 million members.
• CVS CaremarkcoreTechnology or IntegrationServes as Paramount's Prescription Benefit Manager (PBM) to administer prescription drug benefits. Provides mail order services, prescription refill programs, coverage review services, and Medicare Prescription Payment Plan administration.
• SafeRide HealthcoreTechnology or IntegrationProvides transportation services for Paramount Elite Medicare members in eligible plans. Covers up to 24 one-way trips annually to medical-related locations within 35 miles in the service area (Ohio and Michigan counties).
• SilverSneakerscoreTechnology or IntegrationProvides Paramount Elite members with access to thousands of fitness centers with in-person and online fitness classes to support member wellness.
• EyeMedcoreTechnology or IntegrationProvides a network of vision providers enabling members to receive routine eye exams and eyewear allowances as part of Paramount health plans.
• NationsBenefitscoreTechnology or IntegrationAdministers over-the-counter (OTC) benefits for Paramount Elite members in qualifying plans, providing allowances for OTC products.
• TruHearingcoreTechnology or IntegrationProvides hearing benefits including hearing exams and hearing aids for Paramount Elite members as part of comprehensive health coverage.
• Prime Therapeutics Management LLCcoreTechnology or IntegrationConducts organization determination review on Part B drugs that require prior authorization for Medicare Advantage plans.
• ProMedicacoreStrategic or Co-development PartnerFormer parent company of Paramount Health Care. ProMedica is a Toledo- and mission-based, not-for-profit health and well-being organization. Paramount was part of the ProMedica integrated healthcare delivery system combining insurance expertise with clinical excellence. Sale to Medical Mutual completed May 2024.

Scale indicators6 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• CareSource: Dayton, Ohio-headquartered nonprofit health plan with a strong Medicaid, Marketplace, and Medicare Advantage presence across Ohio and other Midwestern states. Competes head-to-head with Paramount for Ohio ACA, MA, and dual-eligible members.
• Priority Health: Michigan-based nonprofit health plan offering individual, group, and Medicare Advantage products throughout Michigan. Competes directly with Paramount in Southeast Michigan and overlaps in product structure.
• Health Alliance Plan (HAP): Michigan-based health plan offering HMO, PPO, Medicare Advantage, and individual plans in Southeast Michigan. A direct regional peer where Paramount Care of Michigan competes for group and Medicare members.

Broad incumbents

• Humana: One of the largest U.S. Medicare Advantage carriers, with major Ohio and Michigan footprints offering HMO/PPO MA plans and group coverage. A direct competitor in Paramount's core MA business across both served states.
• Aetna (CVS Health): National carrier offering MA, individual ACA, and group plans nationwide including Ohio and Michigan; CVS retail footprint and Caremark PBM depth parallel Paramount's own CVS Caremark integration. Competes across all of Paramount's lines.
• Medical Mutual of Ohio: Ohio-based mutual insurer and parent of Paramount since May 2024. Operates across individual, group, Medicare, and dental lines across Ohio and neighboring states — a direct portfolio overlap and now the same corporate family.
• Blue Cross Blue Shield of Michigan: Michigan's dominant Blues carrier with broad employer, individual, MA, and dental offerings. Direct competitor in Michigan for group, MA, and dental customers served by Paramount Care of Michigan.
• UnitedHealthcare (Optum): Largest U.S. health insurer with Medicare Advantage, individual ACA, and employer group plans offered in Ohio and Michigan. Overlaps with Paramount across every line of business and segment.
• Molina Healthcare: Government-program-focused health plan with Medicare Advantage, Marketplace, and Medicaid products in multiple states including Ohio. Competes with Paramount in MA and ACA segments in Ohio.
• Anthem Blue Cross Blue Shield of Ohio: Ohio-licensed Blue plan offering employer group, individual ACA, and Medicare Advantage products. Overlaps directly with Paramount's commercial, individual, and MA portfolios in Ohio.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Facebookfacebook.com/ParamountInsuranceCompany
• LinkedInlinkedin.com/company/paramount-health-care

Compliance4 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles2 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 Paramount Health Care