Enterprise Group Planning

What Enterprise Group Planning does

Enterprise Group Planning, Inc. (EGP) is a privately held third-party administrator (TPA) founded in 1974 and headquartered in Solon, Ohio, with a secondary office in Birmingham, Michigan. The company administers self-funded and level-funded employer-sponsored health benefit plans, providing plan design, enrollment and eligibility management, claims processing, COBRA administration, consumer account (FSA/HSA/HRA) management, stop-loss coverage through its in-house Blue Water Underwriting arm, and risk management with clinical coordination. EGP serves 53,000+ members nationwide, primarily contracted through brokers, consultants, and direct employer relationships, and is positioned as Ohio's oldest continuously operating TPA. The technology stack combines an in-house administration platform integrated with 122+ third-party systems (including 120+ pharmacy benefit managers, Cigna, and Medical Mutual of Ohio), supported by a Zakipoint Health-powered member portal and the EGP Health Connect mobile app with AI chat, all operated under SOC 1, FedRAMP-aligned, and GDPR-compliant data security standards.

Revenue is generated through per-member/per-employee administrative fees on self-funded plans (custom quote-based, multi-year contracts), stop-loss insurance premiums via Blue Water Underwriting, prescription benefit management pass-through economics, reference-based pricing, and ancillary compliance and consumer account administration fees. The go-to-market is sales-led and channel-partner-driven: a direct sales team engages employers, while a parallel broker/consultant channel is cultivated through education sessions, pipeline reviews, and regional sales coverage (notably a Michigan-focused Senior Sales & Marketing Manager). EGP is privately held with no outside investors, venture capital, or debt, and operates as a focused, mid-sized specialist rather than a scaled national platform.

Name

Enterprise Group Planning

Legal name

Enterprise Group Planning, Inc.

Website

https://egp-inc.com

Company type

Private

Founded year

1974

Operating status

Operating

Headcount range

11–50 employees

Short description

Enterprise Group Planning is a privately held Ohio-based third-party administrator, founded in 1974, that administers self-funded employer health benefit plans—including claims, COBRA, stop-loss, and consumer accounts—for 53,000+ members nationwide, distributed through direct employer sales and broker/consultant channels.

Ownership category

akta.pro rank

Product category

Third-Party Employee Benefits Administration

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Health and Welfare Funds (525120)

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

Ancillary Benefits TPA (Dental/Vision/Life/Accident/Critical Illness) (HLAEALAN), Self-Funded Employer POS (ASO/TPA-Administered) (HLAEAOAH)

Keywords

• Third-party administration
• Employee benefits administration
• Self-funded health plans
• Health benefits management
• Stop-loss coverage

Headquarters

HQ city

Solon

HQ country

United States

HQ region

North America

Offices2 records

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 Fees: EGP generates revenue as a third-party administrator (TPA) by charging administrative fees to self-funded employers for plan administration, claims processing, and related services. They serve as the TPA for employer-sponsored health benefit plans, handling everything from enrollment and eligibility to compliance and communications.
2. Stop-Loss Coverage: The company offers stop-loss coverage through their own underwriting and actuary office (Blue Water Underwriting) to protect self-funded employers from high-cost claims. This generates revenue through stop-loss insurance premiums.
3. Plan Design and Administration Services: Revenue is generated through flexible plan design services including self-funded plans, custom plan designs, utilization management, and various benefit options (dental, vision, telemedicine, wellness programs).
4. Consumer Accounts Administration: FSA, HSA, and HRA administration services providing tax-advantaged spending account management for employers and employees.
5. COBRA Administration: Compliance and billing services for COBRA coverage, handling notifications, eligibility tracking, and documentation for employers.

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels5 records

Core offering

Enterprise Group Planning is a third-party administrator (TPA) that designs, administers, and manages self-funded employer-sponsored health benefit plans. The company handles benefits design, enrollment and eligibility, claims processing, COBRA and ERISA compliance, stop-loss coverage through its own underwriting arm, risk management, and member digital tools for self-funded employers and their broker partners.

Product overview

Enterprise Group Planning (EGP) operates as a comprehensive third-party administrator (TPA) offering a modular benefits administration platform. The core offering consists of five integrated service pillars: Benefits Solutions (self-funded plans, dental/vision, telemedicine, wellness, case & disease management, and consumer spending accounts), Cost Management (stop-loss via Blue Water Underwriting, prescription benefit management, and reference-based pricing), Digital Tools (the Zakipoint-powered Member Portal and EGP Health Connect mobile app), Plan Administration (eligibility, enrollment, COBRA, and business process outsourcing), and Risk Management (claim analytics and clinical coordination). EGP's platform integrates with over 120 third-party platforms including PBMs and pharmacy networks, leverages Cigna and Medical Mutual of Ohio national networks alongside its proprietary provider network, and is backed by SOC 1 and FedRAMP-aligned data security infrastructure.

Differentiator

Problem solved

Functional benefit

Products and services

• Benefits Solutions Customizable employee health and benefit plans for self-funded employers, including self-funded medical plans, dental, vision, wellness programs, telemedicine, case and disease management, utilization management, and consumer spending accounts (FSA, HSA, HRA). Designed for employers that want plan design flexibility, cost transparency, and a single administrative partner for a full range of benefits.
• Cost Management Strategic cost management services for self-funded employers, bundling stop-loss coverage underwritten through EGP's Blue Water Underwriting unit, prescription benefit management, and reference-based pricing designed to control healthcare spending while preserving quality and network access.
• Digital Tools Digital platform for members, employers, and providers that delivers a member portal, the EGP Health Connect mobile app, custom reporting, and real-time data feeds, with data security aligned to SOC 1, FedRAMP, and GDPR standards. Built on the Zakipoint Zconnect technology backbone.
• Plan Administration End-to-end administrative services for self-funded health plans covering enrollment, eligibility management, COBRA administration, member communications, and seamless integration with over 122 third-party platforms including PBMs, specialty solutions, and managed care organizations.
• Risk Management

Named customers1 record

Segments4 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration5 records

AI capability1 record

Feature6 records

Partnerships

Eight partnerships are on record, tiered core and major.

• Blue Water UnderwritingcoreTechnology or IntegrationBlue Water Underwriting is EGP's own underwriting and actuary office that provides stop-loss coverage to protect self-funded employers from high-cost claims. This partnership enables EGP to offer integrated risk protection alongside their TPA services.
• CignacoreTechnology or IntegrationNational provider network partnership providing access to Cigna's provider and physician networks nationwide, complementing EGP's proprietary network.
• Medical Mutual of OhiocoreTechnology or IntegrationRegional provider network partnership providing access to Medical Mutual of Ohio's provider networks in addition to EGP's proprietary network and other national networks.
• 120+ Pharmacy Benefit Managers and Specialty SolutionscoreTechnology or IntegrationExtensive integration ecosystem with over 120 pharmacy benefit managers, specialty solutions, and managed care organizations enabling plug-and-play connectivity for client benefit programs.
• The Phia GroupcoreTechnology or IntegrationERISA compliance documentation partnership using The Phia Group's compliant document tools for Master Plan Documents, Summary Plan Descriptions (SPDs), and Summaries of Benefits and Coverage (SBCs).
• WEX HealthmajorTechnology or IntegrationWEX Health provides consumer-directed benefit solutions including HSA, FSA, and HRA administration. EGP offers WEX Employer Portal and WEX Consumer Portal access for plan administration.
• TeladocmajorTechnology or IntegrationTelemedicine partnership providing 24/7 access to quality virtual care for EGP members, improving convenience while lowering traditional care costs.
• Zakipoint HealthmajorTechnology or IntegrationMember portal and digital tools platform partnership providing the technology backbone for EGP's member portal, mobile app (EGP Health Connect), and member-facing digital experiences.

Scale indicators6 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Meritain Health: Meritain Health is one of the largest third-party administrators in the U.S., serving self-funded employer health plans with integrated PBM, network, and stop-loss solutions. Closely mirrors EGP's TPA-plus-cost-management positioning at meaningfully larger scale.
• HealthEZ: HealthEZ is a TPA focused on self-funded employer plans, offering medical, pharmacy, and consumer account administration with a strong digital/member experience emphasis. Highly comparable to EGP's product mix and self-funded mid-market focus.
• Benefit Administrative Systems (BASI): BASI is a Midwest-based TPA delivering self-funded plan administration, claims processing, and COBRA services to employer clients. Comparable regional TPA competing for similar brokers and self-funded employer accounts.
• Key Benefit Administrators: Key Benefit Administrators provides TPA services for self-funded employer plans including medical, dental, disability, and COBRA administration. Comparable mid-size TPA with overlapping product set and employer customer profile.
• Lucet (formerly New Directions): Lucet is a behavioral health TPA and care-management organization serving health plans, employers, and providers. Overlaps with EGP's TPA/administrative services model, though Lucet specializes more deeply in behavioral health.

Broad incumbents

• UMR (UnitedHealthcare): UMR is UnitedHealthcare's TPA arm and the largest TPA in the U.S., serving self-funded employer plans with broad network and analytics capabilities. Represents the scaled incumbent against which EGP competes for self-funded employer business.
• CoreSource (The Cigna Group): CoreSource is Cigna's TPA/ASO subsidiary administering self-funded employer benefit plans with integrated network and clinical management. Direct overlap with EGP's TPA services, particularly given EGP's Cigna network partnership.
• Amwins Connect: Amwins Connect is the benefits administration division of Amwins, a major wholesale insurance distributor offering TPA and stop-loss solutions to employer clients. Comparable stop-loss plus administration model at larger scale.

Others

• ADP TotalSource: ADP TotalSource is a PEO providing co-employed HR, benefits (including health plan administration), and compliance services to small and mid-sized employers. Adjacent competitor for benefits administration though structured as a PEO co-employment model.
• Paychex PEO / Benefits Services: Paychex offers PEO and benefits administration services for small and mid-sized businesses, including health plan access, COBRA, and FSA/HSA administration. Indirect competitor for EGP's employer clients evaluating PEO bundles.

Market position

Strengths5 records

Weaknesses1 record

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/enterprise-group-planning-inc

Compliance3 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 Enterprise Group Planning