Cox HealthPlans
Cox HealthPlans is a privately held, locally based health insurance company in Springfield, Missouri, selling individual, group, Medicare Advantage, short-term, and self-funded plans across a 26-county southwest Missouri service area, with national PPO access via First Health Network.
- Company typePrivate
- Founded1995
- HeadquartersSpringfield, United States
- Headcount101–250
- GTM typeB2B and B2C
- OfferingServices
What Cox HealthPlans does
Cox HealthPlans LLC is a privately held, regional health insurance company founded in 1995 and headquartered in Springfield, Missouri, operating as a subsidiary within the CoxHealth healthcare system. The company is the only locally based health insurer in the Ozarks region and sells a portfolio of health coverage products through three primary entities: Cox Health Systems Insurance Company, Cox Health Systems HMO, and Cox HealthPlans LLC. Products span Individual Marketplace plans (On-Exchange and Off-Exchange through healthcare.gov), Group plans (Bronze, Silver, and Gold tiers including PPO, EPO, and HDHP options), Medicare Advantage plans, Short-Term Plus limited-duration plans (30 days to 6 months, non-ACA), and self-funded Level Solutions plans for employer groups of 10 or more employees.
The company's service footprint is concentrated in a 26-county area across southwest Missouri, with national PPO coverage extended through a First Health Network partnership for out-of-area care. Underlying technology components include a HealthX-powered member and employer portal, the MedImpact pharmacy benefit platform (transitioned from Elixir in November 2024), a CoxHealth-branded video visit service for common conditions, and AAAHC-accredited ambulatory operations. Cox HealthPlans relies on its affiliated CoxHealth provider network and physical facility footprint, which is itself expanding into Arkansas and additional southwest Missouri locations.
Revenue is generated almost entirely through recurring monthly insurance premiums across individual, group, Medicare Advantage, short-term, and self-funded products, supplemented by administrative fees on self-funded plans. Distribution is multi-channel: direct employer group sales, a broker/agent network compensated on a per-member-per-month basis scaling from $15 to $30 by agency size, healthcare.gov marketplace listings for individual plans, and direct-to-consumer enrollment for short-term medical products. The company markets to individuals, families, small and mid-market employers, and Medicare beneficiaries primarily through its website, broker partners, community events, and the CoxHealthNow digital portal launched in June 2022.
Cox HealthPlans firmographics
Firmographics- Name
- Cox HealthPlans
- Legal name
- Cox HealthPlans LLC
- Website
- https://coxhealthplans.com
- Company type
- Private
- Founded year
- 1995
- Operating status
- Operating
- Headcount range
- 101–250 employees
- Short description
- Cox HealthPlans is a privately held, locally based health insurance company in Springfield, Missouri, selling individual, group, Medicare Advantage, short-term, and self-funded plans across a 26-county southwest Missouri service area, with national PPO access via First Health Network.
- Ownership category
- akta.pro rank
Cox HealthPlans industry classification
Industry- Product category
- Health Insurance
- NAICS
- Direct Health and Medical Insurance Carriers (524114), Direct Life, Health, and Medical Insurance Carriers (52411)
- SIC
- Hospital & Medical Service Plans (6324), Accident & Health Insurance (6321)
- akta.pro primary industry
- Managed Care / Network-Based Group Health Plans (Carrier Network Products) (FSAIAFAO)
- akta.pro secondary industries
- Small Group Health Insurance (2–50/100) (FSAIAFAD), MA Employer Group Waiver Plans (EGWP) (HLAEACAH)
Keywords
Where Cox HealthPlans is headquartered
LocationHeadquarters
- HQ city
- Springfield
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
Cox HealthPlans business model
Business model- GTM type
- B2B and B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure, Supply Chain
Revenue model
- Individual Health Insurance Premiums: Premium-based revenue from Individual Marketplace (On-Exchange and Off-Exchange) plans covering individuals and families in southwest Missouri
- Group Health Insurance Premiums: Premium revenue from employer group plans including PPO, HDHP, and EPO options for businesses of various sizes, including self-funded plan administration
- Medicare Advantage Premiums: Medicare Advantage plan premiums from beneficiaries during Annual Enrollment Period (October 15 - December 7)
- Short-Term Medical Plan Premiums: Short-term limited-duration insurance premiums with terms from 30 days to 6 months, marketed as affordable alternative to traditional insurance
- Self-Funded Plan Administration: Administrative services for self-funded employer health plans with Level Solutions products offering budgetable monthly premium payments
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Short-Term Plus EPO Plans - Deductible options $1,000/$2,500/$5,000 with lifetime maximum $1,000,000 |
| Subscription | Monthly | Group Bronze HDHP 7500 - 0% co-insurance for primary care, hospital, emergency |
| Subscription | Monthly | Group Silver Plans - Various deductible and co-pay combinations |
| Subscription | Monthly | Group Gold Plans - Lower deductibles and co-pays |
| Subscription | Monthly | Level Solutions Self-Funded Plans - Multiple co-insurance and deductible combinations |
| Other | Monthly | Broker Commission Structure |
Go-to-market motion3 records
Distribution channels5 records
Marketing channels7 records
Cox HealthPlans product offering
Product offeringCore offering
Cox HealthPlans is a locally based health insurance company operating in southwest Missouri since 1995, providing a portfolio of health insurance products to individuals, families, employers, and Medicare beneficiaries. The company offers Medicare Advantage plans, Individual Marketplace plans (On-Exchange and Off-Exchange), Short-Term Plus Medical Plans, and Group/Business Health Plans (PPO, HDHP, EPO, and self-funded options), with provider network access through CoxHealth and First Health Network for out-of-area coverage.
Product overview
Cox HealthPlans is a health insurance provider and the only locally-based health insurance company in the Ozarks region (Southwest Missouri). The company offers a comprehensive portfolio of health insurance products including Medicare Advantage Plans, Individual Marketplace Plans (On-Exchange and Off-Exchange), Short-Term Plus Medical Plans (EPO-based temporary coverage from 30 days to 6 months), and Group Health Plans. Group plans include Bronze, Silver, and Gold tier options along with PPO, HDHP, EPO, and Self-Funded Health Plans. Level Solutions Plans provide self-funded options for groups of 10+ employees. The company operates an EPO network across 13 counties and partners with First Health Network for nationwide PPO coverage. Additional services include Medical Management programs, Healthy Living Initiatives, and prescription benefits administration through MedImpact.
Differentiator
Problem solved
Functional benefit
Brands
- CoxHealth Medicare Advantage: Medicare Advantage Plans offered by Cox HealthPlans
- Short-Term Plus Medical Plans
- Level Solutions
- Partners Plans
Products and services
- Medicare Advantage Plans Medicare Advantage health insurance plans providing coverage for Medicare-eligible individuals (adults 65 and older or those with qualifying disabilities) sold during the Annual Enrollment Period (October 15 - December 7).
- Individual Marketplace Plans Individual and family health insurance plans available On-Exchange and Off-Exchange through healthcare.gov for self-employed individuals, families, and those between coverage periods in southwest Missouri.
- Short-Term Plus Medical Plans Short-term limited-duration health insurance providing temporary coverage from 30 days to 6 months with EPO network access, including hospital, physician, and emergency services. Does not comply with Affordable Care Act requirements.
- Business Health Plans (Group Plans) Group health insurance plans for employers offering flexible coverage options with multiple plan types including PPO, HDHP, EPO, and self-funded options across Bronze, Silver, and Gold metal levels, with nationwide access through First Health Network partnership.
- Level Solutions Self-Funded Plans Self-funded health plans for groups of 10+ employees or 15+ insured members offering budget-friendly set monthly premium payments with predictability, including HDHP options for HSA eligibility.
Quantifiable outcome
- Over 95% of members indicated their personal doctor communicated well with them
- +2 more outcomes
Companies that use Cox HealthPlans
Customer profileNamed customers2 records
Segments5 records
Ideal customer profiles4 records
Cox HealthPlans technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature4 records
Cox HealthPlans partnerships and signals
Strategic signalPartnerships
Four partnerships are on record, tiered core.
- First Health NetworkcorePartnership with First Health Network provides Preferred Provider Organization (PPO) network services outside the Cox HealthPlans 26-county service area. First Health is one of the leading PPO networks in the United States with providers and hospitals in urban, suburban, and rural areas throughout the country including the District of Columbia. Members can locate First Health providers by calling 1-800-226-5116 or through the online provider locator.
- MedImpactcoreMedImpact administers prescription benefits for Cox HealthPlans members. Services include pharmacy locator, prescription drug pricing, drug information, mail order administration, and 24/7 pharmacy technician support at 844-838-1522. Member benefits can be accessed through MedImpact's secure member site.
- InDemand Interpreting ServicescoreInDemand provides over 200 languages of medical interpreting services at no charge to members. All interpreters are medically certified. Services available through Member Services department via 3-way call and through provider offices via telephone or video call.
- CoxHealthcoreCoxHealth is the affiliated health system providing the provider network and healthcare facilities for Cox HealthPlans members. CoxHealth has been recognized as a Top 100 Integrated Health System. The affiliation provides access to dozens of hospitals and clinics staffed by physicians and specialists throughout the region.
Scale indicators4 records
Recent moves10 records
Expansion highlights6 records
Cox HealthPlans competitors and assessment
Company assessmentDirect peers
- Cox HealthPlans (self-affiliated): Listed for completeness — comparable product structure; not a true independent peer.
- Blue Cross and Blue Shield of Kansas City: Regional Blue Cross Blue Shield plan serving western Missouri and Kansas with Individual, Group, and Medicare products. Closely comparable to Cox HealthPlans in product mix, geographic adjacency, and regional carrier positioning, and a direct competitor for employer accounts in the southwest Missouri market.
Broad incumbents
- Cigna Healthcare: Global health services company with significant Missouri group and individual presence. Comparable in product breadth (especially self-funded administration) and competes with Cox HealthPlans in mid-market and large-group segments.
- Humana: Major Medicare Advantage and group health carrier operating across Missouri. Particularly relevant as a competitor in Cox HealthPlans' MA segment, where Humana has national MA scale advantages.
- Aetna (CVS Health): National carrier offering Individual, Group, and Medicare plans in Missouri through CVS-owned infrastructure. Competes with Cox HealthPlans for ACA Marketplace and employer group business in the same geography.
- HealthLink (Wellpoint/Anthem): Anthem-affiliated PPO/HMO network serving Missouri and surrounding states. Competes with Cox HealthPlans for larger employer group business in the same southwest Missouri footprint while leveraging Anthem's national scale and broader network.
- Centene Corporation (Ambetter in Missouri): Major Marketplace and Medicaid managed-care operator with strong Missouri presence through Ambetter. Direct competitor in the Individual ACA Marketplace segment that Cox HealthPlans serves via healthcare.gov.
- UnitedHealthcare (Oxford/UMR in Missouri): Largest U.S. health insurer offering Individual, Group, Medicare Advantage, and self-funded administration across Missouri. Direct competitor in Cox HealthPlans' service area for employer groups, MA, and individual ACA Marketplace plans.
Emerging players
- Medica: Regional, non-profit health plan operating across the Midwest with Individual, Group, and Medicare products. Comparable mid-size scale and provider-network-led model make it a useful peer for assessing Cox HealthPlans' regional carrier trajectory.
Regional players
- Mercy Health Plans / Cox HealthPlans peer regional carriers: Mercy operates health plans and ACO products in adjacent Missouri/Arkansas regions. Relevant peer because Mercy's provider-integrated insurance model mirrors the CoxHealth/Cox HealthPlans affiliation structure, even if not a direct head-to-head competitor in all 26 counties.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
Cox HealthPlans social profiles
Digital presenceCox HealthPlans compliance and trust
Trust signalCompliance1 record
Cox HealthPlans financial estimates
Financial estimateRevenue estimate
Valuation estimate
Cox HealthPlans leadership team
Management profileNumber of profiles
Profiles1 record
Cox HealthPlans funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Cox HealthPlans 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 Cox HealthPlans
What does Cox HealthPlans do?
Cox HealthPlans is a locally based health insurance company operating in southwest Missouri since 1995, providing a portfolio of health insurance products to individuals, families, employers, and Medicare beneficiaries. The company offers Medicare Advantage plans, Individual Marketplace plans (On-Exchange and Off-Exchange), Short-Term Plus Medical Plans, and Group/Business Health Plans (PPO, HDHP, EPO, and self-funded options), with provider network access through CoxHealth and First Health Network for out-of-area coverage.
Is Cox HealthPlans a public or private company?
Cox HealthPlans is a private company. It is classified as corporate owned and is currently operating.
When was Cox HealthPlans founded?
Cox HealthPlans was founded in 1995. It employs 101 to 250 people.
Where is Cox HealthPlans based?
Cox HealthPlans is headquartered in Springfield, United States, in the North America region.
How does Cox HealthPlans make money?
Five revenue lines are on record. Individual Health Insurance Premiums are the primary driver. The others are group Health Insurance Premiums, medicare Advantage Premiums, short-Term Medical Plan Premiums and self-Funded Plan Administration.
Who are Cox HealthPlans's main competitors?
Direct peers on record are Cox HealthPlans (self-affiliated) and Blue Cross and Blue Shield of Kansas City. Broad incumbents are Cigna Healthcare, Humana, Aetna (CVS Health), HealthLink (Wellpoint/Anthem), Centene Corporation (Ambetter in Missouri) and UnitedHealthcare (Oxford/UMR in Missouri). Medica is listed as an emerging player. Mercy Health Plans / Cox HealthPlans peer regional carriers is listed as a regional player.
Does Cox HealthPlans have an API?
No public API is recorded for Cox HealthPlans.
What industry is Cox HealthPlans in?
Cox HealthPlans's product category is Health Insurance. Its primary akta.pro industry code is FSAIAFAO, Managed Care / Network-Based Group Health Plans (Carrier Network Products), with a secondary code of FSAIAFAD, Small Group Health Insurance (2–50/100). Its NAICS code is 524114 and its SIC code is 6324.