SilverSummit Healthplan

Name

SilverSummit Healthplan

Legal name

SilverSummit Healthplan, Inc.

Website

https://silversummithealthplan.com

Company type

Private

Founded year

2017

Operating status

Operating

Headcount range

1–10 employees

Ownership category

akta.pro rank

Product category

Managed 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

TANF/CHIP Managed Care Plans (HLAEAEAA)

akta.pro secondary industries

ACA Marketplace (On-Exchange) Individual Plans (FSAIAEAA), Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage) (BPAIAKAH)

Keywords

• Managed care plans
• Medicaid health insurance
• Medicare Advantage plans
• Health insurance marketplace
• Medicaid managed care

Headquarters

HQ city

Las Vegas

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

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

Revenue model

1. Medicaid Premium Revenue: Capitated premium payments from Nevada Medicaid Managed Care program for covering eligible members
2. Medicare Advantage Premium Revenue: Premium revenue from Medicare Advantage plans (Allwell brand) for senior and disabled members
3. Marketplace Premium Revenue: Premium revenue from Health Insurance Marketplace (Ambetter from SilverSummit Healthplan) plans, with premium tax credits available to eligible individuals

Pricing tiers

Go-to-market motion1 record

Distribution channels4 records

Marketing channels5 records

Core offering

SilverSummit Healthplan is a Nevada managed care organization providing government-sponsored and marketplace health insurance plans. The company delivers comprehensive Medicaid managed care, Medicare Advantage (under the Allwell brand), and Health Insurance Marketplace (under the Ambetter brand) coverage to members across all Nevada counties, supplemented by care coordination, telehealth, behavioral health, pharmacy benefits, transportation services, and rewards programs.

Product overview

SilverSummit Healthplan is a managed care plan that provides health insurance to Nevadans through three core product lines: the Medicaid Plan (primary managed care product), Ambetter from SilverSummit Healthplan (Health Insurance Marketplace/sub-brand), and Allwell Medicare Advantage Plan (Medicare Advantage sub-brand). The plan operates as a Centene Corporation company, established in 2017. The offering functions as a platform-plus-modules architecture where the core insurance products are supplemented by specialized wellness and care coordination programs including Start Smart for Your Baby (maternity program), Project Accelerate (expedited cancer care), Behavioral Health Services, Telehealth Services, My Health Pays Rewards, Transportation Services, and Housing Supports. Recent additions include the Blueberry Pediatrics virtual care partnership for pediatric access and the Rural Healthcare Investment Program supporting critical access hospitals. The company leverages third-party utilization management vendors including TurningPoint, Evolent (National Imaging Associates), New Century Health, and Centene's own vision and dental services for specialized care coordination.

Differentiator

Problem solved

Functional benefit

Brands

• Ambetter Health: Health Insurance Marketplace product offering affordable health insurance plans in Nevada with tax credit savings and rewards programs.
• Project Accelerate
• Start Smart for Your Baby

Products and services

• SilverSummit Medicaid Plan Comprehensive Medicaid managed care health plan providing coverage for Nevada Medicaid-eligible low-income individuals and families and Nevada Check Up participants across all Nevada counties, including preventive care, behavioral health, pharmacy benefits, transportation, and care management services. Trusted by thousands of Nevada members since the plan's establishment in 2017.
• Ambetter from SilverSummit Healthplan Health Insurance Marketplace (ACA) product underwritten by SilverSummit Healthplan, Inc., a Qualified Health Plan issuer in Nevada. Offers tiered health insurance plans through Nevada Health Link with premium tax credit savings, My Health Pays rewards (up to $500+), Ambetter Telehealth, Express Scripts mail-order pharmacy, HealthHub by WebMD Ignite wellness resources, YMCA360 fitness access, and behavioral health benefits. Designed for individuals and families purchasing coverage through the federally-facilitated Marketplace.
• Allwell Medicare Advantage Plan Medicare Advantage plan offered under the Allwell brand by SilverSummit Healthplan for seniors and qualifying individuals with disabilities. Provides comprehensive Medicare coverage with additional supplemental benefits beyond Original Medicare, including prescription drug coverage, care coordination, and access to a broad provider network across Nevada. Enrollment occurs through Open Enrollment (starting October 15th) and Special Enrollment Periods.
• Project Accelerate Innovative breast cancer care initiative that streamlines the diagnostic and treatment journey for SilverSummit members through expedited diagnostic mammograms (within 3 days of detection), rapid reporting of imaging and biopsy results, coordinated referrals to surgeons and oncologists, and accelerated treatment start. Operated in partnership with The Oncology Institute, SimonMed Imaging, Las Vegas Surgical Associates, Quest Diagnostics, and the XpediteMD care coordination platform.
• Blueberry Pediatrics Virtual Care Statewide partnership-enabled pediatric virtual care service providing Nevada Medicaid families with unlimited 24/7 access to board-certified pediatricians via secure chat, video, and phone visits at no additional cost. Enrolled families receive a free Blueberry Medical Kit (digital otoscope, pulse oximeter, thermometer) for in-home pediatric assessments, reducing unnecessary emergency department visits and expanding access for rural and working-parent households.

Quantifiable outcome

• Breast cancer treatment time reduced from 66 days to 17 days from positive biopsy to treatment start
• +3 more outcomes

Named customers3 records

Segments4 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration11 records

Feature4 records

Partnerships

Seven partnerships are on record, tiered core.

• Blueberry PediatricscoreStrategic or Co-development Partner · 12 June 2026Statewide partnership to provide Nevada Medicaid families with unlimited 24/7 access to board-certified pediatricians through secure chat, video, and phone visits at no additional cost. Enrolled families receive a free Blueberry Medical Kit containing diagnostic tools (digital otoscope, pulse oximeter, thermometer).
• The Oncology InstitutecoreStrategic or Co-development PartnerSouthern Nevada partner in Project Accelerate breast cancer care initiative, working to expedite diagnostic mammograms, rapid reporting of imaging and biopsy results, and coordinated referrals to surgeons and oncologists.
• SimonMed ImagingcoreTechnology or IntegrationSouthern Nevada partner in Project Accelerate, providing expedited diagnostic imaging and mammogram services within three days of detection.
• Las Vegas Surgical Associates (Dr. Peter Caravella)coreStrategic or Co-development PartnerSouthern Nevada breast surgeons partner in Project Accelerate, providing expedited surgical appointments and treatment coordination for breast cancer patients.
• Quest DiagnosticscoreTechnology or IntegrationDiagnostic laboratory partner in Project Accelerate, providing expedited biopsy results and pathology services to support faster cancer diagnosis and treatment initiation.
• XpediteMDcoreTechnology or IntegrationMedical and software platform supporting coordination of care in Project Accelerate, enabling seamless communication, faster scheduling, and connected care experience for members.
• 13 Critical Access Hospitals and Rural Health ClinicscoreStrategic or Co-development PartnerRural healthcare providers receiving $650,000 investment ($25,000 per facility in 2025 and 2026) for infrastructure, workforce capacity, transportation needs, imaging equipment, and software upgrades. Includes Desert View Hospital in Pahrump.

Scale indicators5 records

Recent moves6 records

Expansion highlights6 records

Direct peers

• Health Net (Centene subsidiary): Sister Centene subsidiary operating Medicaid and Marketplace plans in other states. Closely mirrors SilverSummit's operating model, technology stack, and product portfolio under the same parent, making it the most structurally comparable entity.
• Molina Healthcare: Pure-play government-sponsored managed care company with significant Medicaid footprint. Operates a similar capitation model focused on Medicaid and dual eligibles, often bidding against Centene subsidiaries in state procurements.
• Anthem Blue Cross and Blue Shield Nevada: Operates as a competing Medicaid managed care plan in Nevada alongside SilverSummit, serving the same Medicaid and Medicare Advantage populations with overlapping provider networks. Directly comparable on product mix, regulatory framework, and contract basis.
• UnitedHealthcare Nevada: Largest health insurer in the U.S. with a major Nevada Medicaid presence competing head-to-head with SilverSummit. Comparable across Medicaid, Medicare Advantage, and individual ACA Marketplace segments in the same geography.

Broad incumbents

• Aetna (CVS Health): National managed care competitor with Medicaid, Medicare Advantage, and Marketplace products overlapping SilverSummit's full portfolio. Backed by CVS Health's care delivery and pharmacy infrastructure provides a different but overlapping competitive dynamic.
• Humana: Dominant Medicare Advantage carrier that competes with SilverSummit's Allwell brand in Nevada. Operates at a much larger national scale but overlaps on the Medicare Advantage and dual-eligible product lines central to SilverSummit's senior segment.
• Cigna Group: Large national insurer with Medicare Advantage and individual Marketplace exposure that competes with SilverSummit's non-Medicaid product lines. Less direct Medicaid overlap but competes for the same dual-eligible and ACA members in Nevada.

Emerging players

• Oscar Health: Technology-led individual ACA Marketplace insurer that competes directly with SilverSummit's Ambetter product in Nevada. Comparable on the Marketplace product line and digital member experience, though without the Medicaid book.
• Alignment Healthcare: Medicare Advantage-focused insurer leveraging technology and care coordination. Conceptually aligned with SilverSummit's Project Accelerate-style care management approach, competing for senior membership in overlapping markets.

Regional players

• Blue Shield of California: California-focused nonprofit plan that is the parent of Blueberry Pediatrics — SilverSummit's pediatric virtual care partner. Comparable on Medicaid-adjacent populations and pediatric care delivery model, though not directly competing in Nevada.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

• Xx.com/SilverSummitHP
• YouTubeyoutube.com/@SilverSummitHP/videos
• Facebookfacebook.com/SilverSummitHealthplan
• LinkedInlinkedin.com/company/silversummit-healthplan-inc.

Compliance6 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 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 SilverSummit Healthplan