SilverSummit Healthplan
- Company typePrivate
- Founded2017
- HeadquartersLas Vegas, United States
- Headcount1–10
- GTM typeB2C
- OfferingServices
SilverSummit Healthplan firmographics
Firmographics- 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
SilverSummit Healthplan industry classification
Industry- 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
Where SilverSummit Healthplan is headquartered
LocationHeadquarters
- HQ city
- Las Vegas
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
SilverSummit Healthplan business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Operations, Personnel, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- Medicaid Premium Revenue: Capitated premium payments from Nevada Medicaid Managed Care program for covering eligible members
- Medicare Advantage Premium Revenue: Premium revenue from Medicare Advantage plans (Allwell brand) for senior and disabled members
- Marketplace Premium Revenue: Premium revenue from Health Insurance Marketplace (Ambetter from SilverSummit Healthplan) plans, with premium tax credits available to eligible individuals
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Medicaid Plan - Government subsidized coverage for eligible Nevadans |
| Subscription | Monthly | Ambetter Marketplace Plans - Tiered health insurance options |
Go-to-market motion1 record
Distribution channels4 records
Marketing channels5 records
SilverSummit Healthplan product offering
Product offeringCore 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
Companies that use SilverSummit Healthplan
Customer profileNamed customers3 records
Segments4 records
Ideal customer profiles4 records
SilverSummit Healthplan technology and API
TechnologyTechnology focussed No
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
Integration11 records
Feature4 records
SilverSummit Healthplan partnerships and signals
Strategic signalPartnerships
Seven partnerships are on record, tiered core.
- Blueberry PediatricscoreStatewide 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 InstitutecoreSouthern 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 ImagingcoreSouthern Nevada partner in Project Accelerate, providing expedited diagnostic imaging and mammogram services within three days of detection.
- Las Vegas Surgical Associates (Dr. Peter Caravella)coreSouthern Nevada breast surgeons partner in Project Accelerate, providing expedited surgical appointments and treatment coordination for breast cancer patients.
- Quest DiagnosticscoreDiagnostic laboratory partner in Project Accelerate, providing expedited biopsy results and pathology services to support faster cancer diagnosis and treatment initiation.
- XpediteMDcoreMedical 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 ClinicscoreRural 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
SilverSummit Healthplan competitors and assessment
Company assessmentDirect 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
SilverSummit Healthplan social profiles
Digital presenceSilverSummit Healthplan compliance and trust
Trust signalCompliance6 records
SilverSummit Healthplan financial estimates
Financial estimateRevenue estimate
Valuation estimate
SilverSummit Healthplan leadership team
Management profileNumber of profiles
Profiles3 records
SilverSummit Healthplan funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
SilverSummit Healthplan 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 SilverSummit Healthplan
What does SilverSummit Healthplan do?
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.
Is SilverSummit Healthplan a public or private company?
SilverSummit Healthplan is a private company. It is classified as corporate owned and is currently operating.
When was SilverSummit Healthplan founded?
SilverSummit Healthplan was founded in 2017. It employs 1 to 10 people.
Where is SilverSummit Healthplan based?
SilverSummit Healthplan is headquartered in Las Vegas, United States, in the North America region.
How does SilverSummit Healthplan make money?
Three revenue lines are on record. Medicaid Premium Revenue is the primary driver. The others are medicare Advantage Premium Revenue and marketplace Premium Revenue.
Who are SilverSummit Healthplan's main competitors?
Direct peers on record are Health Net (Centene subsidiary), Molina Healthcare, Anthem Blue Cross and Blue Shield Nevada and UnitedHealthcare Nevada. Broad incumbents are Aetna (CVS Health), Humana and Cigna Group. Emerging players are Oscar Health and Alignment Healthcare. Blue Shield of California is listed as a regional player.
Does SilverSummit Healthplan have an API?
Yes. SilverSummit Healthplan provides machine-readable files (JSON format) containing product, formulary, and provider network information. These files can be downloaded by third parties to review data. The transparency in coverage machine-readable files include network rates and out-of-network allowed amounts. Developer documentation is at api.centene.com/ambetter/reference/cms-data-index.json.
What industry is SilverSummit Healthplan in?
SilverSummit Healthplan's product category is Managed Health Insurance. Its primary akta.pro industry code is HLAEAEAA, TANF/CHIP Managed Care Plans, with a secondary code of FSAIAEAA, ACA Marketplace (On-Exchange) Individual Plans. Its NAICS code is 524114 and its SIC code is 6324.