IOA Re

What IOA Re does

IOA Re is a Pennsylvania-based managing general underwriter (MGU) and reinsurer founded in 1987, operating under the Carbon Stop Loss Solutions brand within the Novacore commercial specialty insurance platform. The firm provides employer stop loss, managed care, special risks, and cost containment reinsurance solutions to self-insured employer groups, HMOs, physician groups, and other healthcare providers across the United States. Services are delivered by IOA Re, LLC (NPN #2006648) and Sequoia Reinsurance Services, LLC (NPN #18853752), with Rockport Benefits operating as a division of IOA Re, LLC.

The underlying platform integrates actuarial, financial, medical underwriting, clinical, cost containment, and claims expertise into customized excess loss and risk-transfer solutions, supported by long-standing partnerships with A to A++ rated carrier networks. The four-pillar product suite — Employer Stop Loss, Managed Care, Special Risks, and Cost Containment — is delivered through direct enterprise sales and a broker/consultant channel comprising top health and benefit brokers, third-party administrators, and key carrier partners. Pricing is quote-based, tailored to each client's specific needs, and structured around multi-year contracts.

Revenue is generated through reinsurance premiums, managed care and special risks underwriting income, and professional services fees tied to cost containment engagements. Customer engagement is relationship-led rather than product-led: IOA Re's value proposition rests on decades of underwriting experience, cross-functional clinical and claims expertise, and family-style service to self-funded plan sponsors navigating rising specialty pharmacy, emergent therapy, and catastrophic claim costs.

Name

IOA Re

Legal name

IOA Re, LLC

Website

https://ioare.com

Company type

Private

Founded year

1987

Operating status

Operating

Headcount range

51–100 employees

Short description

IOA Re is a U.S. managing general underwriter providing employer stop loss, managed care, special risks, and cost containment reinsurance to self-insured employer groups, HMOs, physician groups, and healthcare providers, operating under the Carbon brand within the Novacore specialty insurance platform.

Ownership category

akta.pro rank

Product category

Medical Stop Loss Reinsurance

NAICS

Insurance Carriers and Related Activities (524), Direct Life, Health, and Medical Insurance Carriers (52411)

SIC

Accident & Health Insurance (6321), Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Stop-Loss / Medical Excess-of-Loss Reinsurance (FSAIANAI)

akta.pro secondary industry

Self-Funded (ASO) Group Health Plans & Stop-Loss (FSAIAFAB)

Keywords

• Stop loss reinsurance
• Managed care reinsurance
• Excess loss coverage
• Medical stop loss
• Healthcare reinsurance

Headquarters

HQ city

Norristown

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Employer Stop Loss Reinsurance: Provides stop loss coverage for self-insured employer groups, protecting against catastrophic medical losses. Revenue generated through reinsurance premiums paid by self-funded plan sponsors.
2. Managed Care Reinsurance: Reinsurance solutions for HMOs and managed care organizations covering excess loss exposure and medical cost management.
3. Special Risks Coverage: Specialized reinsurance for unique or complex risk exposures outside standard managed care offerings.
4. Cost Containment Services: Services focused on reducing medical costs, managing waste and maintaining access to care for plan sponsors.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels1 record

Core offering

IOA Re, operating under the Carbon Stop Loss Solutions brand, provides employer stop loss and managed care reinsurance solutions to self-insured employer groups, HMOs, physician groups and other healthcare providers. The company combines actuarial, finance, medical underwriting, clinical, cost containment and claims expertise to deliver customized excess loss coverage that protects plan sponsors against catastrophic medical losses, manages healthcare cost trends (including specialty pharmacy and emergent therapies), and supports risk protection for complex healthcare environments.

Product overview

Carbon Stop Loss Solutions is a unified platform delivering employer stop loss and managed care reinsurance solutions. The platform operates under IOA Re, LLC (NPN #2006648) and unites legacy organizations IOA Re, Sequoia Reinsurance Services, and Rockport Benefits. The product portfolio consists of four core offerings: Employer Stop Loss (market-leading excess loss solutions), Managed Care (comprehensive reinsurance with underwriting and actuarial expertise), Special Risks (coverage for unusual scenarios), and Cost Containment (as an add-on module for managing specialty pharmacy and catastrophic claim expenses). Rockport Benefits operates as a division of IOA Re, LLC.

Differentiator

Problem solved

Functional benefit

Products and services

• Carbon Stop Loss Solutions Umbrella brand providing employer stop loss and managed care reinsurance solutions, uniting the expertise of IOA Re, Sequoia Reinsurance Services, and Rockport Benefits to deliver innovative risk solutions for self-insured employer groups, HMOs, physician groups, and healthcare providers. Services are provided by IOA Re, LLC (NPN #2006648) and Sequoia Reinsurance Services, LLC (NPN #18853752).
• Employer Stop Loss Market-leading employer and provider excess loss solutions designed to effectively lower costs and protect plan assets for self-insured employer groups. Provides protection against catastrophic medical losses for self-funded health plans.
• Managed Care Comprehensive managed care reinsurance solutions with expertise in medical underwriting, actuarial support, and cost containment strategies for healthcare providers, HMOs, and managed care organizations. Covers excess loss exposure and medical cost management.
• Special Risks Specialized reinsurance solutions for high-risk or unusual coverage scenarios beyond standard managed care offerings. Addresses unique or complex risk exposures that fall outside standard reinsurance products.
• Cost Containment Innovative cost-saving strategies and emerging solutions to manage healthcare expenses, reduce waste, and maintain access to care, particularly for specialty pharmacy medications and catastrophic claims. Includes solutions for hospital inpatient services and emergent therapies.

Named customers4 records

Segments4 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature1 record

Partnerships

Three partnerships are on record, tiered core.

• Sequoia Reinsurance ServicescoreStrategic or Co-development PartnerSequoia Reinsurance Services (NPN #18853752) is a legacy organization united with IOA Re under the Carbon Stop Loss Solutions brand. Together they deliver cutting-edge employer stop loss and managed care reinsurance solutions that are stronger by design.
• Rockport BenefitscoreStrategic or Co-development PartnerRockport Benefits operates as a division of IOA Re, LLC, contributing to the integrated reinsurance solutions platform. The company united expertise of Rockport Benefits with IOA Re and Sequoia Reinsurance Services under the Carbon brand.
• A to A++ rated insurance carrierscoreStrategic or Co-development PartnerLongstanding partnerships with top-rated insurance carriers (A to A++ rated) provide added peace of mind that Carbon/IOA Re solutions are backed by financially strong and reliable partners.

Scale indicators1 record

Recent moves6 records

Expansion highlights4 records

Direct peers

• RGA Reinsurance Company: RGA is one of the largest dedicated stop loss and managed care reinsurance providers globally. Direct competitor to IOA Re's employer stop loss and managed care offerings; notably, IOA Re recently hired veterans from RGA's managed care team to expand its own managed care capabilities.
• Sun Life Financial (U.S. Stop Loss business): Sun Life operates a major U.S. stop loss insurance and reinsurance business serving self-funded employers, HMOs, and healthcare providers. Overlaps with IOA Re on employer stop loss, managed care reinsurance, and cost containment services delivered through broker and consultant channels.
• Symetra Life Insurance Company: Symetra is a significant stop loss insurer serving self-funded employer plans with stop loss coverage and related reinsurance solutions. Directly comparable product portfolio, customer base (self-funded employer groups), and broker-distribution model to IOA Re.
• Tokio Marine HCC: Tokio Marine HCC operates a stop loss division providing employer stop loss coverage to self-insured plans, alongside other specialty insurance lines. Comparable specialty insurance / stop loss MGU business model and broker-driven distribution to IOA Re.
• Companion Life (BlueCross BlueShield of South Carolina): Companion Life is a stop loss carrier specializing in employer stop loss coverage for self-funded plans, including managed care reinsurance and excess loss products. Closely comparable niche specialty carrier serving the same self-insured employer and HMO segments.
• Voya Financial (Stop Loss business): Voya has historically operated a stop loss insurance business providing employer stop loss and excess loss solutions to self-insured employer groups. Comparable product set (employer stop loss, managed care reinsurance) and distribution through brokers and consultants.
• BCS Financial Corporation: BCS Financial operates a stop loss insurance subsidiary providing employer stop loss coverage to self-funded plans, with similar broker and consultant distribution. Comparable specialty stop loss carrier serving the same self-insured employer and healthcare provider segments as IOA Re.

Broad incumbents

• Munich Re (Stop Loss / Health Reinsurance): Munich Re is a global reinsurance giant with a substantial U.S. stop loss and health reinsurance portfolio. Indirectly comparable through reinsurance capacity backing for MGU partners and direct competition for large managed care reinsurance deals; operates at much broader scale.
• Swiss Re (Health Reinsurance): Swiss Re is a major global reinsurer providing stop loss and health reinsurance capacity in the U.S. market. Overlaps with IOA Re in providing excess loss and managed care reinsurance capacity, but as part of a much broader reinsurance portfolio.
• Berkshire Hathaway Specialty Insurance: Berkshire Hathaway Specialty Insurance writes medical stop loss and related specialty lines. Comparable stop loss product offering and carrier-style underwriting approach, but operates as part of Berkshire's broad specialty insurance portfolio.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

• Xx.com/ioare
• LinkedInlinkedin.com/company/ioa-re

Revenue estimate

Valuation estimate

Number of profiles

Profiles4 records

Subsidiaries1 record

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 IOA Re