What Opyn Health does

Opyn Health is a Wayne, Pennsylvania-based healthcare technology company that operates a unified AI-powered platform designed for the self-funded benefits ecosystem. The platform bundles five integrated modules — Opyn Agents (AI-driven automation handling provider interactions, member navigation, prior authorization, and claims coordination via voice and chat), Opyn Engage (a consumer-grade member app paired with an admin Partner Console), Opyn Live (24/7 nationwide virtual care spanning urgent, primary, behavioral, dermatology, musculoskeletal, and lab services), Opyn Iris (price transparency and benefit-aware provider navigation aligned to the No Surprises Act and Transparency in Coverage), and Opyn Index (provider directory intelligence with real-time in-network validation) — and can be adopted modularly or as a fully unified stack. The company additionally markets specialized functionality for schools and universities, including FERPA-aligned student care delivery.

The business model is enterprise SaaS delivered as a configurable, white-label platform licensed primarily to TPAs, health plans, PEOs, employers, brokers and benefit consultants, captives, PBMs, and educational institutions. Pricing is quote-based and not publicly disclosed, with modular adoption enabling customers to start with a single solution and expand; the go-to-market is sales-led enterprise motion with demo-driven conversion and claims of 'weeks, not months' onboarding. Distribution is U.S.-only, served through direct enterprise sales without a consumer storefront.

Opyn acquired Empara, an AI-led benefits engagement and administration platform, in October 2025, bringing its co-founders onto the Opyn executive team (Markus Waite as EVP, Ben Callaghan as CPO, Mike Nigels as CIO) and broadening the platform's AI and member-engagement surface. The company remains private, with Transparent Health Marketplace, Inc. disclosed as a parent entity at the same Wayne address; no institutional venture or growth funding rounds are publicly disclosed. Key named customer Marpai, a TPA, publicly cites Opyn as central to its TPA evolution, and disclosed metrics include 30–50% efficiency gains for health plan administrators, a $1-per-call cost reduction through Provider Interaction Agent, and 9.3-second AI response times versus 39 seconds for human agents.

Name

Opyn Health

Legal name

Opyn Health, Inc.

Website

https://opynhealth.com

Company type

Private

Founded year

2022

Operating status

Operating

Headcount range

11–50 employees

Short description

Opyn Health is a Wayne, PA-based healthcare technology company that sells a configurable, white-label SaaS platform combining AI-driven automation, a member app, virtual care, price transparency, and provider-directory intelligence to TPAs, health plans, PEOs, employers, brokers, captives, PBMs, and schools.

Ownership category

akta.pro rank

Product category

Healthcare Benefits Administration Software

NAICS

Custom Computer Programming Services (541511), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (51821)

SIC

Services-Prepackaged Software (7372), Services-Health Services (8000)

akta.pro primary industry

Employer/Member Engagement Platforms for Provider-Sponsored Plans (HLACAEAM)

akta.pro secondary industry

Data Aggregation, Interoperability & APIs for RPM (FHIR/IoMT Gateways) (HLACAFAO)

Keywords

• Healthcare benefits platform
• Virtual care software
• Healthcare price transparency
• Provider network intelligence
• AI benefits administration

Headquarters

HQ city

Conshohocken

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

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

Revenue model

1. Platform Licensing/Subscription: SaaS-based platform licensing model providing access to integrated Opyn solutions (Agents, Engage, Live, Iris, Index). Delivered as white-label, configurable platform to TPAs, health plans, PEOs, employers, brokers, captives, and PBMs. Revenue likely derived from subscription fees with modular adoption options.

Go-to-market motion2 records

Distribution channels1 record

Marketing channels4 records

Core offering

Opyn Health sells a unified, AI-powered healthcare benefits platform that combines member navigation, virtual care delivery, cost transparency, and provider network intelligence into a single white-label system. The platform is sold to third-party administrators, health plans, employers, brokers, PEOs, captives, PBMs, and schools/universities as modular subscriptions (Opyn Agents, Engage, Live, Iris, Index) that can be adopted individually or together. The company monetizes via SaaS-style platform licensing with enterprise sales and configuration support.

Product overview

Opyn Health offers a unified platform-plus-modules architecture centered on the Opyn Platform, which integrates navigation, virtual care, cost transparency, and provider network intelligence. The platform comprises five integrated modules: Opyn Agents (AI-driven automation), Opyn Engage (member portal and admin console), Opyn Live (virtual care delivery), Opyn Iris (price transparency and cost navigation), and Opyn Index (provider data management). These modules can be deployed together for a fully unified experience or activated individually. Opyn acquired Empara in October 2025, adding an AI-powered benefits engagement and administration platform to its portfolio. The combined solution targets TPAs, health plans, employers, brokers, PEOs, and self-insured organizations.

Differentiator

Problem solved

Functional benefit

Brands

• Opyn Agents: AI-driven automation platform that scales operations and boosts efficiency for healthcare teams.
• Opyn Engage
• Opyn Live
• Opyn Iris
• Opyn Index

Products and services

• Opyn Platform Unified healthcare administration platform that connects member navigation, virtual care, cost transparency, and provider network intelligence under one scalable system for TPAs, health plans, employers, brokers, PEOs, captives, PBMs, and schools/universities.
• Opyn Agents AI-driven automation module providing virtual teammates trained on organizational data, documents, and processes to handle member navigation, provider interactions, prior authorization status, coordination of benefits, and accident claim coordination via voice and chat with 24/7 availability and human escalation.
• Opyn Engage Consumer-grade health engagement app and portal combining a member-facing mobile application with a partner console for administrators; delivers single-login member experience, AI-guided benefit navigation, and centralized plan management with shared workspaces.
• Opyn Live 24/7 virtual care platform delivering nationwide access to urgent care, primary care, behavioral health, dermatology, musculoskeletal care, labs, and peer-to-peer support through an integrated network of licensed clinicians.
• Opyn Iris Healthcare price transparency and cost navigation tool providing personalized cost estimates, quality insights, and provider comparisons with real-time, benefit-based pricing aligned to No Surprises Act and Transparency in Coverage requirements.
• Opyn Index Provider data management and network intelligence directory delivering accurate provider directories with real-time validation against in-network rules; continuously updates specialty, location, and affiliation data to address the 82% industry-wide provider directory inaccuracy rate.
• Empara AI-led benefits engagement and administration platform offering intelligent automation and a consumer-grade member app for benefits engagement; acquired by Opyn in October 2025 and integrated with Opyn's product portfolio to create a unified AI-driven experience for members and administrators.

Quantifiable outcome

• 30-50% efficiency gains for health plan administrators
• +4 more outcomes

Named customers2 records

Segments8 records

Ideal customer profiles5 records

Technology focussed Yes

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

AI capability9 records

Feature5 records

Partnerships

One partnership is on record.

• EmparacoreStrategic or Co-development Partner · 22 October 2025Opyn acquired Empara, an AI-led benefits engagement and administration platform, to enhance its benefits administration capabilities. The acquisition combines Empara's AI platform and member app with Opyn's product portfolio and deep data capabilities, creating a unified, AI-driven healthcare experience for members and administrators. Empara founders Markus Waite, Ben Callaghan, and Mike Nigels joined Opyn Health.

Scale indicators9 records

Recent moves5 records

Expansion highlights6 records

Direct peers

• HealthJoy: HealthJoy delivers a virtual care and benefits navigation platform for employers, including AI-driven assistance and provider search. Closely matches Opyn's Opyn Live + Opyn Engage + Opyn Agents combination for self-funded employers.
• Accolade: Accolade provides AI-powered benefits navigation, virtual care, and advocacy to employers and health plans. Directly comparable to Opyn's combined Agents + Engage + Live + Iris offering with overlapping customer base and similar B2B SaaS GTM motion.
• Included Health: Included Health offers integrated virtual care, navigation, and insurance navigation for employers and health plans. Competes head-to-head with Opyn's combined virtual care + benefits navigation + AI agent platform.
• Castlight Health: Castlight Health provides healthcare price transparency and navigation tools to employers and health plans. Directly comparable to Opyn Iris (price transparency) and provider search functionality.
• Quantum Health: Quantum Health provides care navigation and utilization management for self-funded employers and health plans, with TPA-like service infrastructure. Overlaps with Opyn's navigation, prior authorization, and coordination of benefits capabilities.

Emerging players

• Turquoise Health: Turquoise Health provides a price transparency platform with negotiated rate data and consumer-facing cost comparison. Closely aligned to Opyn Iris and Index in addressing No Surprises Act and TiC compliance.
• Soda Health: Soda Health offers a healthcare benefits navigation platform focused on health plan supplemental benefits. Comparable emerging player in payer-facing member engagement for non-medical benefits, similar market segment to Opyn.
• Solera Health: Solera Health provides a benefits management platform that connects payers, employers, and members to condition-specific programs. Overlaps with Opyn's navigation and recommendation engine for guiding members to high-value care.

Broad incumbents

• Virgin Pulse (Personify Health): Personify Health (formerly Virgin Pulse) is a large employee wellbeing and benefits navigation platform serving global employers. Broader portfolio with overlapping member engagement and navigation capabilities.

Others

• Marpai Health: Marpai is a technology-driven TPA for self-funded health plans. Strategic customer and channel partner for Opyn rather than a direct competitor, illustrating Opyn's go-to-market into the TPA ecosystem.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/thmcorp
• LinkedInlinkedin.com/company/opyn-health

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles14 records

Subsidiaries1 record

Funding overview

Funding rounds2 records

Investors3 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A1 record

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Opyn Health