Texicare

What Texicare does

Texicare is a Texas-domiciled health insurance carrier founded in 2023 that sells level-funded group health plans to small businesses with 2-250 employees. The company was created by Texas Mutual Insurance Company — the state's leading workers' compensation insurer — following a 2021 legislative directive, and operates as Texas Mutual's health insurance affiliate under two legal entities: Texicare Health Insurance Company (the carrier underwriting stop-loss coverage) and TXM Holdings LLC dba Texicare (administrative services). Headquartered in Austin with 11-50 employees, Texicare has rolled out coverage sequentially across seven Texas markets — Lubbock, Amarillo, Midland, Odessa, Houston, El Paso, and San Antonio — and is approved for $300 million in total funding from Texas Mutual.

The product suite is built around three core plan tiers (TotalCare, SimplicityCare, SavingsCare) that share a common technology backbone: a proprietary provider network (TXC Health Network), exclusive lab services through Quest Diagnostics, 24/7 virtual care via CirrusMD, pharmacy benefits through Optum Rx, flexible billing via TempoPay, and dental coverage through Ameritas. The level-funded structure — fixed monthly payments covering administrative costs, expected claims, and stop-loss premiums, with potential surplus reimbursement — is the core actuarial and commercial differentiator versus traditional ACA community-rated plans. Distribution is multi-channel: exclusive agent networks, large broker partnerships (Hub International, The Baldwin Group), and the PerfectQuote digital quoting platform, which together provide access to 11,000+ Texas employers.

Texicare's revenue model is premium-driven, combining recurring health insurance premiums, stop-loss insurance underwriting income, and administrative service fees, all quoted on a per-employee-per-month basis. Go-to-market is sales-led through agents and brokers, supplemented by direct employer outreach and earned media, with positioning emphasizing Texas roots, affordability ($0 preventive care, $0 virtual care, $5 prescriptions), and ease of use. The company's strategic positioning is to capture the 68% of Texas's 3.2 million small businesses that do not currently offer health coverage, leveraging Texas Mutual's brand, balance sheet, and 30-year operating history as its primary commercial advantage.

Name

Texicare

Legal name

Texicare Health Insurance Company

Website

https://texicare.com

Company type

Private

Founded year

2023

Operating status

Operating

Headcount range

11–50 employees

Short description

Texicare is a Texas-domiciled health insurer that sells level-funded group health plans to small businesses (2-250 employees) across Texas. Founded in 2023 as a health affiliate of Texas Mutual, it has launched in seven Texas markets and is backed by $300 million in approved parent-company funding.

Ownership category

akta.pro rank

Product category

Small Business Group Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114), Direct Life, Health, and Medical Insurance Carriers (52411)

SIC

Accident & Health Insurance (6321), Hospital & Medical Service Plans (6324), Insurance Carriers, Nec (6399)

akta.pro industry

PRIMARYHLAEAAAE

Level-Funded Employer Plans

Healthcare & Life Sciences/Health Insurance & Managed Care/Commercial (Employer-Sponsored) Health Insurance

SECONDARYFSAIAFAC

Level-Funded Group Health Plans

Financial & Insurance/Insurance — Life & Health/Group Health Insurance (Employer-Sponsored)

SECONDARYFSAIAFAD

Small Group Health Insurance (2–50/100)

Financial & Insurance/Insurance — Life & Health/Group Health Insurance (Employer-Sponsored)

Keywords

• Level-funded health insurance
• Small business health plans
• Group medical insurance
• Stop-loss insurance coverage
• Health benefits administration

Headquarters

HQ city

Austin

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Health Insurance Premiums: Level-funded health insurance plans where employers pay fixed monthly payments that cover administrative costs, expected claims based on group status, and stop-loss insurance premiums
2. Stop-Loss Insurance: Stop-loss insurance from Texicare Health Insurance Company protects employers against large or catastrophic medical claims
3. Administrative Services: Administrative services provided by TXM Holdings LLC dba Texicare and its partners for level-funded plans

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels4 records

Core offering

Texicare offers level-funded health insurance plans to Texas small businesses with 2–250 employees. Plans are sold under three core tiers (TotalCare, SimplicityCare, SavingsCare) that bundle medical coverage with stop-loss insurance underwritten by Texicare Health Insurance Company, $0 preventive and virtual care, prescription coverage, and optional dental, diabetes reversal, and flexible payment benefits.

Product overview

Texicare is a health insurance company offering level-funded health care plans specifically designed for Texas small businesses with 2-250 employees. The company provides three core plan tiers (TotalCare, SimplicityCare, and SavingsCare) that include features such as $0 preventive care, virtual care through CirrusMD, prescription drug coverage, mental health services, and optional dental coverage through Ameritas. All plans include stop-loss insurance underwritten by Texicare Health Insurance Company, administrative services through TXM Holdings LLC, and potential surplus reimbursement. The company operates as a health affiliate of Texas Mutual and is headquartered in Austin, Texas.

Differentiator

Problem solved

Functional benefit

Brands

• TotalCare: Health plan featuring four $0 visits each to six provider types annually, including primary care, specialists, urgent care, mental health, physical therapy, and chiropractors. Includes $0 virtual care through CirrusMD and $5 common prescriptions.
• SimplicityCare
• SavingsCare

Products and services

• Level-Funded Health Plans Level-funded health plan structure where monthly payments are set at a fixed rate based on number of employees covered. Includes administrative costs, expected claims based on group status, and stop-loss insurance from Texicare Health Insurance Company. Plans are exempt from numerous ACA requirements and may offer surplus reimbursement if claims are lower than expected. Targeted at Texas small businesses with 2–250 employees.

Quantifiable outcome

• Quotes turnaround reduced by up to 95% through PerfectQuote platform
• +1 more outcomes

Named customers4 records

Segments1 record

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration6 records

Feature2 records

Partnerships

Nine partnerships are on record, tiered core, supporting and minor.

• AmeritascoreTechnology or Integration · 25 February 2026Partnership to expand dental coverage options for Texas small business employees. Texicare members gain access to Ameritas' network of over 99,000 dental access points and 14,000 providers in Texas. Six plan options including no-deductible plans, with Dental Rewards program allowing members to earn up to $1,200 toward dental services.
• Virta HealthsupportingTechnology or Integration · 28 January 2026Partnership to offer Type 2 diabetes reversal program to Texicare members at no additional cost. Virta's virtual clinic achieves up to 3% A1c reduction, 13% sustained weight loss, and 49% reduction in diabetes prescriptions after one year. Provides nutrition-focused approach with personalized therapy and behavioral coaching.
• PerfectQuotecoreChannel Partner/ Reseller/ Distributor · 7 January 2026Digital group health benefits quoting platform partnership. Provides brokers direct access to Texicare's group medical products through RFP toolset, reaching more than 11,000 Texas-based employers. Platform reduces quoting turnaround times by up to 95% through automation.
• Quest DiagnosticscoreTechnology or Integration · 9 September 2025Selected as exclusive clinical lab provider for Texicare's proprietary network. Gives Texicare members access to Quest's 170+ patient service centers throughout Texas. Quest operates major laboratories in Lewisville, Houston, and Dallas. Full suite of lab services from routine to advanced testing for diabetes, heart disease, and cancer.
• The Hospitals of ProvidencecoreTechnology or Integration · 20 November 2024El Paso health system partner supporting Texicare's proprietary provider network in El Paso. Hospitals of Providence has served El Paso and surrounding areas for more than 120 years, providing localized healthcare access for Texicare members.
• TempoPaysupportingTechnology or Integration · 20 November 2024Flexible payment platform providing employees with ability to pay healthcare bills over time without interest, fees, or credit checks. Interest-free, flexible payment options integrated into Texicare plans.
• CirrusMDcoreTechnology or Integration · 20 August 2024Virtual healthcare provider partnership for around-the-clock virtual care. Texicare members can connect to board-certified clinicians in under 60 seconds through CirrusMD platform, providing free unlimited virtual care access.
• Optum RxsupportingTechnology or IntegrationPharmacy benefits partner connecting Texicare members to prescription medications. Members access medications through Optum Rx platform with covered medication list and prescription reimbursement options.
• Red Fan CommunicationsminorGTM or Marketing PartnerMarketing and communications partner providing brand authority index and media support. Expanded partnership with Texicare as part of Red Fan's client portfolio including Ascension Texas and Kinective.

Scale indicators6 records

Recent moves9 records

Expansion highlights5 records

Broad incumbents

• Aetna (CVS Health): Aetna, owned by CVS Health, is a major national health insurer offering small group plans across multiple states including Texas. It competes with Texicare in employer-sponsored coverage but operates as part of a much larger integrated healthcare and pharmacy enterprise.
• UnitedHealthcare: UnitedHealthcare is the largest U.S. health insurer and offers small business group health plans nationwide, including Texas. It competes with Texicare in the employer-sponsored small group market but operates across all 50 states with a much broader product portfolio.
• Humana: Humana is a major national health insurer with significant small group and individual health plan offerings, including in Texas. It competes with Texicare for Texas small business employers but also offers Medicare, dental, and other lines as part of a broader portfolio.
• Cigna Group: Cigna is a global health services company offering employer-sponsored health plans in Texas and nationwide. It competes with Texicare in the small group market while also offering international health, pharmacy benefits, and behavioral health services.

Emerging players

• Pivot Health: Pivot Health specializes in level-funded and self-funded health plans for small businesses and individuals. It offers similar level-funded plan structures to Texicare and competes for the same small employer market, though it operates in multiple states rather than Texas exclusively.
• Sidecar Health: Sidecar Health is a technology-enabled health plan offering alternative insurance models with price transparency. It targets self-employed individuals and small businesses with a different model than Texicare's level-funded plans but competes for the same price-sensitive small employer segment.
• Oscar Health: Oscar Health is a technology-focused health insurer offering individual and small group plans in select states. It competes with Texicare in tech-enabled health insurance for small employers but focuses on ACA marketplace products rather than level-funded structures.

Direct peers

• Blue Cross Blue Shield of Texas: Blue Cross Blue Shield of Texas is the largest health insurance carrier in Texas and the dominant provider of small group health plans. It directly competes with Texicare in offering employer-sponsored health coverage to Texas small businesses with similar plan structures.
• The Loomis Company: The Loomis Company is a third-party administrator specializing in self-funded and level-funded health plans for small and mid-sized employers. It provides similar administrative services to what Texicare Health Insurance Company offers and competes in the same level-funded plan market.

Others

• Lockton Companies: Lockton is one of the largest independent insurance brokerages in the world and facilitates small group health plan placement for employers. It works with multiple carriers including level-funded providers like Texicare and serves as a distribution channel rather than a direct competitor.

Market position

Strengths1 record

Weaknesses1 record

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/texicare

Revenue estimate

Valuation estimate

Number of profiles

Profiles9 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 Texicare