HealthSource RI

What HealthSource RI does

HealthSource RI is the State of Rhode Island's official health insurance marketplace, established in 2013 under the Affordable Care Act. The organization operates two primary lines of business: an Individual & Family Marketplace connecting Rhode Island residents to Qualified Health Plans with access to federal Advance Premium Tax Credits, and HealthSource RI for Employers, a SHOP-style marketplace serving small businesses and nonprofits with 1-50 employees. Since inception, HSRI has reduced Rhode Island's uninsured rate from 11% to 2.2%, with 98% of state residents now covered and 88% of its customers receiving financial assistance. The platform operates exclusively within Rhode Island under a CMS-approved Section 1332 State Innovation Waiver (effective 1/1/2020 through 12/31/2029) that funds a state reinsurance program to stabilize individual market premiums.

The underlying technology consists of the healthyrhode.ri.gov consumer-facing enrollment portal and the RIBridges eligibility and enrollment system, which is managed by Deloitte as the implementation vendor and integrates with carrier systems for plan comparison, enrollment, and billing. Distribution is multi-channel: a toll-free contact center, live web chat in English and Spanish, virtual information sessions, a statewide Navigator network of 100+ trained multilingual enrollment assisters, and a certified broker channel for the employer segment. HealthSource RI does not underwrite insurance itself; rather, it acts as a regulated intermediary connecting consumers and small employers to a small set of carrier partners (Blue Cross & Blue Shield of Rhode Island and Neighborhood Health Plan of Rhode Island for medical, Delta Dental for dental, plus ancillary providers such as Colonial Life, Principal, VSP, Pets Best, Washington National, and New Benefits). Plan inventory spans Platinum, Gold, Silver, and Bronze metal tiers, with HSA-eligible options.

As a state government agency rather than a privately held company, HealthSource RI is funded through state appropriations, carrier assessments, and user fees under ACA implementation and does not publicly disclose revenue. It records no external funding rounds and is not privately owned. The organization achieved a record 42,695 individual enrollments in Open Enrollment 2025 before seeing a 10% decline to 38,557 in Open Enrollment 2026 following the expiration of enhanced federal premium tax credits. Leadership is headed by Director Lindsay Lang, who assumed the role after serving as interim director following the 2019 departure of prior Director Zach Sherman. The current organizational status is operating, with annual Open Enrollment periods and ongoing special enrollment support, including dedicated pathways for individuals transitioning off Medicaid.

Name

HealthSource RI

Legal name

HealthSource RI

Website

https://healthsourceri.com

Company type

Private

Founded year

2013

Operating status

Operating

Headcount range

11–50 employees

Short description

HealthSource RI is Rhode Island's state-based ACA health insurance marketplace, established in 2013, that connects individuals, families, and small employers (1-50 employees) with medical, dental, and ancillary coverage from BCBSRI, NHPRI, Delta Dental, and partner carriers, providing enrollment support, Navigator assistance, and access to federal premium tax credits.

Ownership category

akta.pro rank

Product category

State Health Insurance Marketplace

NAICS

Insurance Agencies and Brokerages (524210), Agencies, Brokerages, and Other Insurance Related Activities (5242), Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Insurance Agents, Brokers & Service (6411), Hospital & Medical Service Plans (6324)

akta.pro primary industry

Individual Health Insurance Administration (TPA/ASO) (FSAIAEAK)

akta.pro secondary industry

Small Group Health Insurance (2–50/100) (FSAIAFAD)

Keywords

• State health insurance marketplace
• ACA marketplace exchange
• Individual health plans
• Small business insurance
• Health plan comparison

Headquarters

HQ city

Cranston

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

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

Revenue model

1. Government Operations: HealthSource RI operates as Rhode Island's state-based health insurance marketplace established under the Affordable Care Act. The organization is funded through state appropriations and does not charge consumers fees for marketplace services. Revenue is generated through carrier assessments and user fees as part of ACA implementation.

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels5 records

Core offering

HealthSource RI operates Rhode Island's official state health insurance marketplace established under the Affordable Care Act, connecting individuals, families, and small employers with medical and dental Qualified Health Plans from multiple carriers (Blue Cross & Blue Shield of Rhode Island, Neighborhood Health Plan of Rhode Island, and Delta Dental). The marketplace provides access to Advance Premium Tax Credits, plan comparison tools, and a Navigator network for enrollment support, and operates a separate SHOP-style offering for small businesses with 1-50 employees.

Product overview

HealthSource RI is Rhode Island's official state health insurance marketplace, comprising two main offerings: the Individual & Family Marketplace and HealthSource RI for Employers. The Individual & Family Marketplace connects Rhode Islanders with medical and dental coverage from carriers including Blue Cross & Blue Shield of Rhode Island and Neighborhood Health Plan of Rhode Island, offering Platinum/Gold/Silver/Bronze metal-level plans plus HSA-eligible options. The HealthSource RI for Employers program serves small businesses with 1-50 employees, offering 18 health plan options and 6 dental plan options from the same carriers, plus ancillary benefits. Both segments provide access to financial assistance including Advance Premium Tax Credits, Navigator enrollment support, and online plan comparison tools. The platform has decreased Rhode Island's uninsured rate from 11% in 2012 to approximately 2.2% in 2024.

Differentiator

Problem solved

Functional benefit

Brands

• HealthyRhode: Mobile application for health insurance enrollment and management

Quantifiable outcome

• Decreased uninsured rate by more than two thirds since 2013, from 11% to 2.2%
• +3 more outcomes

Named customers3 records

Segments3 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Partnerships

13 partnerships are on record, tiered core and minor.

• Centers for Medicare and Medicaid Services (CMS)coreStrategic or Co-development Partner · 8 July 2019Federal agency that approved Rhode Island's Section 1332 State Innovation Waiver application, enabling the state reinsurance program to lower premiums in the individual market. Waiver approved 1/1/2020 through 12/31/2029.
• Blue Cross & Blue Shield of Rhode IslandcoreOthersPrimary medical insurance carrier offering individual and small group plans through the HSRI marketplace. BCBSRI is the largest health insurer in Rhode Island and provides the majority of plan options available to consumers.
• Neighborhood Health Plan of Rhode IslandcoreOthersMedical insurance carrier providing individual and small group health plans through the HSRI marketplace. NHPRI serves diverse populations including Medicaid managed care and marketplace enrollees.
• Delta DentalcoreOthersDental insurance carrier providing plans through the HSRI for Employers program for small group coverage.
• Rhode Island Department of Human Services (DHS)coreStrategic or Co-development PartnerState agency partner for SNAP benefits referral and Medicaid transition coordination. HSRI provides pathways for individuals losing Medicaid to enroll in marketplace coverage.
• Deloitte (RIBridges)coreImplementation/ SI/ Consulting PartnerTechnology vendor managing the RIBridges information system used for eligibility and enrollment. HSRI relies on this system for customer account management and eligibility processing.
• Navigator AgenciescoreChannel Partner/ Reseller/ DistributorNetwork of over 100 trained community organizations across Rhode Island providing free in-person enrollment assistance to consumers. Many Navigators are fluent in languages other than English.
• Colonial LifeminorGTM or Marketing PartnerAncillary insurance provider offering accident, medical bridge, and critical illness plans through HSRI for Employers. Serves over 75,000 businesses and 3 million policyholders nationwide.
• Principal FinancialminorGTM or Marketing PartnerAncillary insurance provider offering life, vision, and long-term disability plans through HSRI for Employers broker network.
• VSP Vision InsuranceminorGTM or Marketing PartnerVision insurance provider available through HSRI for Employers ancillary benefits offerings.
• Pets BestminorGTM or Marketing PartnerPet insurance provider available as ancillary benefit through HSRI for Employers program.
• Washington NationalminorGTM or Marketing PartnerCritical illness insurance provider offering supplemental coverage through HSRI for Employers ancillary benefits.
• New BenefitsminorGTM or Marketing PartnerProvider of telehealth benefits, security packages, and discount programs available through HSRI for Employers.

Scale indicators9 records

Recent moves7 records

Expansion highlights5 records

Direct peers

• Covered California: California's state-based ACA health insurance marketplace. Operates the individual and SHOP exchanges with similar plan comparison, Navigator, and APTC distribution functions as HealthSource RI, scaled to a much larger population.
• Massachusetts Health Connector: Massachusetts's state-based marketplace, originally the model for ACA exchanges. Comparable to HSRI in administering individual and small group enrollment, distributing state and federal subsidies, and offering Navigator-supported enrollment.
• New York State of Health: New York's official health plan marketplace. Operates individual, small business, and Medicaid enrollment through a single integrated platform, mirroring HSRI's dual individual-and-employer marketplace model.
• Maryland Health Connection: Maryland's state-based health insurance marketplace for individuals and small businesses. Closely comparable to HSRI in scope, Navigator-supported enrollment, and SHOP offerings.
• Washington Healthplanfinder: Washington state's health insurance exchange. Provides individual and small employer marketplace services with similar APTC administration and customer-support functions as HealthSource RI.
• MNsure: Minnesota's state-based ACA marketplace. Comparable state-run entity administering individual market enrollment, broker channels, and financial assistance distribution.
• DC Health Link: District of Columbia's health insurance marketplace serving individuals, families, and small businesses. Closely mirrors HSRI's marketplace-plus-SHOP structure and Navigator-style assisters.
• Access Health CT: Connecticut's state-based health insurance exchange. Operates individual and small business marketplaces with comparable plan-comparison, broker, and APTC distribution functions.
• Your Health Idaho: Idaho's state-based health insurance exchange offering individual marketplace enrollment. Comparable in operating model and customer support functions, though smaller scale than HSRI.

Emerging players

• HealthSherpa: Private-sector ACA enrollment platform that competes with state-based and federal marketplaces for broker and consumer enrollment traffic. Comparable as an ACA distribution channel but operates outside the state-agency model.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

• Xx.com/HealthSourceRI
• YouTubeyoutube.com/channel/UCvQEVNDkmL6Uz-1sn_ghlCA
• Facebookfacebook.com/HealthSourceRI
• LinkedInlinkedin.com/company/healthsource-ri
• Instagraminstagram.com/healthsource_ri

Revenue estimate

Valuation estimate

Number of profiles

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 HealthSource RI