Sierra Health And Life Insurance Company

What Sierra Health And Life Insurance Company does

Sierra Health and Life Insurance Company, Inc. (SHL) is a Nevada-domiciled health insurance carrier and a subsidiary of UnitedHealth Group, operating exclusively within the state of Nevada. The company sells commercial health plans on a calendar-year basis across three core product types — Preferred Provider Organization (PPO), Exclusive Provider Organization (EPO), and HSA-eligible high-deductible PPO — to individuals, families, and employer groups of all sizes, with optional ancillary dental and vision coverage. SHL also supports Medicare-eligible members through a Medicare Options line and works in conjunction with its affiliated Health Plan of Nevada (HPN) entity to serve Nevada Medicaid beneficiaries.

The product portfolio extends beyond core medical insurance into a digital services stack that includes the HPN & SHL Mobile App, separate online portals for members, providers, employers, and brokers, 24/7 Virtual Visits via NowClinic, a 24/7 Advice Nurse line, and a digital health tools program. Pharmacy benefit management is delivered through OptumRx (with mail order and specialty pharmacy via BriovaRx), mental health and substance use benefits are administered through Behavioral Healthcare Options, and clinical programs cover care management, disease management, transplant guidelines, opioid programs, long-acting injectable medications through Genoa Healthcare, HEDIS quality measurement, and an annual Quality Improvement Program governed by a Quality Improvement Committee. ABA therapy authorization is available for autistic children.

Commercially, SHL operates a three-channel distribution model: licensed insurance brokers and agents supported by an Online Broker Center, a direct employer sales team reachable via a dedicated 800 number, and direct-to-consumer individual enrollment through the HPN Quote portal. Premium pricing is quote-based and not publicly disclosed, and revenue is generated through recurring monthly premiums (commercial, Medicare, Medicaid) and pharmacy transaction fees. The company is actively operating and faces two material Nevada regulatory matters in 2025: a Division of Insurance finding that at least 16 carriers, including SHL, likely violated federal mental health and addiction parity law, and a Governor's Council on Developmental Disabilities review of the carrier's and Health Plan of Nevada's limitations on Applied Behavior Analysis therapy benefits for autistic children.

Name

Sierra Health And Life Insurance Company

Legal name

Sierra Health and Life Insurance Company, Inc.

Website

https://sierrahealthandlife.com

Company type

Private

Founded year

1906

Operating status

Operating

Headcount range

11–50 employees

Short description

Sierra Health and Life Insurance Company is a Nevada-domiciled health insurance carrier and UnitedHealth Group subsidiary that sells PPO, EPO, and HSA-PPO plans to individuals, families, employer groups, Medicare, and Medicaid members across Nevada via broker, direct-sales, and direct-to-consumer channels.

Ownership category

akta.pro rank

Product category

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

Fully Insured Group Health Plans (Employer-Sponsored) (FSAIAFAA)

akta.pro secondary industries

Small Group Health Insurance (2–50/100) (FSAIAFAD), Large Group Health Insurance (Mid-Market & National Accounts) (FSAIAFAE), High-Deductible Health Plans (HDHP) with HSA-Eligible Coverage (FSAIAFAM), MA-PD Plans (Medicare Advantage with Prescription Drug Coverage) (FSAIAGAG)

Keywords

• Health insurance
• PPO plans
• EPO plans
• Employer group benefits
• Medicare plans

Headquarters

HQ city

North Las Vegas

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

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

Revenue model

1. Health Insurance Premiums: Primary revenue from monthly premium payments collected from employer groups, individual policyholders, and government programs (Medicare, Medicaid). Premiums are based on plan type, coverage level, and member demographics. All plans operate on a calendar year schedule with deductibles resetting annually on January 1.
2. Pharmacy Benefit Management: Revenue generated through pharmacy claims processing, prior authorizations for specialty medications, step therapy programs, and mail order pharmacy services managed through OptumRx.
3. Mental Health and Behavioral Health Services: Coverage for mental health and substance use services including ABA therapy for autism, outpatient treatment, and psychiatric medications, with authorization requirements managed through Behavioral Healthcare Options.
4. Ancillary Products: Supplemental revenue from dental and vision insurance products offered as add-on benefits to enhance core health plan packages for employer groups and individuals.

Pricing tiers

Go-to-market motion3 records

Distribution channels5 records

Marketing channels7 records

Core offering

Sierra Health and Life Insurance Company offers health insurance plans, including PPO, EPO, and HSA-PPO products, to individuals, families, and employer groups across Nevada. The company bundles medical, pharmacy, mental health, dental, and vision benefits into integrated plan designs and supports members through digital tools, virtual care, and care management programs.

Product overview

Sierra Health and Life Insurance Company (SHL) is a Nevada-based health insurance company operating as part of the Health Plan of Nevada (HPN) and UnitedHealthcare network. SHL offers a platform of health insurance products comprising three core medical plan types — PPO, EPO, and HSA-PPO — available to individuals, families, and employer groups of all sizes, supplemented by ancillary dental and vision add-on plans. The product portfolio also includes a broad suite of digital service portals (Online Member Center, Online Provider Center, Online Employer Center, Online Broker Center, and HPN & SHL Mobile App), pharmacy benefit management through OptumRx with mail order and specialty options, 24/7 Virtual Visits via NowClinic, mental health and substance use benefits administered through Behavioral Healthcare Options, clinical programs (Care Management, Disease Management, Health Education and Wellness, Opioid Programs, Long-Acting Injectable Medications, Transplant Guidelines, HEDIS Measures, and Quality Improvement), and wellness benefits including One Pass Select fitness programs and weight loss programs. The company also provides ABA therapy authorization for children with autism and comprehensive prior authorization, claims management, and credentialing services for its provider network.

Differentiator

Problem solved

Functional benefit

Products and services

• PPO Health Plans

Quantifiable outcome

• Nevada Medicaid paid $75 million for ABA therapy in 2025, up nearly 350% since 2021
• +2 more outcomes

Named customers2 records

Segments6 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature5 records

Partnerships

Five partnerships are on record, tiered core and minor.

• UnitedHealth Group / UnitedHealthcarecoreStrategic or Co-development PartnerSierra Health and Life is a subsidiary of UnitedHealth Group. The company leverages UnitedHealthcare's national resources, technology platforms, and operational infrastructure including OptumRx for pharmacy benefit management, compliance programs, and quality improvement initiatives.
• Behavioral Healthcare OptionscoreTechnology or IntegrationBehavioral Healthcare Options (BHO) is the behavioral health network for mental health and substance abuse services. BHO handles prior authorization for mental health, severe mental illness, and substance abuse services. Providers can join through bhoptions.com and members access behavioral health services via bhoptions.com.
• Health Plan of NevadacoreStrategic or Co-development PartnerHealth Plan of Nevada (HPN) is the affiliated Medicaid and commercial health plan. SHL and HPN share administrative infrastructure, provider networks, and compliance programs. HPN Medicaid serves Nevada beneficiaries. Both plans use the same provider portals and member services.
• OptumRxcoreTechnology or IntegrationOptumRx provides pharmacy benefit management services including prescription drug lists, network pharmacies, mail order pharmacy, medication history, cost checking, and prior authorization for specialty medications. Members access OptumRx tools through optumrx.com.
• Count the Kicks (Healthy Birth Day, Inc.)minorStrategic or Co-development PartnerCount the Kicks is an evidence-based stillbirth prevention campaign. SHL partners with this nonprofit to educate expectant parents about kick counting during pregnancy to reduce Nevada's stillbirth rate. Free educational materials are provided to healthcare providers.

Scale indicators3 records

Recent moves3 records

Expansion highlights5 records

Direct peers

• Health Plan of Nevada: SHL's affiliated sister company under UnitedHealth Group, also serving Nevada with commercial, Medicaid, and Medicare plans. Highly comparable in product mix, provider network, and digital platforms, and the closest functional peer in the same geography.
• Hometown Health Plan: Nevada-based regional health insurer offering commercial group, individual, Medicare Advantage, and Medicaid plans to northern Nevada. Directly competes with SHL in the same state for employer group business and individual market share.
• Prominence Health Plan: Nevada-licensed health plan offering commercial, Medicare Advantage, and Medicaid products. Competes with SHL for employer groups and individual enrollees in the same geography with comparable plan structures.

Broad incumbents

• Anthem Blue Cross Blue Shield Nevada: National carrier with strong Nevada PPO, HMO, and individual market presence. Competes with SHL on employer group business, individual ACA plans, and through broad network contracts.
• Aetna (CVS Health): National insurer with commercial, Medicare, and Medicaid products sold in Nevada. A direct competitor to SHL for large employer group and individual business, leveraging CVS Health's clinical footprint.
• Cigna Healthcare: National health insurer selling commercial group and individual plans in Nevada, often through UHC partner networks. Competes with SHL for employer group business with comparable product design.
• Humana: Major Medicare Advantage and commercial carrier with Nevada presence. Particularly comparable to SHL in the Medicare Advantage segment, where both target senior enrollees with integrated drug benefits.
• Molina Healthcare: Government-focused managed care company serving Medicaid and Medicare members in Nevada. Direct competitor to SHL/HPN in the Medicaid segment and increasingly in dual-eligible and exchange populations.
• Centene / Ambetter: National managed care leader selling Ambetter individual marketplace plans and Medicaid products in Nevada. A significant competitor in the individual ACA segment where SHL also competes.

Regional players

• SelectHealth: Intermountain Health-affiliated regional health plan offering commercial, individual, and Medicare plans in the western U.S. While not in Nevada, it is structurally comparable as a vertically integrated regional carrier with strong provider network ties and quality ratings.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

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 Sierra Health And Life Insurance Company