Exemplar Insurance Associates

What Exemplar Insurance Associates does

Exemplar Insurance Associates, Inc. is a privately held insurance brokerage headquartered in High Point, North Carolina, founded in 2018 as the exclusive sales, marketing, and product development arm of its parent, Exemplar, The Health Care Partnership Organization. The firm distributes a single product family — the Royalty Series — comprising 12 ACA-compliant metallic health plan designs targeted at small and mid-sized employer groups of 5 to 100 employees across 47 U.S. states (excluding New York, Hawaii, and Washington). Its go-to-market is broker-first, with simplified census-based underwriting that bypasses traditional health applications for most groups, supplemented by direct employer engagement through online quote forms, phone outreach, and a self-service employer portal hosted on vbagateway.com.

Revenue mechanics are anchored in subscription-style recurring flows: insurance premium commissions on employer group placements, plus a base Per Employee Per Month (PEPM) administrative fee of $30 that can be throttled based on group savings, with no rate cap. The Royalty Series is offered alongside level-funded programs (with 0%, 50%, or 100% surplus-return options to the employer), Reference Based Pricing variants, traditional PPO networks, and three HSA-compatible plan designs. The company supports its distribution with three web-based portals — Member, Employer, and Agent — providing claims access, enrollment tracking, and group management for brokers.

The operating model is partnership-heavy at the carrier layer, with seven PPO network partners (including Cigna, First Health, Medcost, PHCS, HealthLink, Alliance, and Trilogy) and four stop-loss carriers (Liberty Mutual, All-State, US Fire, and Crum and Forester) underwriting the level-funded and self-funded risk. The firm is led by CEO Tim Hawley with a lean executive team that includes regional sales directors and a national marketing director. No external funding rounds, M&A activity, or institutional ownership are disclosed.

Name

Exemplar Insurance Associates

Legal name

Exemplar Insurance Associates, Inc.

Website

https://exemplarinsuranceassociates.com

Company type

Private

Founded year

2018

Operating status

Operating

Headcount range

11–50 employees

Short description

Exemplar Insurance Associates is a High Point, NC-based insurance brokerage that distributes group health insurance to small and mid-sized employers (5-100 employees) across 47 U.S. states, operating as the exclusive sales arm of Exemplar, The Health Care Partnership Organization.

Ownership category

akta.pro rank

Product category

Group Health Insurance Brokerage

NAICS

Agencies, Brokerages, and Other Insurance Related Activities (5242), Insurance Agencies and Brokerages (524210)

SIC

Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Self-Funded (ERISA) Employer Plans (HLAEAAAC)

Keywords

• Group health insurance
• Small business health plans
• Level funded insurance
• ACA metallic plans
• Health insurance brokerage

Headquarters

HQ city

High Point

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, Infrastructure

Revenue model

1. Insurance Premium Revenue: Exemplar Insurance Associates generates revenue as the exclusive sales and marketing arm of Exemplar, The Health Care Partnership Organization. Revenue comes from broker commissions and insurance premium contributions from employer groups. The company offers level-funded programs and traditional PPO networks.
2. Administrative Fees (PEPM): Base Per Employee Per Month (PEPM) administrative fee of $30, which can be throttled up or down based on overall group savings. No CAP on rates.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels3 records

Core offering

Exemplar Insurance Associates is the exclusive sales and marketing arm of Exemplar, The Health Care Partnership Organization, distributing the Exemplar Royalty Series — a packaged group health insurance product line that consolidates 12 ACA-compliant metallic plan designs into a single offering. The agency sells level-funded and Reference Based Pricing health plans to employer groups of 5–100 employees across 47 U.S. states, supported by four online portals (Agent, Member, Employer, and a Provider Member Eligibility System) used for enrollment, servicing, and eligibility verification.

Product overview

Exemplar Insurance Associates operates as a single-product-focused insurance brokerage, offering group health insurance exclusively through the Exemplar Royalty Series. The Royalty Series is a unified product line comprising 12 ACA-compliant metallic health plan designs (Level Funded and Reference Based Pricing options), targeting small to mid-sized employer groups of 5 to 100 employees in 47 states. The company supplements its core insurance offering with three digital portals: a Member Portal, an Employer Portal, and a Member Eligibility System for providers — all hosted on the vbagateway.com platform.

Differentiator

Problem solved

Functional benefit

Products and services

• Exemplar Royalty Series A packaged group health insurance product line consisting of 12 ACA-compliant metallic plan designs offered as a single consolidated product. Available to employer groups of 5–100 employees across 47 U.S. states, with options for level-funded program structures (including 0%, 50%, or 100% surplus-return elections) and Reference Based Pricing as an alternative reimbursement methodology. Targeted at small and mid-market employers and distributed primarily through independent insurance brokers and agents.
• Level-Funded Health Plan Program A level-funded group health plan funding structure that pairs a fixed monthly amount with stop-loss protection, allowing employers to elect 0%, 50%, or 100% return of any unused claim surplus. Designed for small and mid-market employer groups that want budget predictability and shared-savings potential, with integrated stop-loss carrier coordination.
• Reference Based Pricing Health Plan Option A health plan reimbursement option that prices medical claims against a reference benchmark rather than a traditional provider network, used to lower claim costs for self-funded and level-funded employer groups. Sold as an alternative funding/reimbursement configuration within the Royalty Series.
• Member Eligibility System (Provider Portal) A provider-facing online portal that allows healthcare providers to verify in real time whether a patient is an active member of an Exemplar Royalty Series plan. Used by hospitals, physician offices, and ancillary providers servicing Royalty Series members.
• Member Portal A self-service online portal for enrolled health plan members to access plan information, benefits, ID cards, and servicing resources tied to their Royalty Series coverage. Used by individual members covered under an employer's Royalty Series plan.
• Employer Portal A self-service online portal for employer group administrators to manage enrollment, billing, eligibility updates, and ongoing administration of their Royalty Series group health plan. Used by HR and benefits staff at small and mid-market employer groups.
• Agent Portal A broker-facing online portal that supports quoting, enrollment, and servicing of Royalty Series group health plans. Used by independent insurance brokers and agents as the primary digital tool to place and maintain employer group business.

Quantifiable outcome

• Bronze-level pricing for platinum-level benefits
• +2 more outcomes

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

Twelve partnerships are on record, tiered core, supporting and flagship.

• MedcostcoreOthersHealthcare provider network offering PPO network options for Exemplar's group health insurance plans.
• First HealthcoreOthersHealthcare provider network partner offering PPO network options for Exemplar's group health insurance plans.
• CignacoreOthersHealthcare provider network partner offering PPO network options for Exemplar's group health insurance plans.
• PHCS (Private Healthcare Systems)coreOthersHealthcare provider network partner offering PPO network options for Exemplar's group health insurance plans.
• HealthLinkcoreOthersHealthcare provider network partner offering PPO network options for Exemplar's group health insurance plans.
• Alliance NetworkcoreOthersHealthcare provider network partner offering PPO network options for Exemplar's group health insurance plans.
• TrilogycoreOthersHealthcare provider network partner offering PPO network options for Exemplar's group health insurance plans.
• Liberty MutualsupportingOthersStop loss insurance carrier providing coverage for Exemplar's self-funded or level-funded group health insurance plans.
• All-StatesupportingOthersStop loss insurance carrier providing coverage for Exemplar's self-funded or level-funded group health insurance plans.
• US FiresupportingOthersStop loss insurance carrier providing coverage for Exemplar's self-funded or level-funded group health insurance plans.
• Crum and ForestersupportingOthersStop loss insurance carrier providing coverage for Exemplar's self-funded or level-funded group health insurance plans.
• Exemplar, The Health Care Partnership OrganizationflagshipStrategic or Co-development PartnerParent company and strategic partner. Exemplar Insurance Associates is the exclusive sales, marketing, and product development arm of this parent organization.

Scale indicators4 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• HealthCare.com: Online health insurance marketplace serving individuals and small businesses with multi-carrier quoting — comparable insurance-distribution technology and SMB-segment focus.
• eHealth: Large online health insurance marketplace with both individual and employer group offerings — comparable agency-as-platform model distributing health plans to small employers across multiple states.
• GoHealth: Online health insurance marketplace leveraging proprietary technology to distribute individual and group Medicare/ACA plans — comparable digitized agency model serving similar buyer personas.
• SimplyInsured: Online SMB health insurance broker offering group health plans to small employers with simplified online quoting and census-based underwriting — directly mirrors Exemplar's Royalty Series distribution model and small-group focus.
• Insureon: Online insurance brokerage focused on small business health and benefits — comparable broker-led GTM targeting similar 5–100 employee employer segments.
• Take Command Health: Health insurance platform specializing in level-funded and reference-based pricing for self-employed individuals and small employer groups — overlaps with Exemplar's level-funded and reference-based pricing value proposition.

Emerging players

• Zenefits: HR and benefits platform bundling payroll with group health insurance for SMBs — overlapping target market and digital brokerage distribution, though broader in scope.

Broad incumbents

• Brown & Brown: Large publicly traded US insurance brokerage distributing group health, employee benefits, and P&C to commercial clients nationwide — directly comparable large-scale brokerage competitor in the employer group health segment.
• NFP (Risk Strategies): National insurance brokerage and advisory firm offering group benefits, health, and property/casualty solutions to mid-market and SMB employers — directly comparable broker-led SMB health distribution at significantly larger scale.
• OneDigital: Large US insurance brokerage and consulting firm providing group health, benefits, and HR consulting to mid-market and SMB employers — directly comparable broker-led employer group health distribution at greater scale.

Market position

Strengths4 records

Weaknesses5 records

Competitive moat4 records

Key risks7 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/exemplar-insurance-associates

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles5 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 Exemplar Insurance Associates