Eliance Health Solutions

What Eliance Health Solutions does

Eliance Health Solutions is a third-party administrator and clinically integrated network operator headquartered in Lancaster, Pennsylvania, founded in 2016 as a division of Lancaster General Health Community Care Collaborative — itself an accountable care organization within Penn Medicine. The company designs and administers self-funded group health plans for employers with 15 or more employees, primarily small and mid-sized businesses in Lancaster County and, since 2023, the Greater Philadelphia Region. It does not operate as a licensed insurance carrier; rather, it functions as a plan administrator, network builder, and care-management integrator on behalf of employer plan sponsors.

Its core offering is the Eliance Preferred Network, a clinically integrated network that combines the Penn Medicine / Lancaster General Health provider footprint with pediatric specialty access via Children's Hospital of Philadelphia (CHOP), pharmacy benefit management through Prime Therapeutics, stop-loss coverage via Cigna, broader network access through First Health, and wellness programming via WellRight. The company also offers Eliance Advantage, an enhanced plan tier integrated with Penn Medicine HealthWorks on-site clinics. Population-health risk stratification is performed using a Johns Hopkins proprietary algorithm. The technology stack is therefore an integration of vendor and partner platforms rather than a proprietary claims or care-management engine.

Eliance's revenue model follows standard self-funded TPA economics: per-employee-per-month (PEPM) administrative fees charged to employer plan sponsors, supplemented by PBM spread and partner-channel economics. The business is internally funded through its Penn Medicine / Lancaster General Health ACO parent and has no disclosed external investors, funding rounds, or M&A activity. Commercial emphasis is on regional employer segments where Penn Medicine brand credibility and provider integration provide a differentiated sales proposition relative to national TPAs.

Name

Eliance Health Solutions

Legal name

Lancaster General Health Community Care Collaborative, LLC

Website

https://eliancehealthsolutions.org

Company type

Private

Founded year

2016

Operating status

Operating

Headcount range

11–50 employees

Short description

Eliance Health Solutions is a Lancaster, Pennsylvania-based third-party administrator that designs and manages self-funded group health plans for small and mid-sized employers, leveraging the Penn Medicine provider network, CHOP, PBM, and wellness partners across Lancaster County and Greater Philadelphia.

Ownership category

akta.pro rank

Product category

Employer Self-Funded Health Insurance

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Services-Health Services (8000), Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Employer Wellness & Population Health Programs (HLAEAAAH)

Keywords

• Self-funded health plans
• Employer health benefits
• Third party administration
• Population health management
• Group health insurance

Headquarters

HQ city

Lancaster

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. Self-Funded Health Plan Administration: Provides self-funded group health plans to employers. Revenue generated through administrative fees, stop-loss placement, and TPA services. Employers retain savings when plan performs under budget through shared savings model.
2. TPA Services: Full service Third Party Administrator for self-funded health plans including claims administration, customer service, fund management, stop loss liaison, and renewal management.
3. Specialty Drug Program: Pharmacy benefit management program with 73% savings on specialty medications, generating savings for the health plan.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels5 records

Core offering

Eliance Health Solutions provides self-funded group health plans and Third Party Administrator (TPA) services to employers with 15 or more employees in Lancaster County and the Greater Philadelphia Region. Plans are backed by Penn Medicine Lancaster General Health and include the Eliance Preferred Network of providers, integrated clinical population health initiatives, wellness programs, and pharmacy benefit management. The offering also includes enhanced tiered plans such as Eliance Advantage with employer-sponsored primary care access through Penn Medicine HealthWorks.

Product overview

Eliance Health Solutions offers a unified self-funded health plan platform for employers in Lancaster and Greater Philadelphia. The core product is a self-funded group health plan backed by Penn Medicine, which includes the Eliance Preferred Network (a clinically integrated network of providers) as a foundational component. Additional products include Eliance Advantage (an enhanced plan tier featuring Penn Medicine HealthWorks primary care integration), an integrated Wellness Program, and Penn Medicine OnDemand telehealth services. All offerings are designed to work together to stabilize costs while improving employee health outcomes.

Differentiator

Problem solved

Functional benefit

Products and services

• Self-Funded Group Health Plans

Quantifiable outcome

• 73% savings on specialty medication costs through PBM program
• +2 more outcomes

Named customers2 records

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration7 records

Feature5 records

Partnerships

Five partnerships are on record, tiered core.

• Children's Hospital of Philadelphia (CHOP)coreTechnology or Integration · 1 January 2023In 2023, CHOP was added to the Eliance Preferred Network (Tier 1), providing members access to pediatric specialty care and services at CHOP locations including Lancaster, King of Prussia, and Philadelphia.
• Penn Medicine Lancaster General HealthcoreStrategic or Co-development PartnerPrimary strategic partner backing Eliance Health Solutions. Provides access to Penn Medicine's nationally recognized programs, services, and provider network. Eliance is a division of Lancaster General Health Community Care Collaborative, LLC, the ACO of Lancaster General Health.
• Preferred Health CarecoreTechnology or IntegrationProvides robust regional network of providers through Preferred Health Care network, complementing the Penn Medicine network.
• Penn Medicine HealthWorkscoreTechnology or IntegrationEmployer-sponsored primary care practice network included in Eliance Advantage plans. Provides no-copay primary care, same-day appointments, virtual visits, and on-site medication dispensary.
• Prime TherapeuticscoreTechnology or IntegrationPharmacy benefit manager for prescription drug coverage. Manages drug pricing and specialty medication program.

Scale indicators4 records

Recent moves7 records

Expansion highlights4 records

Direct peers

• Centivo: Centivo sells self-funded health plans built around curated provider networks to employers. It competes with Eliance in the value-based, provider-aligned employer health plan space, targeting cost containment through network design and member steerage to high-quality providers.
• Healthgram: Healthgram is a TPA and health management company focused on self-funded employer plans with integrated wellness programs. It is closely comparable to Eliance's combination of TPA administration, population health, and employer wellness offerings.
• Imagine Health: Imagine Health operates a self-funded employer health plan model anchored by curated provider networks. Both companies target mid-sized employers seeking alternatives to traditional fully-insured carriers with shared-savings or value-based provider arrangements and similar broker-led distribution.

Regional players

• Capital Blue Cross: Capital Blue Cross is a major Pennsylvania-based health insurer headquartered in the Harrisburg/Lancaster region. It competes directly with Eliance for employer group health plan business across Central PA and Philadelphia with broader network and product breadth.
• Geisinger Health Plan: Geisinger Health Plan is the insurance arm of Geisinger Health, an integrated delivery network serving central and northeastern Pennsylvania. Its provider-aligned health plan model is structurally similar to Eliance's Penn Medicine-backed approach, targeting similar Pennsylvania employer markets.
• Independence Blue Cross: Independence Blue Cross is the dominant Philadelphia-region Blue Cross Blue Shield licensee. It competes with Eliance for employer group business in the Greater Philadelphia market with established broker relationships and a large regional network.
• UPMC Health Plan: UPMC Health Plan is the insurance arm of UPMC, an integrated delivery network headquartered in Pittsburgh, PA. It pairs provider network control with insurance products across Pennsylvania and competes with Eliance for mid-market employer business in overlapping regions.
• Highmark Blue Shield: Highmark is a major Blue Cross Blue Shield licensee operating across Pennsylvania. It is a direct competitor to Eliance for mid-sized employer group business in Central PA and the Greater Philadelphia Region with significantly broader scale and product portfolio.

Broad incumbents

• Aetna: Aetna, a CVS Health company, is a national health insurer offering self-funded ASO and fully-insured group products. It competes with Eliance for mid-sized employer groups across Pennsylvania with significantly greater scale, national networks, and integrated pharmacy and care delivery assets.
• UnitedHealthcare: UnitedHealthcare is the largest national health insurer and competes with Eliance across self-funded and fully-insured group business in Pennsylvania. Its scale, Optum health services integration, and broad national network make it a dominant broad incumbent competitor.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/eliance-health-solutions

Revenue estimate

Valuation estimate

Number of profiles

Profiles14 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 Eliance Health Solutions