Qinetix Group

What Qinetix Group does

Qinetix Group LLC is a private software development firm founded in 2013 and headquartered in Guaynabo, Puerto Rico, that builds custom Health Insurance Exchange Platforms for insurance carriers, large group employers, and financial institutions in Puerto Rico. The company operates two core platforms: a Large Group Exchange Platform that lets enterprise employers offer employees a choice of multiple plan designs across multiple carriers in a single system, and an Individual Market Exchange Platform that enables consumers to compare and enroll in ACA-compliant Qualified Health Plans and complete the entire enrollment cycle electronically in a single session. Both platforms incorporate RiskShare®, a patent-pending algorithm that allows participating carriers to share claims risk within a single insurance system, which the company describes as virtually eliminating adverse selection among carriers.

The technology stack is built on the Symfony2 PHP Framework, ElasticSearch, Twitter Bootstrap, and Amazon AWS Services. Named deployments include the Berrios Health Exchange for Empresas Berríos (800+ employees across three carriers and nine plan designs), TuCubierta for CGF Insurance, MCS Personal Sales for MCS, and First Bank's Plan Grupal Portal. All disclosed clients, projects, and references are based in Puerto Rico, and the company describes itself as the operator of the first and only fully-operational private Health Insurance Exchange in the territory.

Qinetix generates revenue through professional services, delivering bespoke platform implementations as turn-key systems to enterprise clients via direct sales engagements. Pricing is not publicly disclosed, the firm reports 1-10 employees, and there is no disclosed funding, parent entity, or institutional investor in the available material.

Name

Qinetix Group

Legal name

Qinetix Group LLC

Website

https://qinetixgroup.com

Company type

Private

Founded year

2013

Operating status

Operating

Headcount range

1–10 employees

Short description

Qinetix Group LLC is a Puerto Rico-based private software development firm that builds custom health insurance exchange platforms for large employers, insurance carriers, and financial institutions, featuring a patent-pending RiskShare algorithm for cross-carrier risk sharing.

Ownership category

akta.pro rank

Product category

Health Insurance Exchange Software

NAICS

Software Publishers (5132)

akta.pro primary industry

Large Group Health Insurance (Mid-Market & National Accounts) (FSAIAFAE)

akta.pro secondary industry

ACA Marketplace (On-Exchange) Individual Plans (FSAIAEAA)

Keywords

• Health insurance exchange
• Custom software development
• Insurance technology platforms
• Claims risk sharing
• ACA compliance software

Headquarters

HQ city

Guaynabo

HQ country

Puerto Rico

HQ region

Latin America

Markets served

GTM type

B2B

Offering type

Software

Cost components

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

Revenue model

1. Custom Platform Implementation: Qinetix builds custom Health Insurance Exchange Platforms for insurance carriers and large employers. Revenue appears to be generated through custom software development and implementation projects, with the platform implemented as a turn-key system for clients like MCS and First Bank.

Go-to-market motion1 record

Distribution channels1 record

Marketing channels1 record

Core offering

Qinetix Group is a custom software development firm that designs, builds, and implements private Health Insurance Exchange platforms for insurance carriers, large group employers, and financial institutions in Puerto Rico. The company's flagship offerings are the Large Group Exchange Platform (featuring a proprietary patent-pending RiskShare® risk-sharing algorithm) and the Individual Market Exchange Platform, which enables ACA-compliant Qualified Health Plan comparison and end-to-end electronic enrollment in a single session.

Product overview

Qinetix Group offers a suite of private health insurance exchange platforms for the Puerto Rico market. The core offerings consist of two platforms: the Large Group Exchange Platform serving enterprise employers (such as Empresas Berrios and First Bank) with over 800 employees, and the Individual Market Exchange Platform enabling consumers to compare and enroll in ACA-compliant Qualified Health Plans in a single session. Both platforms share the same technology infrastructure and the proprietary RiskShare® algorithm. The Individual Market Platform has been implemented as a turn-key system for insurance carriers including MCS and powers the consumer-facing TuCubierta portal.

Differentiator

Problem solved

Functional benefit

Products and services

• Qinetix Private Health Insurance Exchange Platform (Large Group) A turn-key private health insurance exchange platform for large group employers, enabling employees to select from multiple plan designs across multiple health insurance carriers. Features the patent-pending RiskShare® risk-sharing algorithm that allows participating carriers to share claims risk and virtually eliminates adverse selection among carriers.
• Qinetix Individual Market Exchange Platform A web-based platform enabling individuals to compare ACA-compliant Qualified Health Plan designs and prices and complete the entire enrollment cycle, including first-month premium collection and family member enrollment, electronically in a single session. Designed to be deployed as a turn-key system for insurance carriers.
• TuCubierta A consumer-facing responsive web application built on the Individual Market Exchange Platform, allowing Puerto Rico residents to compare and enroll in ACA-compliant individual health insurance plans from CGF Insurance.
• MCS Personal Sales Insurance carrier portal built on the Individual Market Exchange Platform for MCS to offer individual market ACA-compliant health insurance plans to consumers.

Named customers4 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

AI capability1 record

Feature1 record

Scale indicators3 records

Recent moves6 records

Expansion highlights4 records

Broad incumbents

• WEX Health: Established benefits technology vendor providing HSA, COBRA, and benefits administration platforms, including exchange-style enrollment tools. Adjacent incumbent operating at significantly greater scale than Qinetix in the same benefits technology space.
• Benefitfocus: Large-scale benefits administration and exchange platform serving employers, carriers, and consumers across the US. Comparable as a broader incumbent offering the same category of multi-carrier benefits exchange functionality Qinetix provides at smaller scale.
• ADP Benefits: Major benefits administration provider (including via Stride) offering group health enrollment and exchange-style tools to employers of all sizes. Comparable as a broad incumbent whose product suite overlaps Qinetix's employer-facing exchange functionality.

Direct peers

• hCentive: Health insurance exchange technology vendor (originally built the federal HealthCare.gov platform) now under DXC Technology. Directly comparable in providing exchange and QHP enrollment technology to carriers and government programs.
• GetInsured: Operates a cloud-based health insurance exchange platform serving carriers, employers, and government ACA marketplaces. Closely comparable to Qinetix in building turn-key enrollment and exchange infrastructure for individual and group markets.
• HealthSherpa: Web-based ACA individual marketplace and enrollment platform serving consumers and brokers. Comparable to Qinetix's Individual Market Exchange Platform in enabling electronic comparison and enrollment in ACA-compliant Qualified Health Plans.
• PlanSource: Cloud-based benefits marketplace and exchange platform enabling employers and employees to shop across multiple carriers. Functionally analogous to Qinetix's exchange platforms for the employer group market.
• Benefitalign: Defined-contribution health benefits platform that lets employers offer multiple carrier plans through a single exchange. Closely mirrors Qinetix's Large Group Exchange Platform and RiskShare®-style multi-carrier approach.
• Softheon: Provides cloud-based exchange, enrollment, and billing technology for health insurers and state-based ACA marketplaces. Directly comparable to Qinetix as a B2B exchange technology vendor with multi-carrier enrollment capabilities.
• Connecture (now PlanSource): Built private and public health insurance exchange and shopping platforms for carriers and employers before being absorbed into PlanSource's benefits marketplace. Highly comparable to Qinetix's exchange-platform heritage and carrier relationships.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat4 records

Key risks5 records

Key highlights5 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 Qinetix Group