Medical Benefit Administrators

Name

Medical Benefit Administrators

Legal name

McClure Benefit Administrators

Website

https://mbatpa.com

Company type

Private

Founded year

2005

Operating status

Operating

Headcount range

11–50 employees

Ownership category

akta.pro rank

Product category

Third Party Health Plan Administration

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Health and Welfare Funds (525120)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Self-Funded Employer Plan TPA (ASO Administration) (HLAEALAA)

akta.pro secondary industries

Flexible Benefits Administration (FSA/HSA/HRA) (HLAEALAK), Compliance, Reporting & Regulatory Administration (ERISA/ACA/No Surprises) (HLAEALAJ), Ancillary Benefits TPA (Dental/Vision/Life/Accident/Critical Illness) (HLAEALAN), Medicare Plan Administration & Third-Party Services (TPA/BPO, Enrollment, Billing) (FSAIAGAI)

Keywords

• Third party administration
• Self-funded health plans
• Employee benefits administration
• Health claims processing
• Benefits management services

Headquarters

HQ city

Saint Augustine

HQ country

United States

HQ region

North America

Offices5 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. TPA Administration Services: Third Party Administration fees for managing self-funded, split funded, and fully insured health plans including plan design, cost containment, claims processing, eligibility, enrollment, and compliance.
2. Insurance Product Commissions: Commissions from selling insurance products including health, dental, vision, life, supplemental products, and Medicare plans.
3. Specialty Risk Management: Management fees for specialty risk products including Business Interruption, Key Customer coverage, Kidnap/Ransom/Extortion, Key Contract Termination, Subcontractor Default, and other specialty coverages.
4. Direct Primary Care Management: Management contract for MedOne DPC and Urgent Care Clinics including managing direct primary care provider networks.

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels4 records

Core offering

Medical Benefit Administrators (MBA TPA) provides third-party administration (TPA) services for employer-sponsored health plans, including fully insured, split funded, and self-funded arrangements. Core services include plan design, cost containment, claims processing, eligibility and enrollment, COBRA administration, provider negotiations, single-source billing, and regulatory compliance support (ACA, ERISA, IRS, DOL). The company also manages direct primary and urgent care clinic operations with over 80 Direct Primary Care Providers offering $0 co-pay plans, and operates a proprietary Benefit Logistics Enterprise Health System platform.

Product overview

Medical Benefit Administrators (MBA) is a Third Party Administrator (TPA) offering a comprehensive suite of employee benefits administration services through the Benefit Logistics Platform. The core offering includes TPA services for Fully Insured, Split Funded, and Self-funded health plans, supplemented by Direct Primary Care & Urgent Care Clinic Management with over 80 providers offering $0 co-pay plans. The product portfolio includes multiple health plan sub-brands (8300 HDHP PLAN, 3500 HSA, 4500 PPO PLAN, 3500 PPO PLAN), Dental Insurance, Vision Insurance, and Supplemental Products (accident, hospitalization, critical illness, disability, long-term care). Add-on services encompass HSA/HRA/FSA administration, Prescription Drug Plans with specialty pharmacy, Retiree & Medicare Health Plans, Compliance Services, Claims Processing, and Specialty Risk Mitigation. The technology infrastructure includes Employer Portal (tpax.net), Member Portal (benefitlogistics.com), and provider-facing platforms for eligibility verification, pre-certification, and claims status. MBA also offers telemedicine services and Human Resources/Economic Development incentive creation.

Differentiator

Problem solved

Functional benefit

Brands

• Benefit Logistics: Technology platform for benefit management, claims processing, and member portal services including the Benefit Logistics App for telemedicine access

Products and services

• TPA Services for Employee Health Plans Unbundled third-party administration of employer-sponsored health plans (fully insured, split funded, and self-funded) covering plan design, cost containment, claims reduction, provider negotiations, single-source billing, eligibility, enrollment, new hires, and COBRA. Sold to employers via direct sales and agent/broker channels across all 50 U.S. states.
• Direct Primary Care & Urgent Care Clinic Management Management of direct primary care and urgent care clinics, leveraging a network of more than 80 Direct Primary Care Providers offering $0 co-pay plans for services to large insured populations. Sold to employers seeking direct-contract provider arrangements.
• Specialty Risk Mitigation Services Insurance coverage for specialty risks not typically addressed by standard health carriers, including business interruption, loss of key customer, kidnap/ransom/extortion, key contract termination, subcontractor default, loss of franchise, competitor entrance, loss of key employee, business risk indemnity, terrorism, supply chain interruption, regulatory/legislative changes, broadform property, and pandemic disease. Sold to employers.
• Claims Processing Expert claims processing for health and welfare, workers compensation, and captive claims, including authentication, subrogation, and settlement services. Sold to employers and carriers as a standalone service.
• Compliance Services Regulatory compliance assistance covering ACA, ERISA, IRS, DOL, state, and federal regulations, including deadline management. Sold to employers as a standalone or bundled service.
• Prescription Drug Plans Customized prescription drug plans for employee populations or personal health plans, including specialty pharmacy options. Sold to employers and individuals.
• Retiree & Medicare Health Plans Medicare Advantage, Medicare Supplements, and Prescription Drug Plans for retirees. Sold to retiree populations through employer group retiree benefits.
• Terminated Employees, 1099 & Individual Health Plans Health coverage options for terminated employees, 1099 workers, and individuals including Minimal Essential Coverage Plans, Marketplace Plans, ACA plans, prescription drug plans, dental plans, and temporary plans.
• Supplemental Products Accident, hospitalization, critical illness, short-term disability, long-term disability, and long-term care insurance products. Sold to employers as part of voluntary benefits packages.
• HSA, HRA & FSA Plan Administration Administration of Healthcare Savings Accounts, Health Reimbursement Arrangements, and Flexible Spending Accounts. Sold to employers alongside health plan offerings.
• Telemedicine Services Virtual access to primary care doctors, specialists, and mental health providers through the Benefit Logistics App, with continuity of care for seen physicians. Sold to employers and members.
• Human Resources & Economic Development Services Economic development incentive creation supporting business expansion, including site selection, grants, and recruit/retain/reward programs for employees. Sold to employers expanding operations.

Named customers1 record

Segments5 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

Three partnerships are on record, tiered major and core.

• MedOne DPCmajorStrategic or Co-development Partner · 1 January 2024MBA announces management contract for MedOne DPC and Urgent Care Clinics. MBA was chosen to provide Third Party Administration services for MedOne's Direct Primary Care and Urgent Care Clinic operations.
• Health Logistics GroupcoreStrategic or Co-development PartnerHealth Logistics Group is the parent company of McClure Benefit Administrators. MBA operates as a Health Logistics Group Company. The Benefit Logistics Enterprise Health System includes proprietary technology platforms and serves as the foundation for MBA's service offerings.
• Benefit Logistics GroupcoreStrategic or Co-development PartnerMBA is a proud partner of the Benefit Logistics Group. The partnership provides access to Benefit Logistics platforms including benefitlogistics.com for member access and various plan information portals (8300HSA.benefitlogistics.com, 3500HSA.benefitlogistics.com, etc.).

Scale indicators2 records

Recent moves5 records

Expansion highlights5 records

Direct peers

• HealthEZ: Independent TPA providing self-funded plan administration, network management, and member engagement tools for employers of all sizes. Closely comparable to MBA in targeting mid-market self-funded employers with unbundled services.
• Meritain Health: Aetna-affiliated TPA administering self-funded medical, dental, vision, and disability plans for employers nationwide. Direct competitor to MBA in unbundled third-party administration for self-funded employer groups.
• CoreSource: Cigna-owned TPA providing self-funded plan administration, stop-loss coordination, and integrated disability/leave services. Competes in the same self-funded employer TPA market with broader carrier backing.
• UMR (United Medical Resources): UnitedHealthcare-owned TPA focused on self-funded employer health plan administration, claims processing, and care management. Operates at materially larger scale but in the same product category as MBA.
• AmeriBen: Third-party administrator offering medical, dental, vision, COBRA, FSA/HRA/HSA, and other benefit administration services to self-funded employers. Overlaps MBA on multi-line benefits administration and employer segmentation.
• Trustmark Companies: Provides third-party administration for self-funded health plans along with supplemental benefits such as disability, critical illness, and accident coverage. Closely mirrors MBA's combination of TPA + ancillary benefits.

Broad incumbents

• UnitedHealthcare (Employer & Individual): Largest U.S. health insurer offering fully insured and self-funded employer products, with UMR as its TPA arm. Sets competitive benchmarks on price, scale, and network access that MBA must meet or differentiate against.
• Sun Life Financial (U.S. Group Benefits): Major insurer offering group dental, vision, disability, and stop-loss products sold through employer benefit plans. Adjacent competitor with overlapping ancillary lines and broker relationships used by self-funded employers.
• Aetna (CVS Health): National health insurer with self-funded employer products and the Meritain TPA subsidiary. Competes with MBA for self-funded accounts while also providing direct insurance products overlapping MBA's Medicare and individual offerings.

Emerging players

• Benefitfocus: Benefits administration technology platform serving employers, carriers, and TPAs with enrollment, billing, and decision-support tools. Comparable as an emerging player whose technology could either compete with or enable TPAs like MBA.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/mba-tpa

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 Medical Benefit Administrators