Ascension Personalized Care

Name

Ascension Personalized Care

Legal name

Ascension Personalized Care

Website

https://ascensionpersonalizedcare.com

Company type

Private

Operating status

Operating

Headcount range

101–250 employees

Ownership category

akta.pro rank

Product category

Individual Health Insurance

NAICS

Direct Life, Health, and Medical Insurance Carriers (52411)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

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

akta.pro secondary industry

Group PPO / EPO / POS Plans (FSAIAFAL)

Keywords

• ACA marketplace plans
• Individual health insurance
• EPO health plans
• Subsidized health coverage
• Medical insurance exchange

Headquarters

HQ city

Troy

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

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

Revenue model

1. Health Insurance Premiums: Monthly premium payments from individual members enrolled in ACA marketplace health plans. Members pay premiums directly, with many receiving government subsidies based on income levels to reduce costs.

Pricing tiers

Go-to-market motion1 record

Distribution channels2 records

Marketing channels4 records

Core offering

Ascension Personalized Care offers ACA-compliant Exclusive Provider Organization (EPO) health insurance plans to individuals and families through the Health Insurance Marketplace. Plans are underwritten by US Health and Life Insurance Company and provide access to Ascension's network of hospitals and providers across Indiana, Kansas, Michigan, Tennessee, and Texas, including medical, pharmacy, and care management benefits.

Product overview

Ascension Personalized Care is a unified ACA Marketplace health insurance product structured as an Exclusive Provider Organization (EPO) plan. The core offering is the Ascension Personalized Care Health Insurance Plan, which provides ACA-compliant medical coverage through Ascension's provider network across five states. The product portfolio includes three complementary web-based portals for members, agents, and clinicians to manage accounts and healthcare services. A Cigna-powered pharmacy benefits module provides prescription drug coverage. Care Management Services and Health & Wellness Programs, including Active&Fit Direct fitness partnerships, serve as integrated member support add-ons. The company is no longer offering coverage starting 2025, with last coverage day being December 31, 2024.

Differentiator

Problem solved

Functional benefit

Products and services

• Ascension Personalized Care Health Insurance Plan An Exclusive Provider Organization (EPO) health insurance plan offered through the Health Insurance Marketplace, providing ACA-compliant medical coverage with access to Ascension's network of hospitals and providers. Available in Bronze, Silver, Gold, and Platinum metal tiers.
• Pharmacy Benefits (Cigna) Prescription drug coverage provided through a partnership with Cigna. Members receive a Cigna pharmacy ID card and can access pharmacy benefits, claims history, medication pricing, and mail-order pharmacy services through my.Cigna.com.
• Care Management Services Utilization management and care coordination services provided through Ascension Care Management Insurance Holdings. Includes care management team support, prior authorization processing, and Health Risk Assessment (HRA) engagement programs for members with complex health needs.
• Health & Wellness Programs

Named customers1 record

Segments1 record

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration7 records

Feature3 records

Partnerships

Nine partnerships are on record, tiered core, flagship, minor and regional.

• US Health and Life Insurance CompanycoreOthersBenefits underwritten by US Health and Life Insurance Company. USHL provides medical and prescription drug coverage, dental and life insurance, and has been protecting employees and families since 1996. Became part of Ascension in 2015 along with Automated Benefit Services.
• CignacoreTechnology or IntegrationPharmacy benefits administered through Cigna. Members receive Cigna pharmacy ID cards and can access my.Cigna.com for prescription benefits, claim history, medication pricing, and mail-order pharmacy services.
• AscensionflagshipStrategic or Co-development PartnerParent organization - one of the largest Catholic nonprofit health systems in the US with over 100 years of healthcare experience. Ascension provides the provider network, operational infrastructure, and brand credibility for Ascension Personalized Care plans.
• Smart Data Solutions (SDS)coreTechnology or IntegrationClaims clearinghouse partner that replaced Change Healthcare following national outage. Clinicians submit electronic claims through SDS portal for processing. Provider must register first before submitting claims.
• Ascension Care Management Insurance HoldingscoreStrategic or Co-development PartnerPartners with Ascension Care Management Insurance Holdings to provide utilization management services including prior authorization processing. Clinicians submit prior authorization requests via phone, fax, email, or portal.
• Active&Fit DirectminorGTM or Marketing PartnerFitness program partnership offering members affordable fitness solutions. Members can access gym memberships and home fitness options through this program.
• Automated Benefit Services (ABS)coreTechnology or IntegrationThird-party administrator and medical management solutions provider. Provides the provider web portal (ABS Provider Portal) for eligibility verification, claims management, and authorization tracking. Part of Ascension since 2015.
• Seton Health PlanregionalChannel Partner/ Reseller/ DistributorTexas-specific network development partner. Clinicians in Texas contact Seton Health Plan for network information and requirements. Email: [email protected] for Texas provider inquiries.
• StripecoreTechnology or IntegrationPayment processing technology partner for online premium payments. Stripe provides PCI DSS Level 1 certification (highest level) for secure payment processing. Members can pay with credit/debit cards, prepaid cards, Google Pay, or Apple Pay.

Scale indicators5 records

Recent moves6 records

Expansion highlights3 records

Direct peers

• Oscar Health: ACA Marketplace-focused health insurer with EPO-style plan designs and tech-forward member experience — closely comparable product/GTM motion to APC. Operates in overlapping geographies and targets the same individual enrollee segment.
• Bright HealthGroup: ACA-focused insurer that built narrow-network individual plans with integrated provider partnerships — a comparable model to APC's Ascension-tied network strategy, especially in similar regional markets.
• Ambetter (Centene): Largest ACA Marketplace carrier in the US; competes head-to-head with APC for individual enrollees across the same states. Same product type (on-exchange individual plans), same metal-tier structure, and similar GTM through healthcare.gov.
• Molina Healthcare: Government-sponsored health plan operator offering ACA Marketplace plans alongside Medicaid. Same individual marketplace product category and multi-state operating model that APC pursued.
• CHRISTUS Health Plan: Catholic nonprofit health system-affiliated ACA Marketplace plan with faith-based mission alignment to Ascension. Closely comparable parent organization profile and value-based care orientation.

Broad incumbents

• Cigna Healthcare: APC's pharmacy benefits partner and a broader incumbent offering individual ACA plans in some markets. Overlapping customer base (individual enrollees) and same regulatory frame.
• Kaiser Permanente: Integrated payer-provider offering individual marketplace plans with provider-network-locked designs. Comparable to APC's Ascension-network strategy at much greater scale.

Emerging players

• Friday Health Plans: Small-to-mid ACA Marketplace carrier operating in selected states — directly comparable scale and product type to APC prior to wind-down. Useful peer for size and unit economics benchmarking.

Regional players

• Blue Cross Blue Shield of Michigan: Dominant regional Blues plan in Michigan, competing for individual ACA enrollees in APC's home state. Comparable distribution through healthcare.gov and overlapping provider network.
• Health Alliance Plan (HAP): Michigan-based regional health plan offering individual ACA products in APC's primary market. Same regulatory jurisdiction and competitive set.

Market position

Strengths3 records

Weaknesses5 records

Competitive moat4 records

Key risks5 records

Key highlights5 records

Customer concentration

• YouTubeyoutube.com/channel/UCnXM-Ml3eN8NRcSy3f4_9Pw
• LinkedInlinkedin.com/company/ascensionpersonalizedcare
• Xx.com/ascpersonalized
• Facebookfacebook.com/ascensionpersonalizedcare

Compliance1 record

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 Ascension Personalized Care