Pomco

What Pomco does

Pomco is a New York-based third-party administrator (TPA), founded in 1978 and operating as a for-profit private company with 501-1,000 employees. The firm provides fully customized health benefits administration solutions to self-funded employer plans, with documented positioning that places it within the broader UMR and UnitedHealth Group ecosystem. Pomco's customer base spans individual members (employees and dependents), employers operating self-funded plans, healthcare providers, brokers and producers, and integration partners.

The core platform is a cloud-based, multi-portal architecture segmented by stakeholder: a member portal for finding providers, checking account balances, and viewing claims; an employer portal for plan administration and reporting; a provider portal for eligibility verification and claims submission; a partner portal for TPA integration; and a broker portal for client management. Authentication is consolidated through HealthSafe ID (member-facing) and One Healthcare ID (employer, provider, partner, broker) identity management systems. A mobile application extends the member experience with on-the-go account access. The platform has achieved URAC accreditation for Health Utilization Management (HUM010029), a procurement-relevant compliance milestone.

Pomco operates a managed-services revenue model, charging administrative fees to employer clients for claims processing, utilization management, and member services. Pricing is not publicly disclosed and is negotiated on a quote basis. Distribution is exclusively digital across the five portal surfaces plus mobile, supported by content marketing assets such as the Healthy You digital magazine and a health education library. The firm is led by Robert Pomfrey as President and Chief Executive Officer. No API, SDK, MCP, or external developer integration is documented, indicating the platform is delivered as a closed, carrier-managed service rather than a headless or extensible platform.

Name

Pomco

Legal name

United HealthCare Services, Inc.

Website

https://pomco.com

Company type

Private

Founded year

1978

Operating status

Operating

Headcount range

501–1,000 employees

Short description

Pomco is a New York-based third-party administrator founded in 1978, providing fully customized health benefits administration for self-funded employer plans through a multi-segment cloud-based portal platform (member, employer, provider, partner, broker) backed by UnitedHealth Group resources.

Ownership category

akta.pro rank

Product category

Third-Party Health Benefits Administration

NAICS

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

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Medicare Plan Administration & Third-Party Services (TPA/BPO, Enrollment, Billing) (FSAIAGAI)

Keywords

• Third-party administration
• Claims processing services
• Benefits administration
• Health plan management
• TPA services

Headquarters

HQ city

New York

HQ country

United States

HQ region

North America

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Third-Party Administration Services: UMR operates as a third-party administrator (TPA) for self-funded employer health plans. Revenue is generated through administrative fees charged to employer clients for claims processing, utilization management, and member services.

Go-to-market motion1 record

Distribution channels6 records

Marketing channels4 records

Core offering

Pomco is a third-party administrator (TPA) that provides fully customized health benefits administration solutions. Its core services include claims processing, utilization management, member services, and multi-stakeholder web portals for members, employers, providers, partners, and brokers. The offering is delivered through a cloud-based platform with integrated identity management and a companion mobile application.

Product overview

UMR is a health care administration platform offering multiple integrated portals for different user segments: members, employers, providers, partners, and brokers. The core offering consists of web-based portals providing access to health care provider searches, claims management, account balances, and benefit administration. Supplementary offerings include a mobile app, a form center for administrative documents, a health education library, and the Healthy You digital magazine. The platform operates as a unified system with role-based access for each stakeholder type.

Differentiator

Problem solved

Functional benefit

Products and services

• Member Portal Web-based self-service portal for individual members and their dependents enrolled in employer-sponsored health plans administered by Pomco, enabling provider searches, claim viewing, account balance checks, and profile management.
• Employer Portal Dedicated portal for employer plan administrators to manage health care plans, employee benefits, cost management, and compliance reporting for self-funded employer groups.
• Provider Portal Portal for doctors, hospitals, and other healthcare providers participating in the network to verify patient eligibility, submit claims, and manage reimbursement processes.
• Partner Portal Web portal for third-party administrator partners to integrate with Pomco's administration platform and access administrative functions.
• Broker Portal Dedicated portal for insurance brokers and producers to manage client accounts, run quotes, and handle enrollment for employer clients using Pomco's administration services.
• Mobile App Mobile application for plan members providing on-the-go access to health care account management, including provider search, claim viewing, and balance checks.

Segments5 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

One partnership is on record.

• UnitedHealth GroupflagshipOthersUMR is a subsidiary of UnitedHealth Group, one of the largest diversified health care companies in the United States. UnitedHealth Group provides UMR with access to its extensive provider networks, technology infrastructure, and operational resources.

Scale indicators1 record

Recent moves6 records

Expansion highlights4 records

Broad incumbents

• Cigna Healthcare: Global health services company with self-funded administration capabilities and Evernorth pharmacy services. Competes with Pomco for large employer accounts, though predominantly through fully-insured and ASO products.
• Aetna (CVS Health): Large national carrier offering fully-insured and self-funded products plus TPA services through Meritain. Competes with Pomco for self-funded employer RFPs but operates across a much broader portfolio including pharmacy, dental, and supplemental benefits.
• Elevance Health (Anthem): Major Blue Cross Blue Shield carrier with significant self-funded and TPA-adjacent offerings across commercial and government segments. Provides broader competitive context for Pomco's mid-market positioning.

Direct peers

• HealthScope Benefits: Independent TPA focused on self-funded employer health plans with customized plan designs and integrated benefit administration. Directly comparable to Pomco's positioning as a customizable TPA serving mid-market employers.
• UMR (United Medical Resources): Also a TPA for self-funded employer health plans under United HealthCare Services, Inc. Closest comparable - both serve the same employer self-funded segment with multi-portal platforms and shared identity infrastructure. Operates as a sibling brand within the same parent ecosystem.
• Meritain Health: Aetna-affiliated TPA providing self-funded medical, pharmacy, and specialty benefit administration to employers. Comparable to Pomco in target customer (mid-market and large employers), business model (administrative fee per member), and core service lines (claims, utilization management, network access).
• Trustmark Companies: Provides self-funded health plan administration and stop-loss insurance for employers and labor groups. Comparable TPA business model with similar customer profile (employers seeking alternatives to fully-insured carrier arrangements).
• WPS Health Solutions: Wisconsin-based health insurer and TPA serving employer-sponsored plans, government programs, and individuals. Overlaps with Pomco in self-funded employer administration and broader benefits services portfolio.
• Allied Benefit Systems: Third-party administrator offering self-funded medical, dental, and ancillary benefit administration for employers. Comparable scale and target market to Pomco, with similar emphasis on flexible plan design and personalized service.

Emerging players

• Maestro Health: Benefits administration platform combining TPA services with technology-enabled decision support for self-funded employers. Comparable target market but with a more technology-led, integrated engagement model.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

• Xx.com/POMCOGroup
• Facebookfacebook.com/pomcogroup
• LinkedInlinkedin.com/company/982867

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

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 Pomco