ClaimLinx
ClaimLinx is a Cincinnati-based benefits consultancy, insurance agency, and MERP administrator founded in 2004 that helps small, medium, and large US businesses reduce health insurance costs through its proprietary Simple Option Solution combining high-deductible plans with Medical Expense Reimbursement Plans.
- Company typePrivate
- Founded2004
- HeadquartersCincinnati, United States
- Headcount11–50
- GTM typeB2B
- OfferingServices
What ClaimLinx does
ClaimLinx, LLC is a Cincinnati-based, privately held insurance agency, benefits consultancy, and third-party administrator founded in 2004 by Christy and Tom Quigley. The company combines the roles of consultant, licensed insurance agency, and Medical Expense Reimbursement Plan (MERP) processor to help small, medium, and large businesses reduce health insurance costs. Its flagship offering, the Simple Option Solution (SOS), pairs high-deductible insurance plans with MERPs structured under Section 105 of the tax code, delivered through three configurable packages: Diamond (group + self-funded), Sapphire (group + individual with MERP), and Crystal (individual plans with tax advantages). ClaimLinx also provides group health insurance brokerage across level-funded, VEBA, and MEWA plans, individual marketplace consulting, COBRA administration via PrimePay, and ancillary products through NatGen Health and Allstate Benefits.
The technology layer consists of three primary portals — a Private Claims Portal built on the MediConnex platform for members and providers, a Member Portal for eligibility and document access, and a Clinked-based Employer Portal for plan documents, billing, and enrollment — integrated with Calendly scheduling, Social Intents live chat, HealthSherpa for exchange shopping, and ApproRx for prescription drug coverage. MERP claims are processed in-house under HIPAA compliance. The firm is bootstrapped with no institutional funding, holds an LLC structure domiciled in Ohio, and operates a satellite office in North Conway, New Hampshire; leadership remains tightly held by the founding Quigleys with two recent promotions (Anthony McMahon to Sales Manager, April Vander Veur to Agency Manager) signaling modest internal professionalization.
Revenue is generated through brokerage commissions on placed group health insurance, fees for MERP setup and ongoing administration, a $110 flat fee for individual health plan consulting, and partner economics on ancillary products and COBRA referrals. The GTM motion is direct-led, combining field sales via named consultants, inside sales at 800-858-1772, and a self-serve online marketplace, supported by content marketing including the Cutting Edge Benefits podcast and an educational blog. ClaimLinx reports having helped 650+ companies save 15-80% on health insurance costs over 18 years.
ClaimLinx firmographics
Firmographics- Name
- ClaimLinx
- Legal name
- ClaimLinx, LLC
- Website
- https://claimlinx.com
- Company type
- Private
- Founded year
- 2004
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Short description
- ClaimLinx is a Cincinnati-based benefits consultancy, insurance agency, and MERP administrator founded in 2004 that helps small, medium, and large US businesses reduce health insurance costs through its proprietary Simple Option Solution combining high-deductible plans with Medical Expense Reimbursement Plans.
- Ownership category
- akta.pro rank
ClaimLinx industry classification
Industry- Product category
- Health Benefits Consulting and Administration
- NAICS
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Insurance Agencies and Brokerages (524210), Insurance and Employee Benefit Funds (5251)
- SIC
- Insurance Agents, Brokers & Service (6411), Accident & Health Insurance (6321)
- akta.pro primary industry
- Claims Administration & Payment Integrity (Medical/Dental/Vision) (HLAEALAD)
- akta.pro secondary industries
- Self-Funded (ASO) Group Health Plans & Stop-Loss (FSAIAFAB), Eligibility, Coverage Verification & Policy Administration Support (BPAAAFAC)
Keywords
Where ClaimLinx is headquartered
LocationHeadquarters
- HQ city
- Cincinnati
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
ClaimLinx business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Marketing or Sales, Technology or R&D, Infrastructure, Others
Revenue model
- Employer Benefit Consulting & MERP Administration: ClaimLinx provides comprehensive benefit consulting and administers Medical Expense Reimbursement Plans (MERPs) for employers. Revenue comes from fees for plan setup, administration, and ongoing consulting services. The company helps businesses save 20% or more on health insurance costs.
- Individual Health Plan Consulting: Consultation service for individuals seeking health insurance through federal/state exchanges or private marketplace. Priced at $110 for full consultation with access to a dedicated Licensed Agent throughout the year.
- Group Health Insurance Sales: Traditional group health insurance sales through full-service insurance consultants who shop multiple carriers including alternative plan types such as level-funded, VEBA, and MEWA plans.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | One time/ perpetual license | Individual Health Plan Consultation - $110 per session |
| Other | Multi-year contract | Custom Business Benefit Plans - Quote-based pricing |
Go-to-market motion1 record
Distribution channels3 records
Marketing channels5 records
ClaimLinx product offering
Product offeringCore offering
ClaimLinx is a benefits consulting firm, licensed insurance agency, and third-party administrator that helps employers reduce health insurance costs through its proprietary Simple Option Solution (SOS), which combines high-deductible insurance plans with Medical Expense Reimbursement Plans (MERPs) under Section 105 of the tax code. The company processes MERP claims in-house via its own HIPAA-compliant claims infrastructure, operates employer, member, and claims portals, and provides customized benefit packages (Diamond, Sapphire, Crystal) for small, medium, and large employers.
Product overview
ClaimLinx is a health benefits consulting firm combining insurance agency, benefits consulting, and MERP processing services. The core offering is the Simple Option Solution (SOS) - a customizable benefits package available in three tiers: Diamond (group + self-funded), Sapphire (group + individual with MERP), and Crystal (individual plans with tax advantages). The company operates digital platforms including a Private Claims Portal for members/providers, a Member Portal for individual benefit management, and an Employer Portal for business administrators. Supplementary services include individual health plan consulting, COBRA administration (via PrimePay partnership), group health insurance placement, and an online insurance marketplace. All plans leverage Medical Expense Reimbursement Plans (MERPs) utilizing Section 105 of the tax code.
Differentiator
Problem solved
Functional benefit
Products and services
- ClaimLinx Simple Option Solution (SOS) Proprietary customizable health benefits package combining high-deductible insurance plans with MERPs; uses physician networks and stop loss from HDHPs paired with the flexibility and cost savings of MERPs. For employers seeking lower health insurance costs.
- Diamond Package Combines a group health insurance plan with a self-funded plan for ease of administration and significant savings; suitable for staffing companies and similar businesses.
- Sapphire Package High-deductible group and individual plan paired with company MERP benefits; targeted at small to medium-sized groups seeking greater savings with customizable benefits.
- Crystal Package Individual plans paired with MERP tax advantages; provides opportunity for significant savings by enrolling employees in individual health plans.
- Medical Expense Reimbursement Plan (MERP) Processor End-to-end MERP administration: handles claim payout determination, fund collection from employers, and provider payment distribution as the claims processor for secondary health insurance plans. HIPAA-compliant.
- Employer Benefit Consulting Consulting service helping businesses decide on optimal health benefit plans; consultants shop all carrier options including level-funded, VEBA, MEWA plans, and alternative options while considering company budget and employee demographics.
- Group Health Insurance Traditional group health insurance plan placement and management; full-service insurance consulting across multiple carriers including level-funded, VEBA, and MEWA plan options.
- Individual Health Plan Consulting Insurance agent services for individuals not covered by group plans; specializes in finding best solutions through federal/state exchanges or private direct-to-carrier marketplace. $110 per consultation with access to a dedicated Licensed Agent throughout the year.
- COBRA Administration Services COBRA continuation coverage guidance and referral services through partnership with PrimePay; covers automated timelines, notifications, eligibility tracking, participant billing, and compliance reporting.
- ClaimLinx Online Marketplace Online insurance marketplace where individuals can browse health insurance plans with agent assistance through federal exchange or private companies.
- Complimentary Elite Services Bundle of additional services including medical claim negotiation, claim reporting and analysis, prescription rebates through PBMs, prescription consulting, customized schedule of benefits, and member/employer education meetings.
Quantifiable outcome
- Save 15% or more per month on health insurance costs
- +3 more outcomes
Companies that use ClaimLinx
Customer profileNamed customers3 records
Segments4 records
Ideal customer profiles4 records
ClaimLinx technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration7 records
Feature3 records
ClaimLinx partnerships and signals
Strategic signalPartnerships
Four partnerships are on record, tiered minor.
- PrimePayminorPrimePay handles COBRA administration services for ClaimLinx clients. They provide automated COBRA timelines & notifications, eligibility tracking & documentation, participant billing & payment management, and reporting for audits and IRS compliance. This partnership allows ClaimLinx to offer comprehensive COBRA services without handling administration internally.
- HealthSherpaminorHealth insurance marketplace platform used by ClaimLinx agents for shopping medical plans on the federal exchange. Agents Malik Hurt and April Vander Veur direct clients to HealthSherpa for application processing.
- NatGen HealthminorAncillary insurance products partner providing accident, cancer, critical illness, dental, hospital indemnity, life, and vision coverage options. Linked through ClaimLinx agent pages for supplemental product shopping.
- Allstate BenefitsminorSupplemental insurance products partner providing accident, cancer, critical illness, dental, hospital indemnity, life, and vision coverage through ClaimLinx agent recommendations.
Scale indicators5 records
Recent moves6 records
Expansion highlights5 records
ClaimLinx competitors and assessment
Company assessmentDirect peers
- USI Insurance Services: Major insurance brokerage and consulting firm with deep employee benefits practice. Overlaps with ClaimLinx in placing group health insurance and advising employers on self-funded/level-funded alternatives, with broader national reach.
- OneDigital: Large US benefits consulting and brokerage firm serving employers of all sizes with group health, voluntary, and self-funded solutions. Comparable to ClaimLinx in serving SMB/mid-market employers with cost-saving benefits strategies, though at much larger national scale.
- The Horton Group: Mid-market insurance and benefits brokerage with employee benefits consulting and self-funded capabilities. Comparable to ClaimLinx in serving SMB employers with group health and alternative funding arrangements.
- BenefitMall: Benefits broker and TPA serving small and mid-sized employers with group health, voluntary, and administration services. Comparable to ClaimLinx's combined agency-plus-administration model for the SMB segment.
- NFP (an Aon company): Insurance brokerage and consulting firm with strong employee benefits practice for mid-market and SMB employers. Directly comparable in benefits advisory, group health placement, and self-funded plan administration.
- Holmes Murphy: Employee benefits brokerage and consulting firm specializing in self-funded plan design, population health, and benefits technology for mid-market employers. Directly comparable to ClaimLinx's self-funded/MERP-oriented advisory offering.
Broad incumbents
- Brown & Brown: Large publicly traded insurance broker offering employee benefits consulting across all employer sizes. Competes with ClaimLinx on group health placement and benefits advisory for SMB clients, but operates at vastly greater scale.
- Hub International: National insurance brokerage with significant employee benefits practice including self-funded and level-funded plan design. Comparable to ClaimLinx's benefits consulting and brokerage model with broader product and geographic coverage.
- Alliant Insurance Services: National specialty insurance brokerage with employee benefits division serving middle-market employers. Comparable to ClaimLinx in group health brokerage and benefits consulting, though at significantly larger scale and broader product mix.
Emerging players
- BeneSys: Third-party administrator focused on self-funded benefit plans, particularly for Taft-Hartley and employer-sponsored funds. Comparable to ClaimLinx's MERP claims administration and self-funded plan processing capabilities.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights6 records
Customer concentration
ClaimLinx social profiles
Digital presenceClaimLinx financial estimates
Financial estimateRevenue estimate
Valuation estimate
ClaimLinx leadership team
Management profileNumber of profiles
Profiles7 records
ClaimLinx funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
ClaimLinx M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about ClaimLinx
What does ClaimLinx do?
ClaimLinx is a benefits consulting firm, licensed insurance agency, and third-party administrator that helps employers reduce health insurance costs through its proprietary Simple Option Solution (SOS), which combines high-deductible insurance plans with Medical Expense Reimbursement Plans (MERPs) under Section 105 of the tax code. The company processes MERP claims in-house via its own HIPAA-compliant claims infrastructure, operates employer, member, and claims portals, and provides customized benefit packages (Diamond, Sapphire, Crystal) for small, medium, and large employers.
Is ClaimLinx a public or private company?
ClaimLinx is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was ClaimLinx founded?
ClaimLinx was founded in 2004. It employs 11 to 50 people.
Where is ClaimLinx based?
ClaimLinx is headquartered in Cincinnati, United States, in the North America region.
How does ClaimLinx make money?
Three revenue lines are on record. Employer Benefit Consulting & MERP Administration is the primary driver. The others are individual Health Plan Consulting and group Health Insurance Sales.
Who are ClaimLinx's main competitors?
Direct peers on record are USI Insurance Services, OneDigital, The Horton Group, BenefitMall, NFP (an Aon company) and Holmes Murphy. Broad incumbents are Brown & Brown, Hub International and Alliant Insurance Services. BeneSys is listed as an emerging player.
Does ClaimLinx have an API?
No public API is recorded for ClaimLinx.
What industry is ClaimLinx in?
ClaimLinx's product category is Health Benefits Consulting and Administration. Its primary akta.pro industry code is HLAEALAD, Claims Administration & Payment Integrity (Medical/Dental/Vision), with a secondary code of FSAIAFAB, Self-Funded (ASO) Group Health Plans & Stop-Loss. Its NAICS code is 524292 and its SIC code is 6411.