Celtic Group

What Celtic Group does

Celtic Insurance Company, operating as part of Celtic Group, is a U.S. individual health insurance carrier founded in 1978 and currently a wholly owned subsidiary of Centene Corporation (NYSE: CNC). The company provides health insurance plans to individuals, families, and self-employed consumers, distributing primarily through the federal and state Health Insurance Marketplaces under the Ambetter Health sub-brand across 26 or more states. Its core product is the Celtic Health Plan, a PPO offering, complemented by Ambetter-branded Marketplace plans and ancillary services including pharmacy benefits, telehealth, provider directories (via Cigna and MultiPlan integrations), member self-service portals, and a mobile app on iOS and Android.

The underlying technology stack centers on a health insurance administration platform supporting enrollment, billing, claims, and member services, with provider lookup powered by third-party network integrations. Celtic does not publish a developer-facing API; member access occurs through web portals and mobile applications. Digital tools include the 2016-vintage QuikForms document platform for state-specific insurance forms and the Ambetter member portal/app for benefits access, claims review, ID card retrieval, and bill payment.

Celtic generates revenue through recurring monthly health insurance premiums from individual and family subscribers, with pricing determined by state, plan tier, and member circumstances. The go-to-market relies on three channels: the Health Insurance Marketplace (healthcare.gov and state exchanges), direct agent/broker sales, and online self-service via the Ambetter enrollment portal. The company is regulated as a licensed insurer across its operating states and operates as a private subsidiary within Centene's diversified healthcare portfolio, which collectively serves over 11 million members.

Name

Celtic Group

Legal name

Celtic Insurance Company

Website

https://celticinsurancecompany.com

Company type

Private

Founded year

1978

Operating status

Operating

Headcount range

5,001–10,000 employees

Short description

Celtic Insurance Company is a wholly owned subsidiary of Centene Corporation that provides individual and family health insurance plans, primarily through the Health Insurance Marketplace under the Ambetter brand, serving consumers across 26+ U.S. states.

Ownership category

akta.pro rank

Product category

Individual Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114)

SIC

Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Off-Exchange Individual & Family Plans (HLAEABAB)

akta.pro secondary industry

Individual Health Insurance Brokerage & Distribution (FSAIAEAL)

Keywords

• Individual health insurance
• Marketplace health plans
• PPO health coverage
• Family health insurance
• Ambetter health plans

Headquarters

HQ city

Chicago

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

Revenue model

1. Health Insurance Premiums: Celtic generates revenue through health insurance premiums paid by individuals, families, and self-employed individuals enrolled in their health plans offered on the Health Insurance Marketplace under the Ambetter brand.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels4 records

Core offering

Celtic Insurance Company sells individual and family health insurance products, including PPO plans and Marketplace plans offered under the Ambetter Health brand on the Health Insurance Marketplace. The products are available to individuals, families, and the self-employed across more than 25 U.S. states, with pricing varying by state and member circumstances.

Product overview

Celtic Group is a health insurance company and subsidiary of Centene Corporation offering a portfolio of individual and family health insurance products. The core product is the Celtic Health Plan (PPO), complemented by the Ambetter Health sub-brand for Marketplace plans. Additional services include telehealth, pharmacy programs, provider directories, member portals, and mobile apps. Products are distributed across 26 states with state-specific plan variations and form numbers (U5-587-00295, U5-588-00296).

Differentiator

Problem solved

Functional benefit

Brands

• Ambetter Health: Health insurance plans offered on the Health Insurance Marketplace. Celtic Insurance Company provides Ambetter Health insurance plans through the marketplace.

Products and services

• Celtic Health Plan Individual and family health insurance plans offered as PPO (Preferred Provider Organization) products, providing financial protection against medical care costs with access to medically appropriate healthcare for individuals, families, and the self-employed.
• Ambetter Health Plans Marketplace health insurance plans available on the Health Insurance Marketplace under the Ambetter Health sub-brand, offered through Centene subsidiaries including Celtic Insurance Company, with plans including health, dental, and vision coverage (benefits varying by state) for individuals, families, and the self-employed across more than 25 states.
• Telehealth Services Virtual telehealth service for Ambetter members providing 24/7 access to healthcare providers via video consultation, currently available in Texas with expansion planned to other states.
• Pharmacy Program Prescription drug coverage program providing appropriate, high-quality, and cost-effective drug therapy, covering prescription medications and certain over-the-counter medications when ordered by a provider, with state-specific preferred drug lists.

Named customers1 record

Segments2 records

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

Partnerships

One partnership is on record.

• Centene CorporationflagshipStrategic or Co-development PartnerCeltic Group, Inc. was acquired by St. Louis-based Centene Corporation (NYSE: CNC). This merger brings potential for growth for both companies, uniquely positioning both to partner on the full range of solutions for the rising number of uninsured Americans and providing market driven healthcare solutions. Celtic operates as a wholly owned subsidiary of Centene.

Scale indicators2 records

Recent moves1 record

Expansion highlights5 records

Broad incumbents

• UnitedHealthcare: Largest U.S. health insurer offering individual Marketplace plans alongside employer, Medicare, and Medicaid products. Competes with Celtic/Ambetter on Marketplace exchanges with superior scale and provider leverage.
• Humana: Major health insurer with growing individual Marketplace presence alongside its dominant Medicare Advantage business. Competes with Celtic for individual ACA customers in shared geographies.
• Kaiser Permanente: Integrated payer-provider offering individual Marketplace plans in select states. While its integrated delivery model differs, it competes for the same individual ACA shoppers in overlapping markets.
• Cigna Group: Global health services company offering individual ACA Marketplace plans in select states. Also serves as Celtic's provider network partner (Cigna directory) in certain markets—creating an interesting competitor-partner dynamic.
• Anthem Blue Cross Blue Shield: Largest Blue Cross Blue Shield licensee offering ACA Marketplace plans across many states. Competes directly with Ambetter in overlapping geographies with broader commercial and Medicaid product lines.

Direct peers

• Oscar Health: Tech-forward individual ACA Marketplace insurer offering plans across multiple states. Directly competes with Celtic/Ambetter on Marketplace exchanges and shares similar target customers and pricing pressure.
• Blue Shield of California: California-focused nonprofit health plan offering individual Marketplace coverage. Directly competes with Ambetter-branded plans in California and shares a similar mission-driven, individual-segment focus.
• Molina Healthcare: Government-focused health insurer (Medicaid + Marketplace) with a similar value-based, low-cost model to Centene/Celtic. Both serve dual eligible and ACA Marketplace populations with comparable product positioning.

Emerging players

• Clover Health: Tech-enabled Medicare Advantage insurer exploring adjacent individual markets. While primarily MA-focused, its technology-first approach and government-program orientation mirror aspects of Celtic's positioning.
• Alignment Health: Tech-driven Medicare Advantage insurer with potential to expand into individual Marketplace. Comparable to Celtic in its reliance on technology to serve government-program populations.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

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 Celtic Group