National Benefits Administrators

What National Benefits Administrators does

National Benefits Administrators, LLC is a Honolulu-based third-party administrator of healthcare benefits, operating as a private LLC incorporated in Hawaii and serving self-funded employers and insurance brokers across the United States. Founded around 2010 and operating with 11–50 employees, the company provides integrated administration for both self-funded and traditional health plans, including claims processing, eligibility and billing administration, stop loss coordination, pharmacy benefit management, employee assistance programs, and telemedicine access. Its core go-to-market is relationship-based, relying on broker partnerships for mid-funnel engagement and direct outreach to employers for enterprise accounts, with quote requests processed via email and fax on roughly a two-week turnaround.

The company's technology stack combines claims cost management systems with third-party administrative capabilities, centered on a predictive modeling and analytics layer that monitors all claims in real time to flag high-cost claimants before catastrophic medical claims occur. An administrative services portal supports drug enrollment, eligibility management, billing, and support lines, while customized reporting covers actuary services, 1095c, and 5500 regulatory filings. Core products include NB Medical Management and EAP (counseling, legal, dependent care, and financial planning), Consult A Doctor (24/7 physician access via phone and secure email), Pharmacy Benefit Management, Reporting and Analytics, Consulting Services, and Self-Funding Administration. The technology is described as differentiated by accuracy of predictive modeling, real-time claims monitoring performance, and customizability of reporting rather than by proprietary AI research or patented IP.

National Benefits generates revenue primarily through per-employer administrative fees for managed services (TPA and PBM) supplemented by professional services fees from consulting engagements in health plan design, pricing, financial reporting, claims reviews, regulatory filings, and wellness planning. Pricing is not publicly disclosed; employers and brokers request quotes by submitting census data, claims history, and coverage specifications. Distribution runs through broker networks (mid-market), direct employer relationships (enterprise), and carrier partnerships for stop loss, Medicare EGWP, and wellness program components, all within a single-country/domestic US footprint. No funding rounds, acquisitions, parent company, or institutional investors are disclosed.

Name

National Benefits Administrators

Legal name

National Benefits Administrators, LLC

Website

https://nationalbenefitsadmin.com

Company type

Private

Founded year

2010

Operating status

Operating

Headcount range

11–50 employees

Short description

National Benefits Administrators is a Honolulu-based third-party healthcare benefits administrator offering claims administration, pharmacy benefit management, telemedicine, EAP, and predictive analytics for self-funded employers and insurance brokers across the United States.

Ownership category

akta.pro rank

Product category

Healthcare Benefits Administration

NAICS

Health and Welfare Funds (525120), Insurance and Employee Benefit Funds (5251)

SIC

Hospital & Medical Service Plans (6324), Accident & Health Insurance (6321)

akta.pro primary industry

Eligibility, Enrollment & Benefits Administration (HLAEALAH)

akta.pro secondary industries

Benefits Administration (BPACAPAC), Benefits Administration & Enrollment Support (BPAAAIAB)

Keywords

• Health benefits administration
• Third party administration
• Self-funded health plans
• Pharmacy benefit management
• Employee assistance programs

Headquarters

HQ city

Honolulu

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Third Party Administration Services: National Benefits generates revenue through third-party administrative services, providing claims processing, plan administration, and cost management for self-funded employer groups and traditional health plans. Revenue is derived from administrative fees charged to employer clients for managing their healthcare benefits.
2. Consulting Services: Consulting fees from health plan design, pricing, financial reporting, claims reviews, regulatory filings, and wellness planning services.
3. Pharmacy Benefits Management: Pharmacy benefit management services including plan and carrier selection, drug claims monitoring, and predictive modeling for prescription drug cost management.

Go-to-market motion1 record

Distribution channels3 records

Marketing channels2 records

Core offering

National Benefits Administrators is a third-party administrator that provides healthcare benefits administration services to self-funded employer groups and insurance brokers. The company delivers health plan design, claims administration, stop loss coverage shopping, pharmacy benefit management, employee assistance programs (EAP), 24/7 telemedicine access, and consulting services supported by predictive modeling analytics for cost containment.

Product overview

National Benefits Administrators is a technology-driven healthcare administration company offering an integrated suite of services for self-funded and traditional health plans. The core offerings include NB Medical Management and EAP (employee assistance program with counseling, legal, and financial services), Consult A Doctor (24/7 telemedicine physician access), Pharmacy Benefit Management, Reporting and Analytics with predictive modeling, Consulting Services, and Self-Funding Administration. These products work together to provide claims cost management, third-party administrative systems, and data-driven solutions to help employers control benefit costs while maintaining care quality.

Differentiator

Problem solved

Functional benefit

Brands

• Consult A Doctor: 24/7 physician consultation service offering phone and secure e-mail access to licensed physicians for non-emergent conditions
• NB Medical Management and EAP
• NB Medical Management and EAP

Products and services

• NB Medical Management and EAP Employee Assistance Program providing confidential short-term counseling, legal services, dependent care referrals, and financial planning consultations for employees and their families. Targeted at employer clients and their workforce as part of an integrated benefits package.
• Consult A Doctor 24/7 on-demand phone and secure email access to licensed U.S.-based physicians for common non-emergent conditions, designed to reduce employer healthcare costs by up to 25% by replacing expensive in-office visits. Offered to employer clients and their employees.
• Pharmacy Benefit Management Prescription drug management services including plan and carrier selection, drug claims monitoring, predictive modeling, enrollment portal, eligibility, and billing administration for employer-sponsored health plans.
• Reporting and Analytics Data-driven analytical solutions utilizing predictive modeling tools and billing analysis for early detection of healthcare conditions, customized reporting for actuary services, 1095c and 5500 reporting, and managed care intervention.
• Consulting Services Advisory services covering health plan design, pricing, financial reporting, claims reviews, regulatory filings, wellness planning, and compliance for traditional and self-funded employer groups.
• Self-Funding Administration Third-party administration of self-funded health benefit plans, allowing employers to cover actual costs with plan sponsor autonomy and customization. Includes claims processing, plan administration, and stop loss coverage shopping with multiple carriers.

Quantifiable outcome

• Employers can save up to 25% in annual healthcare claims costs
• +2 more outcomes

Segments3 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

Four partnerships are on record, tiered core and supporting.

• Consult A DoctorcoreStrategic or Co-development PartnerNational Benefits offers 24/7 phone and secure email access to licensed physicians through this partnership. The service provides on-demand physician consultations for common, non-emergent conditions, replacing expensive in-office visits. Employers can save up to 25% in healthcare claims costs while providing employees unlimited access to medical consultations.
• Medicare CarrierssupportingChannel Partner/ Reseller/ DistributorNational Benefits works with carriers offering individual Medicare plans and Medicare Employee Group Waiver Plans (EGWP) to meet the healthcare needs of employers with senior employee populations.
• Stop Loss Insurance CarrierssupportingChannel Partner/ Reseller/ DistributorNational Benefits shops stop loss coverage with multiple carriers to provide clients with the most competitive options. The company evaluates and presents optimal stop loss solutions to employers.
• Wellness Program CarrierssupportingChannel Partner/ Reseller/ DistributorNational Benefits partners with insurance carriers for wellness programs that include incentives and initiatives to promote employee health and wellbeing, helping to reduce healthcare costs and improve productivity.

Scale indicators2 records

Recent moves6 records

Expansion highlights3 records

Broad incumbents

• UMR: UMR is the TPA subsidiary of UnitedHealthcare and one of the largest third-party administrators of self-funded employer health plans in the U.S. It competes in the same TPA market as National Benefits but at significantly greater scale.
• Amwins: Amwins is a major wholesale insurance distributor and stop loss specialist; its stop loss shopping and employer benefits capabilities overlap with the stop loss and TPA functions National Benefits performs for brokers and employers.
• CoreSource: CoreSource, part of Cigna, provides third-party administration for self-funded employer health plans including claims processing, utilization management, and stop loss support — overlapping heavily with National Benefits' service portfolio.

Direct peers

• Lucent Health: Lucent Health is a technology-enabled third-party administrator focused on self-funded employer health plans, offering claims administration, care management, and analytics — closely aligned with National Benefits' integrated service approach.
• MedBen: MedBen is a third-party administrator specializing in self-funded employer health plans with a focus on cost containment, reporting, and compliance — directly comparable to National Benefits in target customer and value proposition.
• Key Benefit Administrators: Key Benefit Administrators is a third-party administrator offering claims processing, utilization review, and integrated benefit management for self-funded employer groups, comparable in scale and service mix to National Benefits.
• Meritain Health: Meritain Health is a large third-party administrator of self-funded health plans for employers, offering claims administration, pharmacy benefit management, and integrated health management tools — directly comparable to National Benefits' core TPA offering.
• HealthPlan Holdings: HealthPlan Holdings provides third-party administration of self-funded and fully-insured health plans for employers, with comparable claims administration and care management capabilities to National Benefits.
• HealthSCOPE Benefits: HealthSCOPE Benefits is a third-party administrator providing claims administration, utilization management, and customer service for self-funded employer health plans, directly comparable in service mix to National Benefits.

Emerging players

• TASC (Total Administrative Services Corporation): TASC administers employee benefits including COBRA, FSA/HRA/HSA, and other consumer-directed health plans, providing adjacent benefits-administration services to employers served by National Benefits.

Market position

Strengths4 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights5 records

Customer concentration

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 National Benefits Administrators