The Jefferson Health Plan

What The Jefferson Health Plan does

The Jefferson Health Plan is a non-profit health benefits consortium founded in 1985 and headquartered in Steubenville, Ohio, that delivers self-funded employee benefit programs to public employers — political subdivisions of their respective states — across eight states (Ohio, Michigan, Tennessee, Virginia, Indiana, West Virginia, Kentucky, and California). Member organizations pay into the consortium to access group-purchasing economics while retaining individually designed benefit programs, with each member maintaining its own claims reserves under an allocated-balance model. Core benefits include medical, vision, dental, prescription drug, life insurance (including AD&D), and voluntary life, with pharmacy benefit management routed through RxBenefits, TrueScripts, MedOne, and Sav-Rx and stop-loss coverage provided by Sun Life.

The consortium's proprietary technology layer centers on the HealthReach Wellness Portal (a web-based platform offering health risk assessments, biometric screening, lifestyle programs, and incentive management) and HealthReach Care Management (an integrated clinical platform staffed by registered nurses that analyzes medical and pharmacy claims to support chronic-condition management, supplemented by the Maternicare maternity program, Tobacco Cessation, and Diabetes Supply programs). Member-facing access is delivered through Member Connect and an Employee Assistance Program via ESI EAP, with Talkspace providing online therapy integration across web, iOS, and Android.

Revenue mechanics rely on consortium membership fees and the facilitation of broker compensation, which is billed directly to member organizations. The go-to-market motion is broker-led: brokers must be authorized through legal agreements, supported by a national marketing director who cultivates broker relationships and develops quotes for prospective public employer members. Pricing is quote-based and not publicly disclosed, with eligibility set at a minimum of 50 employees per member group and an average member size of approximately 150 employees. The entity is not publicly traded, has no disclosed funding rounds, and operates as a private non-profit without venture or private equity ownership.

Name

The Jefferson Health Plan

Legal name

The Jefferson Health Plan

Website

https://thejeffersonhealthplan.org

Company type

Private

Founded year

1985

Operating status

Operating

Headcount range

11–50 employees

Short description

The Jefferson Health Plan is a non-profit, self-funded benefits consortium serving public employers across eight US states, providing medical, dental, vision, prescription, life insurance, wellness, and EAP programs through proprietary HealthReach platforms and a curated multi-TPA, multi-PBM partner network.

Ownership category

akta.pro rank

Headquarters

HQ city

Steubenville

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Consortium Membership Fees: The Jefferson Health Plan is a non-profit organization operated on an allocated balance model where each member organization maintains its own reserves. Member organizations pay into the consortium to access cost-saving benefits of group purchasing while maintaining individually designed benefit programs.
2. Broker Facilitation Fees: The consortium facilitates compensation to broker agents on behalf of member organizations. Compensation is charged directly to the member organization and is at the discretion of the broker agent and the member organization. The consortium does not directly compensate brokers.

Pricing tiers

Go-to-market motion1 record

Distribution channels2 records

Marketing channels4 records

Core offering

The Jefferson Health Plan is a non-profit consortium that provides self-insured employee benefit programs to public employers (political subdivisions such as counties, school districts, and municipalities) across Ohio, Michigan, Tennessee, Virginia, Indiana, West Virginia, Kentucky, and California. It enables eligible employers to offer individually designed benefit programs to their employees while accessing the cost-saving advantages of group purchasing through the consortium model, operating on an allocated balance where each member organization maintains its own reserves.

Product overview

The Jefferson Health Plan is a consortium providing self-insured benefit solutions to public employers across seven states. The core offering is a modular benefits platform providing customizable Medical, Vision, Dental, and Prescription Drug benefits as the foundational products, with Life Insurance and Accidental Death & Dismemberment coverage through MedMutual Life. The HealthReach suite adds clinical value through the Wellness Program (web portal for health coaching, biometric tracking, and wellness challenges), Care Management (nurse outreach and chronic condition coordination), Maternicare, Tobacco Cessation, and Diabetes Supply programs. The Employee Assistance Program via ESI EAP provides confidential counseling including integrated Talkspace online therapy. Stop-loss coverage through Sun Life protects against catastrophic claims, while pharmacy benefits are managed through multiple PBM partners including RxBenefits, TrueScripts, MedOne, and Sav-Rx.

Differentiator

Problem solved

Functional benefit

Brands

• HealthReach Wellness: A wellness program enabling member organizations to offer customized wellness programs including platforms, assessments, online wellness challenges and targeted lifestyle management programs.
• HealthReach Care Management
• Maternicare
• HealthReach Tobacco Cessation Program
• HealthReach Diabetes Supply Program

Products and services

• Medical Care Benefits Self-insured medical benefit plans offered to public employer members and their employees, with customizable plan designs under the consortium's group purchasing arrangement.
• Vision Care Benefits

Named customers2 records

Segments2 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration24 records

Feature3 records

Partnerships

30 partnerships are on record, tiered core.

• AetnacoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• Anthem Blue CrosscoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• AultcarecoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• CareFactorcoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• Custom Design BenefitscoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• MedBencoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• Medical Mutual of OhiocoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• MeritaincoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• Mutual Health ServicescoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• Paramount Health CarecoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• Preferred Benefit AdministratorscoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• Self Funded Plans, Inc. (SFPI)coreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• Sentara Health PlanscoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• The Health PlancoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• United HealthCarecoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• UMRcoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• Unified Group ServicescoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• WellNet HealthcarecoreTechnology or IntegrationThird Party Administrator option providing claims processing, provider network access, utilization review, and eligibility management.
• RxBenefitscoreTechnology or IntegrationPharmacy Benefit Manager providing prescription drug benefits management and access to affordable medication.
• TrueScriptscoreTechnology or IntegrationPharmacy Benefit Manager providing prescription drug benefits management and access to affordable medication.
• MedOnecoreTechnology or IntegrationPharmacy Benefit Manager providing prescription drug benefits management and access to affordable medication.
• Sav-RxcoreTechnology or IntegrationPharmacy Benefit Manager providing prescription drug benefits management and access to affordable medication.
• US BankcoreOthersTrust Account and Vendor Payment Management services for the consortium.
• HealthReachcoreTechnology or IntegrationCondition Management & Wellness partner providing the HealthReach wellness and care management programs including biometric screening, wellness education, and chronic condition management.
• MedMutual LifecoreOthersLife Carrier providing life insurance products to consortium members.
• Sun LifecoreOthersStop Loss Carrier providing stop loss insurance coverage for self-insured member organizations.
• VSP (Vision Service Plan)coreTechnology or IntegrationVision Service Plan providing vision care benefits and network access for members.
• CliftonLarsonAllencoreImplementation/ SI/ Consulting PartnerAccounting and Auditing Services providing financial oversight for the consortium.
• ESI EAPcoreTechnology or IntegrationEmployee Assistance Program provider offering confidential support for work and life including counseling, resources, referral and support services for personal success including work/life balance, relationships, goals, healthy living, financial stability, resilience, managing life events, and recovery.
• TalkspacecoreTechnology or IntegrationOnline therapy provider integrated with ESI EAP offering text, audio and video therapy sessions accessible via web, iOS, or Android app.

Scale indicators2 records

Recent moves1 record

Expansion highlights5 records

Emerging players

• HealthEquity: Benefits administrator and HSA/consumer-directed health platform that increasingly serves public employers with adjacent benefit account services, representing an emerging competitor in the public-sector benefits ecosystem.

Direct peers

• TASB Risk Management Fund: Texas Association of School Boards risk management fund providing self-funded benefit and liability pools to Texas school districts, a public-employer consortium with a similar allocated-reserve, member-governed structure.
• Meritain Health: TPA specializing in self-funded employer health plans, including public-sector and mid-market employer clients; a JHP partner that also competes for similar member relationships.
• PEHP Health & Benefits: Utah public employee health plan providing self-funded medical, dental, and life benefits to state and local public employers through a pooled/consortium model, closely mirroring JHP's structure and member base.
• BeneSys: Third-party administrator specializing in public-sector and Taft-Hartley benefit funds, offering self-funded medical, dental, vision, and disability programs to government and union employers - functionally analogous to JHP's TPA-led consortium approach.

Others

• Self-Insurance Institute of America: Industry trade association promoting self-funded employer health plans; an ecosystem enabler for JHP's go-to-market model and broker-distribution motion rather than a direct competitor.
• Sun Life Financial: Stop-loss insurance carrier providing catastrophic-claim reinsurance to JHP and other self-funded plans; functionally a critical infrastructure supplier whose pricing directly impacts JHP member economics.

Regional players

• Paramount Health Care: Ohio/regional managed-care plan and TPA serving public and employer clients; JHP partner and a competing provider of self-funded plan administration in overlapping Midwest geographies.

Broad incumbents

• UnitedHealthcare: National carrier that is both a JHP TPA partner and a direct competitor offering self-funded public-sector programs at substantially larger scale across all of JHP's served states.
• Medical Mutual of Ohio: Ohio-based incumbent health insurer and TPA that is both a JHP partner (claims processing) and a broad competitor in the Ohio public-employer benefits market, offering fully-insured and self-funded products to a much larger member base.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights5 records

Customer concentration

• Xx.com/JHealthPlan
• YouTubethejeffersonhealthplan.org/Default.aspx
• Facebookfacebook.com/JeffersonHealthPlan
• Instagramthejeffersonhealthplan.org/Default.aspx
• LinkedInlinkedin.com/company/the-jefferson-health-plan

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 The Jefferson Health Plan