Pinnacle Insurance

What Pinnacle Insurance does

Pinnacle Insurance is a privately held insurance brokerage founded in 2022 and headquartered in Monroe, North Carolina. The company distributes Medicare-related products (Medicare Supplements, Medicare Advantage, Prescription Drug Plans, Dual Eligible Special Needs Plans, Life Insurance, and Long-Term Care Insurance) to Medicare-eligible individuals, primarily through dedicated phone sales lines, a third-party website enrollment portal (sunfirematrix.com), and a differentiated pharmacy partnership channel that places Medicare agents inside independent pharmacies in seven states (Connecticut, Georgia, Kentucky, Montana, North Carolina, Tennessee, West Virginia). For group health insurance, the firm serves small businesses with under 50 employees (fully and self-insured plans, with dental and wellness add-ons) and large businesses with 50+ employees, distributing through independent insurance agents across all 50 states.

The company's large-group offering is anchored by its core partnership with Exemplar, a Healthcare Partnership Organization that aggregates 25,000 independent pharmacies and 76,000 independent physicians and owns a Pharmacy Benefit Manager and Third Party Administrator. This bundled stack is positioned to deliver self-insured pricing advantages to large employers. Pinnacle generates revenue through insurance commissions on each product line; pricing is not publicly disclosed and quotes are delivered via phone consultation. The technology footprint is limited to Exemplar's claims-utilization cross-reference software for high-cost claim analysis and a GoDaddy-powered marketing site; no proprietary AI/ML capabilities, patents, or research output are evidenced. The company also maintains logo-level partnerships with Three Peaks Financial and Elite Benefits Group for referral and benefits distribution reach.

Name

Pinnacle Insurance

Legal name

Pinnacle Insurance

Website

https://pinnacleinsco.com

Company type

Private

Founded year

2022

Operating status

Operating

Headcount range

11–50 employees

Short description

Pinnacle Insurance is a privately held insurance brokerage founded in 2022 in Monroe, North Carolina that distributes Medicare products and small and large business group health insurance via phone sales, independent agents, and pharmacy partnerships across the United States.

Ownership category

akta.pro rank

Product category

Insurance Brokerage — Health and Medicare Insurance

NAICS

Insurance Agencies and Brokerages (52421)

SIC

Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Medicare Advantage (MA) Plans (FSAIAGAA)

akta.pro secondary industry

Medicare Supplement (Medigap) (FSAIAEAG)

Keywords

• Medicare insurance plans
• Health insurance brokerage
• Group health insurance
• Small business insurance
• Supplemental insurance coverage

Headquarters

HQ city

Monroe

HQ country

United States

HQ region

North America

Offices3 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

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

Revenue model

1. Medicare Insurance Products: Commissions from selling Medicare Supplements, Medicare Advantage, Prescription Drug Plans, and Dual Eligible Special Needs Plans to Medicare-eligible individuals.
2. Large Group Health Insurance: Commissions from providing customizable health insurance solutions for businesses with 50+ employees, including fully and self-insured plans through the Exemplar network.
3. Small Business Health Insurance: Commissions from offering both fully and self-insured plans to businesses with under 50 employees, including dental and health & wellness benefits.
4. Life and Long-Term Care Insurance: Commissions from selling life insurance and long-term care insurance products as part of wealth management and retirement planning strategies.

Go-to-market motion2 records

Distribution channels5 records

Marketing channels4 records

Core offering

Pinnacle Insurance is an insurance brokerage that sells Medicare insurance products (Medicare Supplements, Medicare Advantage, Prescription Drug Plans, Dual Eligible Special Needs Plans, Life Insurance, Long Term Care Insurance) to Medicare-eligible individuals, and group health insurance plans (fully insured and self-insured) to small businesses (under 50 employees) and large businesses (50+ employees), with the large-employer self-insured offering powered by its Exemplar partnership.

Product overview

Pinnacle Insurance is an insurance brokerage and advisory firm that operates as a multi-product platform offering Medicare-related insurance products and business health insurance solutions. The product portfolio includes Medicare Options (Original Medicare & Medicare Supplements, Medicare Advantage, Prescription Drug Plans, Dual Eligible Special Needs Plans, Life Insurance, Long Term Care Insurance) and Business Coverage (Small Business Plans for under 50 employees, Large Business Plans for 50+ employees). The company also offers dental plans and health & wellness programs as supplementary benefits. For large business clients, Pinnacle Insurance utilizes Exemplar, a Healthcare Partnership Organization with PBM and TPA capabilities, which partners with 25,000 independent pharmacies and 76,000 independent physicians to provide competitive self-insured health insurance solutions.

Differentiator

Problem solved

Functional benefit

Products and services

• Medicare Supplement Insurance Coverage options designed to supplement Original Medicare and help cover healthcare expenses that Medicare alone does not cover; targeted at Medicare-eligible individuals via phone and online enrollment.
• Medicare Advantage Plans Medicare plans that deliver extras beyond Original Medicare, tailored to individual needs and budgets; marketed to Medicare-eligible individuals.
• Prescription Drug Plans (Part D) Stand-alone Medicare Part D prescription drug plans designed to help cover the costs of medications for Medicare-eligible individuals.
• Dual Eligible Special Needs Plans (D-SNP) Medicare Advantage plans for individuals eligible for both Medicaid and Medicare, offering combined coverage and benefits that neither program provides alone.
• Life Insurance Life insurance products sold as part of wealth management and retirement planning strategies alongside Medicare coverage.
• Long-Term Care Insurance Long-term care insurance addressing health, lifestyle, and family considerations related to aging and longevity, coordinated with retirement planning.
• Small Business Health Insurance Plans Fully insured and self-insured group health plans for businesses with under 50 employees, offering multiple network options with flexibility and control over healthcare budgets.
• Large Business Group Health Insurance (Exemplar-powered) Customizable, cost-effective fully insured and self-insured health plans for businesses with 50+ employees, leveraging Exemplar's network of 25,000 independent pharmacies, 76,000 independent physicians, an owned PBM, an owned TPA, and claims-utilization cross-reference software to deliver greater discounts.

Quantifiable outcome

• Greater discounts on prescription drugs and medical services through independent pharmacy and physician network
• +1 more outcomes

Segments4 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature1 record

Partnerships

Three partnerships are on record, tiered core and minor.

• Exemplar (Healthcare Partnership Organization)coreStrategic or Co-development PartnerExemplar is a Healthcare Partnership Organization that partners with Pinnacle Insurance to provide access to 25,000 independent pharmacies and 76,000 independent physicians. Exemplar also owns a PBM (Pharmacy Benefit Manager) and TPA (Third Party Administrator), enabling competitive self-insured health plans. This partnership allows Pinnacle to offer greater discounts and comprehensive coverage options to large business clients.
• Three Peaks FinancialminorGTM or Marketing PartnerListed as a partner on Pinnacle Insurance's website. Three Peaks Financial appears as a logo partner, suggesting a marketing or referral relationship in the financial services space.
• Elite Benefits GroupminorChannel Partner/ Reseller/ DistributorListed as a partner on Pinnacle Insurance's website. Elite Benefits Group appears as a logo partner, suggesting a benefits distribution or marketing alliance relationship.

Scale indicators3 records

Recent moves5 records

Expansion highlights4 records

Direct peers

• SelectQuote: SelectQuote is a publicly traded direct-to-consumer insurance broker specializing in Medicare and life insurance, using phone-based sales and a large agent workforce. Strong comp on Medicare product breadth, commission model, and multi-state distribution; SelectQuote also offers life insurance like Pinnacle.
• eHealth: eHealth operates an online Medicare marketplace and brokerage, also selling individual/family and small-business health plans. Comparable to Pinnacle across Medicare, ACA, and small-business group health, with a stronger digital self-service portal but similar multi-product carrier-agnostic positioning.
• GoHealth: GoHealth is a leading U.S. Medicare-focused insurance brokerage operating across the majority of states, selling Medicare Advantage, Medicare Supplement, and Part D plans via phone and digital channels. Directly comparable to Pinnacle on the Medicare distribution model, primary product set, and agent/phone sales motion, though at much greater scale.
• BenefitMall: BenefitMall is a wholesale insurance brokerage distributing small-business and group health, life, and voluntary benefits through a national network of agents and agencies. Comparable to Pinnacle's small-business group-health distribution and agent-channel GTM, especially for the under-50 segment.

Broad incumbents

• Aetna (CVS Health): Aetna, owned by CVS Health, is a major Medicare Advantage and Medicare Supplement carrier with strong pharmacy-channel ties through CVS and Caremark. Relevant because Aetna represents the carrier side that agencies like Pinnacle place business with, and competes for the same Medicare-eligible customers Pinnacle's pharmacy-anchored agents target.
• Brown & Brown, Inc. Brown & Brown is a large national insurance brokerage distributing employee benefits (group health, dental, life, disability) and P&C through a vast network of producers. Comparable to Pinnacle on the large-business (50+) employee-benefits brokerage motion and on multi-product cross-sell, though at vastly greater scale and breadth.
• USI Insurance Services: USI is a top-tier insurance brokerage delivering property/casualty, employee benefits, and specialty coverage to mid-market and large employers nationwide. Comparable to Pinnacle's large-business group health/value-based benefits offering and self-insured solutions, with broader product portfolio and geographic reach.

Emerging players

• quotes.com (QuoteLab): QuoteLab operates performance-marketing insurance platforms across Medicare, life, health, and auto verticals through lead-generation and brokerage assets. Comparable to Pinnacle on Medicare-focused lead-to-broker conversion and on multi-carrier agency model.
• Decent Inc. Decent is an emerging health-insurance platform offering small-business group plans and individual coverage with a tech-first experience. Comparable to Pinnacle on the small-business health-insurance side, with a similar focus on cost transparency and customizable/self-insured options.
• HealthCare.com: HealthCare.com is a digital insurance marketplace focused on Medicare, ACA, and small-business health coverage for consumers and brokers. Comparable to Pinnacle in offering a multi-segment health-insurance comparison experience, with greater emphasis on digital/online acquisition versus Pinnacle's phone-and-pharmacy mix.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat3 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/pinnacle-insurance

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 Pinnacle Insurance