Kismet Risk Management Associates

What Kismet Risk Management Associates does

Kismet Risk Management Associates, LLC (KRMA) is a U.S.-based Managing General Underwriter (MGU) founded in 2019 and headquartered in Byron Center, Michigan. The company underwrites Medical Stop Loss Programs — Specific Stop Loss (deductibles from $50,000 and up), Aggregate Stop Loss, Captive & Alternative Funding arrangements, and Cost Containment options — for self-funded health plan sponsors, primarily mid-to-large U.S. enterprises. As an independent MGU, KRMA accesses multiple carrier partners for underlying reinsurance capacity and delivers tailored coverage structures through TPA and broker channels nationwide, with RFPs routed to [email protected].

Beyond pure underwriting, KRMA has built a service platform that includes Claims Adjudication (delivered through the doZEN platform partnership) and Clinical Management (pre-claim plan document reviews, medical bill reviews, out-of-network negotiations, specialty prescription services, Reference Based Pricing analysis, and data analytics with predictive forecasting). Cost-containment services are accessed through specialty vendor partnerships rather than built in-house.

KRMA is a privately held LLC with no disclosed external investors or funding rounds. Revenue derives from underwriting commissions and fees on placed stop loss coverage. The team is small (1–10 employees) and founder-led by President Manjusha P. Sheobaran (20+ years at Genworth, AIG, Berkley Accident & Health, and Greymatter) and Chief Underwriting Officer Kelly Donica (35+ years including VP of Underwriting at International Medical Group). No customer logos, revenue figures, or premium volumes have been publicly disclosed.

Name

Kismet Risk Management Associates

Legal name

Kismet Risk Management Associates, LLC

Website

https://kismetrisk.com

Company type

Private

Founded year

2019

Operating status

Operating

Headcount range

1–10 employees

Short description

Kismet Risk Management Associates is a U.S.-based Medical Stop Loss MGU underwriting Specific and Aggregate Stop Loss, Captive Solutions, Cost Containment, Claims Adjudication (via doZEN), and Clinical Management for mid-to-large self-funded health plan sponsors, distributed through TPAs and brokers nationwide.

Ownership category

akta.pro rank

Product category

Medical Stop Loss Insurance Underwriting

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Finance and Insurance (52)

SIC

Accident & Health Insurance (6321)

akta.pro primary industry

Insurance Program Administration & MGA/MGU Services (FSAEADAK)

akta.pro secondary industry

Captive Insurance Advisory & Management (FSAEADAF)

Keywords

• Medical stop loss
• Managing general underwriter
• Self-funded health plans
• Aggregate stop loss
• Clinical management services

Headquarters

HQ city

Byron Center

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. Medical Stop Loss Underwriting: KRMA underwrites and offers Specific Stop Loss, Aggregate Stop Loss, Cost Containment options, and Captive Solutions for mid to large size enterprises. As an MGU, they earn underwriting commissions and fees from carrier partners for placing stop loss coverage on self-funded health plans.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels3 records

Core offering

Kismet Risk Management Associates (KRMA) is a U.S.-based Managing General Underwriter (MGU) that underwrites and distributes Medical Stop Loss Programs for mid to large size enterprises with self-funded health plans. Its offerings include Specific Stop Loss, Aggregate Stop Loss, Captive Solutions, Cost Containment options, Claims Adjudication services delivered through the doZEN platform, and Clinical Management services such as medical bill reviews, out-of-network negotiations, specialty pharmacy services, and data analytics.

Product overview

Kismet Risk Management Associates (KRMA) is a U.S.-based Managing General Underwriter (MGU) offering a unified platform of medical stop loss insurance and risk management solutions for mid to large size enterprises. The core product portfolio includes Medical Stop Loss Underwriting Services (encompassing Specific Stop Loss, Aggregate Stop Loss, Captive & Alternative Funding Options, and Cost Containment Solutions), Claims Adjudication Services delivered through the DoZEN platform, and Clinical Management services. These products work together to provide comprehensive protection against high claims while advocating for appropriate member care through clinical oversight, data analytics, and cost containment strategies.

Differentiator

Problem solved

Functional benefit

Products and services

• Medical Stop Loss Underwriting Services Customized insurance and risk management underwriting for mid to large size enterprises, offering Specific Stop Loss, Aggregate Stop Loss, Cost Containment, and Captive Solutions through multiple carrier partners.
• Specific (Individual) Stop Loss Protection for employers against high claims on any one individual member of their health plan, with specific deductibles ranging from $50,000 and up, including specific only coverage, aggregating specifics, specific claim advancement, and specific terminal liability.
• Aggregate (Group) Stop Loss Protection for employers against total group claims during a contract period, with variable aggregate attachment points, aggregate accommodation, and aggregate terminal liability options.
• Captive & Alternative Funding Options Stop loss solutions that group together like-minded, high-performing policyholders to provide cost stability and accountability in self-funded health plans via captive program arrangements.
• Cost Containment Solutions Value-added services including data analysis, plan document review, out-of-network repricing, specialty drug carve-outs, and cost containment intervention programs delivered through specialty vendor partners.
• Claims Adjudication Services Claims management services delivered through the doZEN platform, combining innovative technologies with specialized claims professionals to provide proficient claims adjudication, with access to an in-house claims auditor and clinical analyst.
• Clinical Management Cost containment solutions utilizing clinical and administrative systems to identify, examine, prevent and mitigate risks and costs, including pre-claim plan document reviews, medical bill reviews, out-of-network negotiations, specialty prescription services, and data analytics.

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature1 record

Partnerships

Four partnerships are on record, tiered core and support.

• Carrier PartnerscoreOthersAs an independent managing general underwriter, KRMA accesses multiple carrier partners to provide customized insurance and risk management solutions for clients. These partners provide the underlying insurance capacity for Specific Stop Loss, Aggregate Stop Loss, and Captive Solutions offered to mid-to-large enterprises.
• Captive Management CompaniescoreStrategic or Co-development PartnerKRMA partners with captive program and captive management companies to offer alternative funding arrangements that group together like-minded, high-performing policyholders for cost stability and accountability in self-funded health plans.
• Specialty VendorssupportTechnology or IntegrationKRMA offers cost containment value-added services through specialty vendors including data analysis, plan document review, out-of-network repricing, specialty drug carve-outs, and cost containment intervention programs.
• doZEN Platform PartnerscoreTechnology or IntegrationKRMA partners with specialized claims management service providers under the doZEN platform. These partnerships combine innovative technologies with specialized professionals to provide proficient claims adjudication services. The partnerships allow KRMA to focus on core underwriting expertise while delivering unbiased claims interpretation validated through industry benchmarks.

Scale indicators3 records

Recent moves5 records

Expansion highlights4 records

Broad incumbents

• Sun Life Stop Loss: Sun Life's U.S. Stop Loss practice offers Specific, Aggregate, and Captive solutions at meaningful scale. Broader incumbent — overlaps with KRMA's product set but Sun Life's much larger distribution and carrier balance sheet place it in a different competitive tier.
• Voya Stop Loss: Stop Loss practice within Voya Financial's Employee Benefits business, offering Specific and Aggregate coverage. Broader incumbent with similar products but larger balance sheet and broader benefits portfolio.

Direct peers

• HM Insurance Group: One of the largest dedicated Stop Loss MGUs in the U.S., offering Specific and Aggregate Stop Loss plus cost containment through carrier partnerships. Directly comparable as an independent MGU serving TPAs, brokers, and self-funded employers nationwide.
• Companion Life: Medical Stop Loss MGU underwriting Specific and Aggregate coverage distributed through TPAs and brokers. Directly comparable MGU offering, serving the same self-funded employer segment KRMA targets.
• RPS Stop Loss (Risk Placement Services): Wholesale brokerage and MGU operation with a Stop Loss specialty practice serving brokers and self-funded employers. Directly comparable distribution model and product offering.
• Berkley Accident and Health: Specialty Accident & Health insurer with a prominent Stop Loss underwriting practice serving self-funded plans. Directly comparable in product set; notably KRMA's President previously held a Group Benefits Sales Director role here, making it a near-direct competitive and pedigree match.
• Amwins Stop Loss: Major specialty wholesale broker/MGU platform with a dedicated Stop Loss practice offering Specific, Aggregate, and captive solutions via retail brokers. Directly comparable go-to-market through broker and TPA partnerships.
• Greymatter Risk Management: Independent Stop Loss MGU providing Specific, Aggregate, and Captive solutions via broker and TPA channels. Highly comparable business model; multiple KRMA underwriters and its President previously worked at Greymatter, reinforcing the direct peer status.
• Roundstone Insurance: Stop Loss MGU specializing in group captive solutions for small and mid-sized self-funded employers. Comparable MGU model with strong emphasis on captive and alternative funding — a segment KRMA is actively expanding into.
• Symetra Stop Loss: Stop Loss division of Symetra Financial, providing Specific and Aggregate Stop Loss plus cost containment to self-funded employers. Comparable product set and broker/TPA distribution model.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat4 records

Key risks5 records

Key highlights6 records

Customer concentration

• Facebookfacebook.com/KismetRisk
• LinkedInlinkedin.com/company/krma

Revenue estimate

Valuation estimate

Number of profiles

Profiles8 records

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 Kismet Risk Management Associates