What CommonCare does

CommonCare is a privately held US healthcare benefits technology platform based in Greensboro, North Carolina, with a team of approximately 12 employees and no disclosed external funding. It targets small employers (under 50 FTEs), individuals, and self-administered group health plans, offering an alternative to traditional insurance carrier administration. The company’s core thesis is to separate insurance (risk protection against large bills) from healthcare delivery (direct physician relationships), positioning its solution around the ACA’s ICHRA framework and small-employer tax credits.

The platform is built on a modular architecture of seven core products — Care Wallet, Intelligent Admin, ICHRA, Direct Primary Care (DPC), Claim Map, Bill Eraser, and PocketGuard — supported by modules for plan documents, ACA compliance, enrollment, fund management, care adjudication, and custom provider networks. Layered on top are three professional service tiers: Plan Doctor (physician-led care at $10–99 PEPM), Plan Advisor (ongoing plan support at $10 PEPM), and Plan Attorney (compliance review). The technology integrates funds management, claims tracking, bill negotiation, and enrollment into a single administration layer designed to remove carriers, TPAs, and PBMs from the workflow.

CommonCare monetizes entirely through recurring subscription fees on a per-employee-per-month basis and runs a consultative, sales-led go-to-market with demo booking, educational content, and a Plan Doctor/Advisor/Attorney channel. No revenue, customer counts, funding rounds, partnerships, or management team details are disclosed in the available data, and operations are confined to the United States.

Name

CommonCare

Legal name

CommonCare

Website

https://commoncare.org

Company type

Private

Operating status

Operating

Headcount range

11–50 employees

Short description

CommonCare is a US healthcare benefits platform that enables small employers (<50 FTEs), individuals, and self-administered group plans to bypass traditional insurance carriers via ICHRA, Direct Primary Care, and modular admin tools, monetized through PEPM subscriptions.

Ownership category

akta.pro rank

Product category

Healthcare Benefits Administration Platform

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Health Care and Social Assistance (62)

SIC

Services-Computer Programming, Data Processing, Etc. (7370), Services-Misc Health & Allied Services, Nec (8090)

akta.pro primary industry

Direct Primary Care (DPC) & Concierge Medicine (HLAFAGAD)

akta.pro secondary industry

Benefits, Insurance & Entitlement Navigation (Medicare/Medicaid/VA/LTC) (HSABAIAG)

Keywords

• Health benefits administration
• ICHRA administration
• Direct primary care
• Health reimbursement arrangements
• Self-funded health plans

GTM type

B2B and B2C

Offering type

Software

Cost components

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

Revenue model

1. Plan Doctor Services: Charged on a per employee per month (PEPM) basis for physician-led care services including care navigation, negotiation, and direct care provision. Pricing ranges from $10-99 PEPM.
2. Plan Advisor Services: Ongoing advisory and support services for plan setup, reporting, and employee experience management, charged at $10 PEPM.
3. Platform and Administration Services: Technology platform services for ICHRA administration, enrollment, fund management, care adjudication, and custom networks.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels4 records

Core offering

CommonCare is a technology platform that enables small employers (under 50 FTEs) and individuals to offer and access health benefits without traditional insurance carrier administration. The platform combines Direct Primary Care (DPC) physician access with ICHRA (Individual Coverage Health Reimbursement Arrangement) administration, supported by tools such as Care Wallet for fund management, Intelligent Admin for plan administration, Claim Map for claims tracking, Bill Eraser for medical bill negotiation, and PocketGuard for individual spending control. Layered services include Plan Doctor (physician-led care), Plan Advisor (plan management), and Plan Attorney (compliance review).

Product overview

CommonCare is a technology platform that enables small employers (under 50 FTEs) to offer health benefits without traditional insurance carriers. The platform operates on a modular architecture centered around Direct Primary Care (DPC) and Individual Coverage Health Reimbursement Arrangements (ICHRA). The core product suite includes Care Wallet (fund management), Intelligent Admin (plan administration), Claim Map (claims tracking), Bill Eraser (bill negotiation), and PocketGuard (individual spending control). Supporting modules cover Plan Docs, ACA Compliance, Sleek Enrollment, Fund Management, Care Adjudication, and Custom Networks. Optional add-on services include Plan Doctor (physician-led care), Plan Advisor (plan management support), and Plan Attorney (compliance review). The platform emphasizes direct relationships between employees and doctors rather than insurance intermediary networks.

Differentiator

Problem solved

Functional benefit

Products and services

• Care Wallet A digital wallet solution for managing healthcare funds and payments, allowing employers and employees to handle healthcare expenses directly.
• Intelligent Admin Administrative platform for managing group health plans without traditional insurance carrier administration, including plan docs and enrollment capabilities.
• ICHRA (Individual Coverage Health Reimbursement Arrangement) A health reimbursement arrangement that allows employers to provide tax-free reimbursement for individual health insurance premiums and medical expenses.
• DPC (Direct Primary Care) Connects employees with direct primary care doctors outside of insurance networks, providing access to un-conflicted physician care.
• Claim Map Tool for tracking and managing healthcare claims and medical bills.
• Bill Eraser Service for negotiating and reducing medical bills and healthcare costs.
• PocketGuard Health plan management tool for individuals to control and monitor healthcare spending.
• Plan Doctor Physician-led care services ranging from care navigation to negotiation to direct care provision, typically costing $10-99 PEPM.
• Plan Advisor Soft-touch support for plan setup, reporting, employee experience management, and ongoing support, typically costing $10 PEPM.
• Plan Attorney Legal compliance review services for plan documents, compliance verification, and bill negotiation.

Quantifiable outcome

• Employers can receive up to $104,112 in tax credits by offering individual health options instead of traditional group plans

Segments3 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature5 records

Scale indicators1 record

Recent moves4 records

Expansion highlights3 records

Direct peers

• StretchDollar: ICHRA administration platform specifically targeting small businesses seeking to offer health benefits without traditional group insurance. Direct peer competing for the same sub-50 FTE employer segment.
• Take Command Health: ICHRA administration platform that enables employers to reimburse employees for individual health insurance premiums. Most direct competitor in the ICHRA + small employer + benefits administration category CommonCare operates in.
• Venteur: ICHRA-focused benefits platform for small and mid-sized employers. Directly competes with CommonCare's Intelligent Admin and ICHRA product offerings for the same target market.
• PeopleKeep: Specialized HRA/ICHRA administration platform for small businesses, owned by Bennie. Direct competitor in delivering tax-advantaged benefit solutions to sub-50 FTE employers.
• Sana Benefits: Modern self-funded health benefits platform for small employers that combines direct primary care and transparent provider networks. Closely aligned with CommonCare's DPC + custom networks approach.
• Thatch: ICHRA-focused benefits platform aimed at startups and small employers, enabling individual health insurance reimbursement. Direct competitor in the ICHRA administration space.
• Hint Health: Direct Primary Care practice management and DPC network platform. Comparable because both companies build the infrastructure for DPC adoption by employers, though Hint focuses on physician-side tools.
• Decent: DPC + ICHRA combined health benefits platform for small businesses and the self-employed. Highly comparable product offering and target customer to CommonCare.

Broad incumbents

• Brown & Brown Insurance: Large national insurance brokerage and benefits consulting firm. Established incumbent competing for the same small employer benefits market but through traditional insurance carrier channels.
• Health Rosetta Group: Benefits strategy advisory and ecosystem focused on transforming employer-sponsored healthcare purchasing. Adjacent incumbent promoting similar employer benefit redesign philosophies.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/realcommoncare

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 CommonCare