Promise Health Plan

What Promise Health Plan does

Promise Health Plan is a private health insurance company founded in 2022 and headquartered at 300 E McBee Avenue, Suite 501, Greenville, South Carolina. It operates as a wholly owned subsidiary of Prisma Health, South Carolina's largest hospital system, and was established specifically to address employer pain points around rising health insurance costs, inflexible plan design, and lack of claims transparency. The company offers two core insurance products — Level-Funded Plans and Traditional Self-Funded Plans — underwritten through a Clinically Integrated Network (CIN) of 28 hospitals, 1,000 practice locations, and 7,300 providers that serves more than 2.5 million unique patients annually. Its care model is value-based, with incentives aligned between providers and employer groups, and it bundles Complex Care Management, Care Coordination, and Disease Management services into its plan offerings.

Name

Promise Health Plan

Legal name

Promise Health Plan

Website

https://promisehealthplan.com

Company type

Private

Operating status

Operating

Headcount range

11–50 employees

Ownership category

akta.pro rank

Product category

Employer Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114)

SIC

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

akta.pro primary industry

Level-Funded Group Health Plans (FSAIAFAC)

akta.pro secondary industry

Self-Funded (ERISA) Employer Plans (HLAEAAAC)

Keywords

• Employer health insurance
• Self-funded health plans
• Level-funded plans
• Clinically integrated network
• Health benefits administration

Headquarters

HQ city

Greenville

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Health Insurance Premiums: Promise Health Plan generates revenue through employer-paid health insurance premiums for Level-Funded and Self-Funded plan offerings. Premiums are collected from employer groups in exchange for providing healthcare coverage through their Clinically Integrated Network.
2. Self-Funded Plan Administration: Administrative services for self-insured employers, including claims processing, network access, and care management services. Revenue is generated through administrative fees and access to the provider network.

Pricing tiers

Go-to-market motion1 record

Distribution channels4 records

Marketing channels5 records

Core offering

Promise Health Plan is a provider-founded health insurance company that offers Level-Funded Plans and Traditional Self-Funded Plans to employer groups. It is backed by the Prisma Health Clinically Integrated Network of 28 hospitals, 1,000 practice locations, and 7,300 providers, and supports employer-sponsored health benefits with member and provider portals, a mobile app, and integrated care management services.

Product overview

Promise Health Plan is a health insurance provider founded by Prisma Health (South Carolina's largest hospital system) offering employer-sponsored health benefit solutions. The company's portfolio consists of two core insurance products — Level-Funded Plan and Traditional Self-Funded Plan — supported by a Clinically Integrated Network of 28 hospitals, 1,000 practice locations, and 7,300 providers serving over 2.5 million patients. These plans are complemented by self-service digital tools including a Provider Portal, Member Portal, and Mobile App, which enable providers and members to manage claims, eligibility, precertification, and care coordination. Additional services include Nurse Triage Clinical Support, Complex Care Management, and a provider directory powered by HealthSparq. The company operates nationally through Tier 2 network partners including Cigna Healthcare and First Health.

Differentiator

Problem solved

Functional benefit

Products and services

• Level-Funded Plan A level-funded health insurance plan offered to employer groups that combines elements of self-funded and fully insured arrangements, providing predictable monthly costs while limiting the employer's risk through stop-loss coverage. Designed for employer groups seeking cost-predictable health benefits for their employees.
• Traditional Self-Funded Plan A traditional self-funded health insurance plan offered to employer groups, where the employer assumes the financial risk for providing health care benefits to its employees. Designed for employer groups that want flexibility in plan design and direct control over healthcare costs.
• Complex Care Management A care management service that provides personalized support for members with complex or chronic conditions, helping them navigate the healthcare system and access appropriate care. Targeted at employer-group members with high-acuity or multi-condition needs.
• Care Coordination and Disease Management A service that coordinates care across providers and supports members managing chronic diseases, helping to improve outcomes and reduce avoidable utilization. Available to employer-group members within the Prisma Health Clinically Integrated Network.
• Nurse Triage Clinical Support A 24/7 clinical support service that connects members with nurses for triage, symptom guidance, and care direction. Available to employer-group members to help them make informed decisions about where and when to seek care.

Quantifiable outcome

• Network of 28 hospitals, 1,000 practice locations, and 7,300 providers
• +1 more outcomes

Named customers1 record

Segments3 records

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

Three partnerships are on record, tiered flagship and core.

• Prisma HealthflagshipStrategic or Co-development PartnerPrisma Health, South Carolina's largest hospital system, founded Promise Health Plan specifically to address unmet market needs for affordable, transparent health insurance. Prisma Health provides the clinical network infrastructure including 28 hospitals, 1,000 practice locations, and 7,300 providers. This is the founding parent organization relationship.
• Cigna Healthcare (Shared Administration PPO Network)coreTechnology or IntegrationCigna Healthcare provides Tier 2 network access for claims processing. For plans using the Cigna Healthcare Shared Administration PPO Network, claims are submitted to Cigna at PO Box 188061, Chattanooga, TN 37422-8061 with Payer ID 62308.
• First Health Complementary NetworkcoreTechnology or IntegrationFirst Health Complementary Network serves as Tier 2 network partner for additional national coverage. Claims are submitted to Promise Health Plan at PO Box 4278, Clinton, IA 52733-4278 with Payer ID RP128.

Scale indicators3 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• Humana: Humana is a major U.S. health insurer with a strong employer-group footprint and a growing focus on value-based provider partnerships. It competes broadly with Promise Health Plan in employer-sponsored health benefits, particularly among Southeast employers.
• Cigna Healthcare: Cigna Healthcare is both a Tier 2 network partner of Promise Health Plan and a major direct competitor in employer-sponsored health benefits. Its Evernorth platform offers self-funded administration and pharmacy services that overlap with Promise Health Plan's offerings.
• UnitedHealthcare (UnitedHealth Group): UnitedHealthcare is the largest U.S. health insurer offering a broad employer-sponsored portfolio including self-funded, level-funded, and fully insured plans. It competes with Promise Health Plan across employer segments while operating at vastly greater scale.
• Aetna (CVS Health): Aetna, part of CVS Health, is a major national carrier offering fully insured and self-funded employer plans with extensive value-based contracting. It competes for the same mid-market and large employer RFPs that Promise Health Plan targets.

Emerging players

• Oscar Health: Oscar Health is a tech-forward health insurer emphasizing member experience and provider alignment in individual and small-group markets. It is comparable to Promise Health Plan as a smaller, differentiated carrier pursuing employer and consumer segments.
• Molina Healthcare: Molina Healthcare is a managed-care company primarily serving government programs but expanding into Marketplace and employer-adjacent products. It is comparable to Promise Health Plan as a value-based, network-driven payer pursuing growth beyond its core segment.

Regional players

• Health Care Service Corporation (HCSC): HCSC operates Blue Cross and Blue Shield plans across several states and is expanding its employer-group and value-based offerings. It is comparable to Promise Health Plan as a large regional carrier with a similar employer-self-funded playbook.

Direct peers

• Centivo: Centivo is a digital health plan focused on self-funded and level-funded employer-sponsored plans built around value-based provider networks. It directly competes with Promise Health Plan for the same mid-market employer RFPs emphasizing cost transparency and aligned incentives.
• Kaiser Permanente: Kaiser Permanente is the prototypical provider-owned, vertically integrated health plan combining delivery and insurance under one organization. It is comparable to Promise Health Plan because both pursue aligned-incentive models where the payer and provider are integrated.
• BlueCross BlueShield of South Carolina: BlueCross BlueShield of South Carolina is the incumbent health insurer in Promise Health Plan's primary market, offering employer-sponsored plans across fully insured and self-funded structures. It is the most direct head-to-head competitor for South Carolina employer groups.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights5 records

Customer concentration

• LinkedInlinkedin.com/company/promise-health-plan

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 Promise Health Plan