OPEH

What OPEH does

OPEH&W Health Plan (Oklahoma Public Employees Health & Welfare Plan) is a non-profit public trust that administers self-funded health and welfare benefit plans exclusively for Oklahoma local government employer groups and their employees, retirees, and dependents. Founded in 1992 by 15 Oklahoma counties, the plan has grown to serve 100+ participating employer groups under governance of a 15-member Executive Voting Board. It offers eight health plan tiers ranging from a zero-cost Tungsten plan through high-deductible catastrophic options (Cobalt, Copper), alongside Enhanced and Standard dental and vision coverage, group life insurance from $20,000 to $50,000, Medicare supplements for retirees, and a suite of ancillary products including accident, cancer, critical illness, disability, and pet insurance.

The plan is administered by McElroy & Associates under a contract held since 1996, with medical claims administered through BlueCross BlueShield of Oklahoma (BlueAdvantage/BluePreferred networks), pharmacy through Express Scripts, vision through VSP, and group life through MetLife. The HEART Platform serves as the cloud-based member and group administration portal, and a 2025-launched OPEH&W Mobile App with 24/7 Care Guides provides a member-facing interface. A flagship differentiator is the "Making Healthy Cheaper" program, which bundles 30+ zero-cost benefits (free major medical procedures via BlueDistinction+ providers, virtual care through MDLIVE, diagnostic imaging through Green Imaging, virtual checkups through Catapult Health, direct primary care through RemedyHealth, addiction treatment through Pelago, diabetes reversal through Virta, musculoskeletal care through Hinge Health, and others) as standard components of every health plan tier.

Revenue mechanics are subscription-based monthly premiums billed to employer groups for each enrolled employee and dependent tier (member, child, children, spouse, spouse+child, spouse+children). Distribution is direct-to-government-employer through on-site presentations, downloadable briefing books, and a benefit coordinator network that handles enrollment and ongoing administration. Geographic scope is limited to Oklahoma, with no disclosed revenue figures given the non-profit public trust structure.

Name

OPEH

Legal name

Oklahoma Public Employees Health & Welfare Plan

Website

https://www.opehw1.com/

Company type

Private

Founded year

1992

Operating status

Operating

Short description

OPEH&W is a non-profit public trust administering self-funded health, dental, vision, and life benefit plans for 100+ Oklahoma local government employer groups and their employees, retirees, and families, distinguished by 30+ zero-cost bundled benefits and historically below-national rate increases.

Ownership category

akta.pro rank

Product category

Group Health Insurance

NAICS

Health and Welfare Funds (52512), Direct Life, Health, and Medical Insurance Carriers (52411)

SIC

Hospital & Medical Service Plans (6324), Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Public Sector & Government Employer Group Health Plans (FSAIAFAF)

akta.pro secondary industries

Large Group Health Insurance (Mid-Market & National Accounts) (FSAIAFAE), Small Group Health Insurance (2–50/100) (FSAIAFAD), Group AD&D Insurance (Employer-Sponsored) (FSAIALAA)

Keywords

• Group health insurance
• Public sector benefits
• Health plan administration
• Government employee benefits
• Self-funded health plan

Headquarters

HQ city

Bartlesville

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Health Insurance Premiums: Monthly premium payments from participating employer groups for health coverage options including Tungsten, Diamond, Platinum, Gold, Silver, Bronze, and Cobalt plans. Premiums are paid by employer groups for their employees and dependents.
2. Dental Coverage Premiums: Additional monthly premiums for dental coverage options (Enhanced and Standard) with per-member rates
3. Vision Coverage Premiums: Monthly premiums for vision coverage (Enhanced and Standard options) providing eye exams, lenses, frames, and contacts
4. Group Life Insurance Premiums: Monthly premiums for group life coverage at various benefit levels ($20,000 to $50,000)
5. Ancillary Products: Additional insurance products including accident, cancer, critical illness, disability, hospital indemnity, home & auto, identity protection, legal support, medical transportation, and pet insurance

Pricing tiers

Go-to-market motion2 records

Distribution channels2 records

Marketing channels6 records

Core offering

OPEH&W Health Plan is a non-profit public trust that administers self-funded health, dental, vision, life, and ancillary benefit plans for Oklahoma local government employer groups (counties, cities, schools, and other public entities) and their employees, retirees, and dependents. The plan offers multiple health coverage tiers (Tungsten through Copper), dental and vision options, group life insurance, Medicare supplements, and an integrated portfolio of 30+ zero-cost benefits under its "Making Healthy Cheaper" program.

Product overview

OPEH&W Health Plan is a non-profit public trust health insurance provider offering a platform of health coverage products for Oklahoma local government employees. The core offering includes eight health plan tiers (Tungsten, Diamond, Platinum, Gold, Silver, Bronze, Cobalt, Copper) ranging from premium to catastrophic coverage, supplemented by Enhanced and Standard dental and vision plans, group life insurance ($20K-$50K), optional additional life coverage, and Medicare supplement plans for retirees. The flagship Making Healthy Cheaper program provides 30+ zero-cost benefits including free major medical care, virtual care (MDLIVE), direct primary care (RemedyHealth), diagnostic imaging (Green Imaging), wellness checkups (Catapult), addiction programs (Pelago), diabetes management (Omada), diabetes reversal (Virta), pain management (Hinge Health), mental health (Brain Code), and wellness support (Well onTarget, Ovia). Ancillary products include accident, cancer, critical illness, disability, hospital indemnity, identity protection, legal support, pet insurance, and FSAs. The plans are administered through BlueCross BlueShield (medical), Express Scripts (pharmacy), VSP (vision), and MetLife (life).

Differentiator

Problem solved

Functional benefit

Products and services

• Health Coverage Plans Tiered health coverage plans (Tungsten, Diamond, Platinum, Gold, Silver, Bronze, Cobalt, Copper) offering varying deductibles, out-of-pocket limits, and premium levels for Oklahoma local government employees and dependents, with all tiers including 30+ zero-cost benefits such as free major medical care, virtual primary care, imaging, and wellness programs.
• Dental Coverage Dental insurance offered in Enhanced ($2,500 annual maximum, $25 deductible, orthodontics for adults and children) and Standard ($1,500 annual maximum) options for participating employer group members and their families.
• Vision Coverage Vision insurance offered in Enhanced and Standard options through VSP Signature network, covering eye exams, lenses, frames, contacts, retinal screenings, and laser vision surgery discounts for participating members.
• Group Life Insurance Term life insurance provided through MetLife for participating employer group employees, with coverage tiers from $20,000 to $50,000, including accidental death and dismemberment benefits and dependent coverage options.
• Additional Life Coverage Optional supplemental term life insurance with $20,000 minimum up to $500,000 maximum (5x gross annual pay), including optional accidental death coverage and spouse/child coverage options.
• Ancillary Products Suite of supplemental insurance products including accident, cancer, critical illness, short-term and long-term disability, hospital indemnity, identity protection, legal support, medical transportation, pet insurance, and Flexible Spending Accounts (FSAs).
• Medicare Supplement Plans Medicare supplement coverage for retirees aged 65+ from participating Oklahoma public employers, covering Part A hospital deductible, Part B co-insurance, Part B excess charges, with no networks or referrals required.

Quantifiable outcome

• Rate increases historically 50% below national trends (e.g., 4.5% vs 9.0% national in 2025-26)
• +5 more outcomes

Named customers2 records

Segments3 records

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature2 records

Partnerships

Ten partnerships are on record, tiered core.

• McElroy & AssociatescoreImplementation/ SI/ Consulting Partner · 1 January 1996Plan administrator since 1996, responsible for day-to-day operations including eligibility, group invoicing, customer service, vendor contract negotiation, financial controls, and regulatory compliance. Administration office is contracted to McElroy & Associates due to public trust structure.
• BlueCross BlueShield of OklahomacoreTechnology or IntegrationMedical network provider using BlueAdvantage network. Provides claims administration, provider network access, and member services for medical benefits.
• Express Scripts (ESI)coreTechnology or IntegrationPharmacy benefit manager providing prescription drug coverage, formulary management, mail order pharmacy, and specialty pharmacy services.
• MDLIVEcoreTechnology or IntegrationVirtual care provider offering $0 office visit co-pays for primary care, pediatric care, behavioral health services including psychiatry and counseling through mobile app or web interface.
• Green ImagingcoreTechnology or IntegrationDiagnostic imaging solution providing free MRI, CT, PET, X-Ray, and Ultrasound scans at 235 Oklahoma network locations plus thousands nationwide.
• Catapult HealthcoreTechnology or IntegrationVirtual checkup program providing home-kit health screenings with $250 deductible reduction for completion. Includes blood pressure, cholesterol, A1C testing and live video consultations.
• ConnectDMEcoreTechnology or IntegrationMedical equipment and supplies vendor providing over 4,500 items including braces, CPAP, insulin pumps, wheelchairs at zero cost with free shipping and in-home setup.
• Hinge HealthcoreTechnology or IntegrationMuscle and joint pain program providing exercise therapy, behavioral therapy, and education. Includes pelvic floor pain program. 71% report reduced pain, 67% avoided surgery.
• MetLifecoreTechnology or IntegrationGroup life insurance provider offering $20,000 to $50,000 coverage options with accidental death and dismemberment benefits.
• VSP (Vision Service Plan)coreTechnology or IntegrationVision coverage provider using Signature network, offering eye exams, lenses, frames, contacts, and laser vision surgery discounts.

Scale indicators5 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• CalPERS Health Benefits: Largest public purchaser of employee health benefits in the US, administering HMO, PPO, and EPO plans for California public employees and retirees. Comparable in scale and public-employer focus, though operating at much larger scope.
• Blue Cross Blue Shield of Oklahoma: Dominant commercial health insurer in Oklahoma providing medical network, claims administration, and direct group products. Functions as OPEH&W's network partner but also competes for the same Oklahoma employer group business.

Emerging players

• HealthSCOPE Benefits: TPA focused on self-funded employer health plans, including public sector and mid-market employer groups. Comparable in administering self-funded/group health benefits though operating in a different ownership model than OPEH&W's public trust.

Others

• Mercer (Marsh McLennan): Global benefits consulting and administration firm advising public-sector employers on health plan design, vendor selection, and procurement. Relevant as a peer/competitor for benefits advisory work in the Oklahoma public sector.
• National Insurance Crime Bureau - Oklahoma Trust Pool alternatives: Wider ecosystem of public employer risk pools and MEWAs that compete for Oklahoma local government benefits business. Indirect peer representing the alternative structures OPEH&W competes against for member employer groups.

Direct peers

• PEHP (Public Employees Health Program): Utah's non-profit public employee health plan offering medical, dental, vision, and life benefits to state and local public employers. Highly comparable to OPEH&W as a public-sector health trust with multi-tier plan design and below-market pricing strategy.
• BeneSys: Third-party administrator specializing in Taft-Hartley and public-sector multi-employer health and welfare funds. Comparable to OPEH&W in administering pooled health/welfare benefits for a collectively governed employer base.
• Oklahoma Schools Insurance Group (OSIG): Oklahoma-based public trust providing property, casualty, and health benefits to school districts and public employers statewide. Closest geographic and structural peer to OPEH&W given shared Oklahoma public-trust model and overlapping employer base.
• TRS-ActiveCare: Texas public school employee health plan administered via BCBS networks with multiple plan tiers and statewide purchasing scale. Direct peer to OPEH&W in offering tiered group health benefits to a defined public-sector vertical.

Regional players

• Oklahoma Public Employees Retirement System (OPERS): Oklahoma state government pension and benefits system for state employees. Adjacent to OPEH&W as another Oklahoma public-sector benefits vehicle, though serving state-level rather than county/local employees.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

Revenue estimate

Valuation estimate

Number of profiles

Profiles7 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 OPEH