CHRISTUS HEALTH PLAN

What CHRISTUS HEALTH PLAN does

CHRISTUS Health Plan is a private health insurance subsidiary of CHRISTUS Health, a Catholic health system with origins in the 1870s when the Sisters of Charity of the Incarnate Word and the Sisters of the Holy Family of Nazareth established healing ministries in Texas. Headquartered at 5101 N. O'Connor Blvd in Irving, Texas, the plan operates four core insurance lines: Individual and Family Plans (ACA Exchange metal tiers) in Texas and Louisiana; Medicare Advantage plans (Part C) including the CHRISTUS Health Medicare Guardian HMO sub-brand in New Mexico and Northeast Texas; the US Family Health Plan, a TRICARE Prime option serving active-duty dependents, retirees, and military families in defined service areas; and Employer Sponsored Health Plans, including the CHRISTUS Elite Group Health Plan. Distribution combines direct-to-consumer enrollment through christushealthplan.org and dedicated phone lines per product, Medicare.gov marketplace enrollment, broker portal access, and direct employer group sales.

The technology stack is anchored on CMS-mandated interoperability rather than proprietary innovation. The Patient Access API, operated by HealthTrio, conforms to CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button) and DaVinci Payer Data Exchange (PDex) US Drug Formulary Implementation Guide specifications; the Provider Directory API, operated by HealthSparq, conforms to DaVinci PDEX Plan-Net, with token-based authentication and 15-minute token expiration. Clinical decision support is sourced from MCG care guidelines for medical necessity assessment, with member-facing access via determination letters and MCG codes. Ancillary services include Delta Dental for Employer and Medicare Advantage members, Dentegra discounted dental for USFHP, and VytlOne mail-order pharmacy for USFHP. There are no disclosed AI/ML capabilities, proprietary models, or patents in the source material.

The business model is subscription-recurring revenue from monthly premiums across all four product lines, supplemented by per-member-per-month capitated payments from CMS (Medicare Advantage) and the Department of Defense (TRICARE/USFHP). Revenue, membership, and headcount beyond a small administrative core (listed at 1-10) are not publicly disclosed. Pricing varies by plan, geography, metal tier, and demographics, with no public rate sheets. Accreditation stack includes AAAHC Health Plan Accreditation, HIPAA compliance, 2024 Press Ganey HX Pinnacle of Excellence Award, 2025 AMA Joy in Medicine (Silver), 2025 Forbes America's Best Employers by State, Magnet nursing designation, and 2026 Great Place to Work certification. Ownership remains within the parent CHRISTUS Health system with no venture capital or private equity backing indicated.

Name

CHRISTUS HEALTH PLAN

Legal name

CHRISTUS Health Plan

Website

https://christushealthplan.org

Company type

Private

Founded year

1870

Operating status

Operating

Headcount range

1–10 employees

Short description

CHRISTUS Health Plan is a private, Texas-based health insurance subsidiary of CHRISTUS Health, offering Individual & Family, Medicare Advantage, US Family Health Plan (TRICARE), and Employer Sponsored Plans across Texas, Louisiana, and New Mexico.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Direct Life, Health, and Medical Insurance Carriers (52411)

SIC

Hospital & Medical Service Plans (6324), Services-Health Services (8000)

akta.pro primary industry

MA Provider-Sponsored/Payvider MA Plans (HLAEACAJ)

akta.pro secondary industries

MA HMO Plans (HLAEACAA), Group HMO Plans (FSAIAFAK), MA Prescription Drug Plans (MA-PD) (HLAEACAF)

Keywords

• Health insurance plans
• Medicare Advantage plans
• TRICARE coverage
• ACA marketplace plans
• Employer group health plans

Headquarters

HQ city

Irving

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

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

Revenue model

1. Health Insurance Premiums: Monthly, quarterly, or annual premium payments from enrolled members across Individual & Family Plans, Medicare Advantage plans, US Family Health Plan (TRICARE), and Employer Sponsored plans. Premiums vary by plan level, coverage type, and member demographics.
2. Government Program Payments: Revenue from Medicare (Part C Medicare Advantage) and TRICARE (US Family Health Plan) government healthcare programs based on per-member-per-month (PMPM) capitated payments from CMS and DoD.

Pricing tiers

Go-to-market motion3 records

Distribution channels6 records

Marketing channels8 records

Core offering

CHRISTUS Health Plan is a regional health insurance company that sells Individual and Family ACA marketplace plans, Medicare Advantage plans (including CHRISTUS Health Medicare Guardian HMO), the US Family Health Plan (a TRICARE Prime option for active-duty families, retirees, and dependents), and Employer Sponsored group health plans (including CHRISTUS Elite). Coverage is delivered through contracted provider networks in Texas, Louisiana, and New Mexico with supporting pharmacy, dental, and clinical decision-support services.

Product overview

CHRISTUS Health Plan is a health insurance provider offering a portfolio of health insurance products across Texas, Louisiana, and New Mexico. The company provides four core insurance products: Individual and Family Plans (ACA Exchange plans), Medicare Advantage (including Medicare Guardian HMO sub-brand), US Family Health Plan (TRICARE Prime option for military families), and Employer Sponsored Health Plans (including CHRISTUS Elite Group Health Plan). Additional services include pharmacy benefits through VytlOne for USFHP members, dental coverage through Delta Dental and Dentegra, and clinical decision support via MCG Care Guidelines. All plans are supported by a contracted provider network and FHIR-based interoperability APIs for member data access and provider directory information.

Differentiator

Problem solved

Functional benefit

Brands

• CHRISTUS Elite: Group Employer Health Plan coverage option
• CHRISTUS Health Medicare Guardian
• CHRISTUS Health Medicare Complete & Plus

Products and services

• Individual and Family Plans ACA marketplace health insurance plans for individuals and families in Texas and Louisiana, offered in tiered metal levels (Bronze, Silver, Gold, Platinum) with monthly billing and access to income-based tax credits and cost-sharing reductions.
• Medicare Advantage Plans Medicare Part C plans for seniors and Medicare-eligible individuals, often including integrated Part D drug coverage and supplemental dental and vision benefits; sold through direct enrollment and Medicare.gov.
• CHRISTUS Health Medicare Guardian (HMO) Medicare Advantage HMO sub-brand available in New Mexico and Northeast Texas, offering supplemental benefits including dental coverage through Delta Dental.
• US Family Health Plan (USFHP) TRICARE Prime option providing health coverage for active-duty dependents, military retirees, and their families residing in defined service areas, delivered through a dedicated USFHP provider network.
• Employer Sponsored Health Plans Group health insurance plans sold to employers for their employees, including the CHRISTUS Elite Group Health Plan in Texas, providing cost-saving health care solutions for organizations.
• USFHP Pharmacy (VytlOne) Prescription mail order pharmacy service for US Family Health Plan members providing home delivery of medications.
• Provider Network Contracted network of providers, pharmacies, and ancillary services across Texas, Louisiana, and New Mexico, with searchable provider directories for each plan type powered by HealthSparq.

Quantifiable outcome

• 2024 Press Ganey HX Pinnacle of Excellence Award winner for leadership in patient experience, employee experience, physician experience, clinical quality performance, consumer experience, and member experience
• +1 more outcomes

Named customers4 records

Segments4 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration6 records

Feature4 records

Partnerships

Eleven partnerships are on record, tiered core and minor.

• Combined ArmscoreStrategic or Co-development Partner · 2 July 2026CHRISTUS Health is collaborating with Combined Arms, a Houston-based nonprofit veteran services organization, on a new monthly food distribution program for military-connected families in Fort Bend County, Texas. The program, launching July 13, 2026, involves six organizations including the Michael E. DeBakey VA Medical Center, providing veterans and military families with essential goods and connections to broader support services, aligning with America250 Semiquincentennial celebration.
• Michael E. DeBakey VA Medical CentercoreStrategic or Co-development Partner · 2 July 2026Partner in Combined Arms food distribution program for military-connected families, collaborating with CHRISTUS Health and other organizations to provide essential goods and connections to broader support services for veterans.
• CHRISTUS Health US Family Health PlancoreStrategic or Co-development Partner · 2 July 2026Part of the Combined Arms food distribution collaborative effort involving six organizations to provide veterans and military families with essential goods and connections to broader support services.
• Family HopeminorStrategic or Co-development Partner · 2 July 2026Partner organization in Combined Arms collaborative food distribution program for military-connected families in Fort Bend County, Texas.
• Parkway FellowshipminorStrategic or Co-development Partner · 2 July 2026Partner organization in Combined Arms collaborative food distribution program for military-connected families.
• MAD for VetsminorStrategic or Co-development Partner · 2 July 2026Partner organization in Combined Arms collaborative food distribution program for military-connected families.
• HealthSparqcoreTechnology or IntegrationCHRISTUS Health Plan contracted with HealthSparq to manage and support the Provider Directory API meeting DaVinci PDEX Plan-Net Implementation Guide specifications, enabling third-party applications to query provider information through FHIR-compliant endpoints.
• HealthTriocoreTechnology or IntegrationCHRISTUS Health Plan contracted with HealthTrio to manage and support the Patient Access API meeting CARIN Consumer Directed Payer Data Exchange and DaVinci Payer Data Exchange specifications mandated by CMS.
• MCGcoreTechnology or IntegrationCHRISTUS Health Plan utilizes MCG care guidelines to assess medical necessity of healthcare requests. MCG provides a member-facing tool to review care guidelines online using determination letters and MCG codes.
• Delta DentalcoreChannel Partner/ Reseller/ DistributorDelta Dental provides dental coverage for 2026 plan year for Employer Sponsored Plans members and Medicare Advantage members of CHRISTUS Health Plan.
• DentegraminorChannel Partner/ Reseller/ DistributorDentegra provides discounted dental services for US Family Health Plan members of CHRISTUS Health Plan.

Scale indicators3 records

Recent moves5 records

Expansion highlights5 records

Regional players

• Community Health Choice: Houston-based, non-profit health plan serving Texas with Marketplace and Medicaid products. Regional peer with comparable community-focus, ACA marketplace emphasis, and Texas-based provider-network orientation.
• Sendero Health Plans: Central Texas ACA marketplace non-profit plan. Regional peer competing in the same Texas ACA exchange market with similar mission-driven, narrow-network, community-based positioning.

Broad incumbents

• UnitedHealthcare (UnitedHealth Group): Largest U.S. health insurer across MA, ACA exchange, employer group, and TRICARE-adjacent products. Direct competitive incumbent in every product line CHRISTUS Health Plan operates and across its three-state footprint.
• Humana: Largest Medicare Advantage-focused national carrier and the dominant MA competitor in CHRISTUS Health Plan's Texas and Louisiana markets. Broad incumbent peer for MA pricing, product design, and Star Ratings comparison.
• Molina Healthcare: Government-program-focused health plan with strong Medicare Advantage and ACA marketplace presence and a track record of acquiring regional health plans. Comparable for ACA risk-pool positioning and MA growth strategy in the same Southern geographies.
• Centene Corporation: Government-program-focused national carrier with large ACA marketplace and MA footprints, including Ambetter (ACA) and Wellcare (MA) brands. Comparable as a cross-program government-program specialist competing head-to-head in ACA and MA.
• Aetna (CVS Health): National MA and individual/employer carrier, owned by CVS Health with integrated pharmacy and care delivery assets. Comparable across MA HMO and employer group lines and a key competitor in Texas and Louisiana markets.
• Blue Cross and Blue Shield of Texas (HCSC): Regional Blue Cross Blue Shield licensee operating across Texas with MA, ACA, and employer group products. Historic incumbent in CHRISTUS Health Plan's largest market and the natural benchmark for IFP/employer group pricing.

Direct peers

• Ascension Health Plan (Ascension Personalized Care): Catholic, multi-state health-system-sponsored plan offering Individual/Family ACA plans across multiple states. Closely comparable as a faith-based, non-profit integrated delivery network (IDN)-sponsored plan serving a similar mid-South/Southwest geography.
• Baylor Scott & White Health Plan: Texas-based, health-system-sponsored health plan offering Individual/Family ACA, Medicare Advantage, and employer group products. Direct comparable as another provider-sponsored payvider operating in the same Texas markets with a similar multi-product model.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

• Facebookfacebook.com/CHRISTUSHealthPlan
• LinkedInlinkedin.com/company/christus-health-plan

Compliance5 records

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 CHRISTUS HEALTH PLAN