mcmi
Maryland Health Connection is the state of Maryland's official ACA health insurance marketplace, operated by the Maryland Health Benefit Exchange since 2013. It serves Maryland residents by enabling enrollment in private qualified health plans, Medicaid, MCHP, dental coverage, and SHOP small business plans.
- Company typePrivate
- Founded2013
- HeadquartersBaltimore, United States
- Headcount101–250
- GTM typeB2C
- OfferingDigital Commerce or Content
What mcmi does
Maryland Health Connection is the State of Maryland's official health insurance marketplace, established in 2013 under the Affordable Care Act and operated by the Maryland Health Benefit Exchange (MHBE), a state government agency headquartered in Baltimore. The platform serves Maryland residents seeking health coverage, enabling unified eligibility determination and enrollment across private qualified health plans (QHPs) offered by participating carriers (CareFirst BlueCross BlueShield, Kaiser Permanente, United Healthcare, Wellpoint), Medicaid and the Maryland Children's Health Program (MCHP), dental and vision plans (Delta Dental, Dominion National), and the SHOP small-business program. Its core technology is a government-operated exchange platform that integrates electronically with federal agencies (HHS, CMS, SSA, IRS, DHS, DoD, VHA) and state agencies (MDH, MIA, State Board of Elections, state-designated HIE) for real-time income, citizenship, immigration, and death-registry verification; this integration footprint is paired with a consumer-facing website, the Enroll MHC mobile app (launched 2021), a multilingual call center supporting 200+ languages, and a statewide field network of hundreds of certified brokers, navigators, and connectors delivering free enrollment assistance.
The business model is non-standard for a commercial technology company. As a state-based exchange, Maryland Health Connection generates operating revenue primarily through assessments on participating health insurance carriers rather than consumer charges; all enrollment assistance, broker services, and consumer support are provided free to consumers. Financial assistance delivered through the platform includes federal Advance Premium Tax Credits (APTC), Cost Sharing Reductions (CSR) on Silver plans, and a state-funded Maryland Premium Assistance subsidy available to residents earning up to 400% of the federal poverty level. Average customer savings on monthly premiums are reported at $388 per month. The platform operates AI-assisted automation for consumer identity verification, phone call transcription, and general inquiry handling, with explicit PII safeguards.
The entity's scope is strictly intra-Maryland and is scheduled to undergo a material policy reset in 2026: enhanced federal premium tax credits are set to expire, new Medicaid eligibility rules take effect in January and October 2026, and Maryland Premium Assistance will end for new enrollees on April 1, 2026 — collectively compressing the affordability stack for subsidized QHP enrollees. There is no parent company, no private equity or venture capital involvement, no subsidiaries, and no external funding rounds; the entity operates as a self-sustaining government agency under state oversight.
mcmi firmographics
Firmographics- Name
- mcmi
- Legal name
- Maryland Health Benefit Exchange
- Website
- https://marylandhealthconnection.gov
- Company type
- Private
- Founded year
- 2013
- Operating status
- Operating
- Headcount range
- 101–250 employees
- Short description
- Maryland Health Connection is the state of Maryland's official ACA health insurance marketplace, operated by the Maryland Health Benefit Exchange since 2013. It serves Maryland residents by enabling enrollment in private qualified health plans, Medicaid, MCHP, dental coverage, and SHOP small business plans.
- Ownership category
- akta.pro rank
mcmi industry classification
Industry- Product category
- Health Insurance Marketplace
- NAICS
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)
- SIC
- Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage) (BPAIAKAH)
- akta.pro secondary industry
- Patient Financial Engagement (Estimates, Billing Presentment, Payments) (HLACAEAI)
Keywords
Where mcmi is headquartered
LocationHeadquarters
- HQ city
- Baltimore
- HQ country
- United States
- HQ region
- North America
Offices3 records
Markets served
mcmi business model
Business model- GTM type
- B2C
- Offering type
- Digital Commerce or Content
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- Insurance Carrier Assessments and Fees: Maryland Health Connection, operated by the Maryland Health Benefit Exchange, generates revenue through assessments on health insurance carriers participating in the marketplace. As a state-based exchange, MHBE operates as a self-sustaining entity through fees assessed on issuers rather than direct consumer charges.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Financial Assistance — Advanced Premium Tax Credits (APTC) |
| Subscription | Monthly | Cost Sharing Reductions (CSR) |
| Subscription | Monthly | Maryland Premium Assistance (State Subsidy) |
| Unit Pricing | Monthly | Value Plans — Diabetes Care Coverage |
| Freemium | Monthly | Free Consumer Assistance Services |
Go-to-market motion4 records
Distribution channels5 records
Marketing channels8 records
mcmi product offering
Product offeringCore offering
Maryland Health Connection is a state-operated health insurance marketplace that enables Maryland residents and small businesses to compare, shop for, and enroll in ACA-certified private health and dental plans, Medicaid, and the Maryland Children's Health Program (MCHP). The platform centralizes eligibility determination for federal Advance Premium Tax Credits (APTC), Cost Sharing Reductions (CSR), and the state-funded Maryland Premium Assistance subsidy, integrating in real time with federal and state data systems to verify identity, income, and citizenship. Free enrollment assistance is delivered through a statewide network of certified brokers, navigators, and connectors, supported by a multilingual call center and the Enroll MHC mobile app.
Product overview
Maryland Health Connection is Maryland's state health insurance marketplace operating under the Maryland Health Benefit Exchange. The platform offers a unified ecosystem of health coverage products including private health insurance plans (Bronze, Silver, Gold, Platinum, Catastrophic, and Value tiers) from multiple carriers (CareFirst, Kaiser Permanente, United Healthcare, Wellpoint), Medicaid enrollment, Maryland Children's Health Program (MCHP), and Small Business SHOP plans. The core offering includes enrollment assistance, financial help tools (APTC, CSR, state premium assistance), and a mobile app (Enroll MHC). The platform connects with federal agencies (HHS, CMS, SSA, IRS, DHS), state agencies (MDH, Medicaid, CHIP), and the State Board of Elections for voter registration. The platform employs AI for consumer identity verification, phone call transcription, and general inquiry handling.
Differentiator
Problem solved
Functional benefit
Brands
- SHOP: Small Business Health Options Program - allows small businesses to compare and purchase health insurance plans for employees
- Maryland Children's Health Program (MCHP)
- Maryland Premium Assistance
- Special Enrollment
- Easy Enrollment
Products and services
- Private Health Insurance Plans ACA-certified Qualified Health Plans (Bronze, Silver, Gold, Platinum, and Catastrophic tiers) offered through Maryland's marketplace from carriers including CareFirst BlueCross BlueShield, Kaiser Permanente, United Healthcare, and Wellpoint. Plans cover at least 60% of annual medical costs and meet ACA essential health benefit standards. Targeted at Maryland residents without employer-sponsored coverage.
- Medicaid Enrollment
Quantifiable outcome
- Average customer savings of $388/month on monthly premiums for those purchasing private health insurance through the marketplace.
- +2 more outcomes
Companies that use mcmi
Customer profileNamed customers7 records
Segments5 records
Ideal customer profiles3 records
mcmi technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration8 records
AI capability3 records
Feature3 records
mcmi partnerships and signals
Strategic signalPartnerships
Twelve partnerships are on record, tiered core and supporting.
- CareFirst BlueCross BlueShieldcoreParticipating insurance carrier offering private health plans (HMO, PPO, and other plan types) through the Maryland Health Connection marketplace. CareFirst is one of the primary insurance carriers listed on the MHC website alongside other carriers.
- Kaiser PermanentecoreParticipating insurance carrier offering private health plans through the Maryland Health Connection marketplace. Kaiser Permanente provides integrated healthcare coverage and is prominently featured as a carrier option on MHC.
- United HealthcarecoreParticipating insurance carrier offering private health plans through the Maryland Health Connection marketplace.
- WellpointcoreParticipating insurance carrier (formerly part of Anthem) offering private health plans through the Maryland Health Connection marketplace.
- Delta DentalsupportingParticipating dental insurance carrier available through Maryland Health Connection for standalone dental plan coverage, serving consumers who purchase dental coverage separately from their health plan.
- Dominion NationalsupportingParticipating dental insurance carrier available through Maryland Health Connection for standalone dental plan coverage.
- U.S. Department of Health and Human Services (HHS)coreFederal agency providing regulatory oversight, data sharing, and system integration for eligibility determination and enrollment. MHC operates under HHS/CMS authority and receives federal tax information from IRS through HHS channels.
- Centers for Medicare and Medicaid Services (CMS)coreFederal agency overseeing state-based exchanges, Medicaid, and CHIP programs. CMS provides system interoperability, data sharing agreements, and regulatory guidance for MHC operations.
- Social Security Administration (SSA)coreFederal agency providing data for income and citizenship verification to support eligibility determinations for marketplace plans and insurance affordability programs.
- Internal Revenue Service (IRS)coreFederal agency providing federal tax information (FTI) for eligibility verification and Advance Premium Tax Credit reconciliation. IRS Safeguard Review processes govern FTI handling by MHC.
- Maryland Department of Health (MDH)coreState agency partner for Medicaid administration, health policy coordination, and the Healthy Babies Program. MDH works with MHC on eligibility and enrollment for Medicaid and Maryland Children's Health Program.
- State-Designated Health Information Exchange (HIE)supportingState HIE provides limited Protected Health Information (PHI) for individuals who consent to MHC determining their eligibility and facilitating Medicaid enrollment.
Scale indicators5 records
Recent moves6 records
Expansion highlights6 records
mcmi competitors and assessment
Company assessmentDirect peers
- Covered California: California's state-based health insurance marketplace established under the ACA. Operates the largest state-based exchange in the U.S. with comparable eligibility determination, QHP/Medicaid enrollment, carrier assessment funding, and subsidy administration functions.
- NY State of Health: New York's official health plan marketplace operating under the ACA. Comparable in offering combined QHP, Medicaid, and Child Health Plus enrollment with state-specific subsidy programs and a community navigator network.
- Massachusetts Health Connector: Massachusetts' state-based health insurance marketplace—the original model that pre-dated and inspired the ACA. Operates comparable QHP, Medicaid, and ConnectorCare subsidy programs with similar carrier assessment funding and navigator distribution.
- Washington Healthplanfinder: Washington state's ACA marketplace. Operates comparable eligibility and enrollment functions for QHPs and Apple Health (Medicaid), with similar technology platform structure and in-person assister network.
- Pennie: Pennsylvania's state-based health insurance marketplace. Provides comparable ACA marketplace services including QHP enrollment, APTC/CSR administration, and Medicaid referral with carrier assessment funding.
- Access Health CT: Connecticut's state-based health insurance marketplace. Operates comparable ACA marketplace functions with QHP enrollment, Medicaid (HUSKY Health) integration, and state-funded subsidy programs.
- MNsure: Minnesota's state-based health insurance marketplace. Comparable in offering combined QHP and MinnesotaCare/Medicaid enrollment with broker-navigator distribution and state subsidy administration.
- Be Well Louisiana: Louisiana's state-based health insurance marketplace operated under the ACA. Provides comparable QHP enrollment and Medicaid integration functions with a similar carrier-funded operating model.
Broad incumbents
- HealthCare.gov: The federally-facilitated marketplace used by states that did not establish their own exchange. Serves a comparable consumer need (QHP enrollment, APTC) but is operated by CMS at national scale rather than by a single state agency, making it a broader incumbent rather than direct geographic competitor.
Emerging players
- eHealth: Private online health insurance marketplace and brokerage that competes for individual and Medicare plan enrollment nationally. Adjacent in providing consumer-facing QHP comparison and enrollment, but lacks MHC's regulatory monopoly, government subsidy administration, and Medicaid integration.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
mcmi social profiles
Digital presencemcmi financial estimates
Financial estimateRevenue estimate
Valuation estimate
mcmi leadership team
Management profileNumber of profiles
mcmi funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
mcmi M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about mcmi
What does mcmi do?
Maryland Health Connection is a state-operated health insurance marketplace that enables Maryland residents and small businesses to compare, shop for, and enroll in ACA-certified private health and dental plans, Medicaid, and the Maryland Children's Health Program (MCHP). The platform centralizes eligibility determination for federal Advance Premium Tax Credits (APTC), Cost Sharing Reductions (CSR), and the state-funded Maryland Premium Assistance subsidy, integrating in real time with federal and state data systems to verify identity, income, and citizenship. Free enrollment assistance is delivered through a statewide network of certified brokers, navigators, and connectors, supported by a multilingual call center and the Enroll MHC mobile app.
Is mcmi a public or private company?
mcmi is a private company. It is classified as state government owned and is currently operating.
When was mcmi founded?
mcmi was founded in 2013. It employs 101 to 250 people.
Where is mcmi based?
mcmi is headquartered in Baltimore, United States, in the North America region.
How does mcmi make money?
One revenue line is on record: insurance Carrier Assessments and Fees.
Who are mcmi's main competitors?
Direct peers on record are Covered California, NY State of Health, Massachusetts Health Connector, Washington Healthplanfinder, Pennie, Access Health CT, MNsure and Be Well Louisiana. HealthCare.gov is listed as a broad incumbent. eHealth is listed as an emerging player.
Does mcmi have an API?
No public API is recorded for mcmi.
What industry is mcmi in?
mcmi's product category is Health Insurance Marketplace. Its primary akta.pro industry code is BPAIAKAH, Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage), with a secondary code of HLACAEAI, Patient Financial Engagement (Estimates, Billing Presentment, Payments). Its NAICS code is 524292 and its SIC code is 6324.