A Leading Health Insurance Company Engaged Stax to Assess the Opportunity for a New Business Within Several Target Markets

A Leading Health Insurance Company Engaged Stax to Assess the Opportunity for a New Business Within Several Target Markets

February 11, 2019
February 11, 2019

Share

THE SITUATION

  • The client seeks national expansion, planning to launch a new business, offering self funded plans for small group employers within several target markets.
  • Stax assignment: Determine addressable market size and assess the competitive landscape within the target geographies.

THE ASSIGNMENT

  • We conducted a comprehensive assessment of the target markets, the landscape and channel dynamics, determining current and potential market opportunity.

THE BENEFITS

  • Based on our assessment we were able to provide a market map of the commercial payer landscape in each target market, including: Size, Share and expected shifts in share.
  • Stax was able to provide a comparison and review of offerings and key competitors in the space for prioritization of most attractive markets for growth expansion.

THE FINDING

  • Growing Acceptance of Self-Funding:
  • There is growing awareness and interest in self-funding among smaller employers. More brokers are presenting self-funding as an option to smaller employers—sometimes to firms as small as 5–10 employees.
  • Broker’s Play a Large Role in Employer Benefits Decision-Making:
  • Benefits decision-makers in small-mid sized firms lack familiarity with both the extent and variety of available plan options as well as current regulations and their implications. Therefore, smaller employers tend to rely heavily on brokers to recommend the plans best-suited for them—entrusting them to understand their needs and shop for plans.
  • High Healthcare Costs is a Key Pain Point:
  • Driving down healthcare costs is a key concern for smaller employers as premiums and employer contributions continue to rise at 4%–5% annually over the last 5 years. Greater cost predictability and sustainable financial management are particularly critical for smaller employers in the current healthcare environment.

Read More

Why Embedded Payments are Becoming Critical to SaaS Value Creation
By Palash Misra May 18, 2026
Embedded payments are becoming a major growth engine for SaaS platforms. Palash Misra shares insights from his experience on how the market is evolving. Read more here.
Grant Thornton Stax Provides Sell-side Support to Thibaut on its Acquisition by Quad-C Management​
May 14, 2026
Grant Thornton Stax supported Thibaut, a premier designer and distributor of luxury wallcoverings, fabrics, rugs, and furniture, on its acquisition by Quad-C Management. Read more.
Palash Misra Named Among The Top M&A Consultants and Leaders of 2026
By Palash Misra May 8, 2026
We are excited to announce that Palash Misra has been named among The Consulting Report's "The Top M&A Consultants and Leaders of 2026" list. Read more about the honor here.
Featured by PYMNTS: FinTechs Cut Staff as AI and Margins Redefine Growth
By Palash Misra April 23, 2026
Palash MIsra was interviewed by PYMNTS to share his thoughts on AI's impact on FinTech. See what perspectives Palash shared on current investor priorities.
Tyler Michaels Recognized at 2026 Rising Star Awards
April 23, 2026
Grant Thornton Stax congratulates Tyler Michaels on being recognized at the 2026 Consulting Magazine Rising Star Awards for Software & Technology. Read more here.
Yiwei Jiang Recognized for Thought Leadership in Private Equity
April 21, 2026
We are proud to congratulate Yiwei Jiang on being recognized at the 2026 Consulting Magazine Rising Star Awards in the category of Thought Leadership and Intellectual Capital. Read more.
Show More