Marpai offers a technology‑driven third‑party administration platform that lets small and mid‑size employers transition to self‑funded health plans while cutting claim costs by 40‑60% through AI‑powered pricing and network discount strategies. The solution automates claims processing, compliance, and benefits administration—including medical, dental, vision, pharmacy, and COBRA—and provides an in‑house clinical team, member portal, and analytics tools to improve care quality and reduce expenses.
Funding
Funding not disclosed
Founders
Product
Problem
Employers, especially small businesses, face high costs and administrative complexity when offering self‑funded health plans, while members often experience fragmented care and limited access to high‑quality provider networks.
Solution
Marpai provides a technology‑driven third‑party administration platform that enables employers to transition to self‑funded health plans with lower overall spend. Its AI‑powered analytics identify cost‑saving opportunities such as reference‑based pricing, out‑of‑network repricing, and network discount negotiations, delivering savings of 40‑60% on claims. The platform automates claims processing, compliance, and benefits administration—including medical, dental, vision, and COBRA—while offering a member portal and mobile app for easy access. Integrated clinical management teams deliver chronic‑condition, acute‑care, and utilization management, guiding members to high‑quality providers and closing gaps in care. Employers receive actionable analytics and customizable plan design tools, allowing them to balance cost containment with member experience.
Target Audience
Primary customers are small to mid‑size employers seeking self‑funded health plans, as well as brokers and consultants who design and manage employee benefit programs.
Features
- AI and machine‑learning engine that continuously uncovers claim‑level savings through reference‑based pricing, out‑of‑network repricing, and network discount optimization
- End‑to‑end SMART claims processing with HIPAA‑compliant, real‑time data flow and stop‑loss discount integration
- Comprehensive benefits administration (medical, dental, vision, pharmacy, COBRA) with a single web dashboard and mobile app (myMarpai)
- In‑house clinical management (utilization, chronic and acute care management) that proactively connects high‑risk members to value‑based care programs
- Value‑based care network (Marpai Connect) that enrolls expensive members into clinical programs under value‑based contracts to improve outcomes and reduce costs
- Integrated pharmacy benefit management, captive solutions, and pharmacy cost‑savings programs
- Detailed compliance, analytics, and reporting tools for plan design, cost tracking, and regulatory adherence
- 24/7 top‑rated customer service and provider support portal