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Products / TPAs

HP

Health Plans Inc

Public facts

National TPA

National TPA (HPI) for customized self-funded plans, including level funding and reference-based pricing; acquired MedCost in 2025.

Visit healthplansinc.com

Overview

Health Plans, Inc. (HPI) is a national third-party administrator headquartered in Westborough, Massachusetts. Public pages describe customized self-funded solutions for employers and brokers, analytics-driven cost-driver identification, level funding, and reference-based pricing. HPI reports 96% client retention. On July 23, 2025 it announced the acquisition of MedCost, LLC, a North Carolina TPA and proprietary PPO, expanding Southeast reach. In June 2026 it named Tim O’Brien president.

Why it matters HPI is a long-running national TPA that added MedCost’s Southeast network and TPA book, and it publicly administers both level-funded and RBP designs.

Target buyer
Employers and benefits brokers seeking a national independent TPA, including groups that want level-funded or RBP designs or Southeast MedCost network access.
Pricing model
Not published; custom TPA quote
No PEPM on healthplansinc.com / hpitpa.com. Level-funding and RBP are plan-design strategies, not published price lists.
Availability
National
Research
Last researched 2026-08-23
Public facts category

Key features

  • Custom self-funded plan administration
  • Level-funding strategies
  • Reference-based pricing administration
  • Analytics to identify healthcare cost drivers
  • Consumer-driven health-plan designs (about page)
  • MedCost TPA book and proprietary PPO in NC/SC/VA (2025 acquisition)

Integrations

  • MedCost Network and MedCost Virginia Network (acquired; provider participation described as unchanged at announcement)
  • HPI provider portal at hpitpa.com for transitioned groups

Overview

HPI (Health Plans, Inc.) partners with employers and brokers on self-funded health plans. The public site (healthplansinc.com / hpitpa.com) stresses national reach with local-market focus. The about page says HPI has delivered on self-funding for 40 years and specializes in strategies such as reference-based pricing and consumer-driven plans, using analytics to manage cost drivers.

The homepage states that 96% of HPI clients stick with the company (vendor-reported). Headquarters are identified as Westborough, Massachusetts in the July 23, 2025 MedCost acquisition release.

That release said MedCost, founded in 1983 and formerly owned by Advocate Health, brought a proprietary PPO of about 100,000 contracted providers, 300+ employees, and about 150,000 members in North Carolina, South Carolina, and Virginia. MedCost later said Benefit Services clients would move to HPI’s claims system in phases through 2026 while MedCost network contracts stayed in place.

Key Capabilities

  • Customized self-funded administration for varied group sizes and industries.
  • Level funding as a named funding strategy.
  • Reference-based pricing as a named cost strategy.
  • Analytics and reporting for cost-driver management.
  • Service model described as high-touch (rush reports, complex claims questions).
  • Combined HPI + MedCost administration and Southeast network after the 2025 deal.

Integrations & Ecosystem

The MedCost Network (and MedCost Virginia Network where applicable) is the named network asset from the acquisition. Other national PPOs, PBMs, and stop-loss carriers are not listed as a public catalog on the about/home pages. Provider portal traffic for transitioned groups is directed to hpitpa.com.

Pricing

No public administrative-fee schedule. Level-funded monthly equivalents and RBP reimbursement formulas are not published as list prices.

Notes & Limitations

  • healthplansinc.com and hpitpa.com are the same organization; some about URLs 404’d on the www host.
  • MedCost TPA conversion was described as phased in 2026; a given group may still show MedCost administration during transition.
  • Retention and MedCost provider-count figures are company-stated.
  • Not a carrier; stop-loss is not described as an HPI-underwritten product on the pages reviewed.

Sources

Tags: TPA · self-funded · level-funded · RBP · MedCost