Meritain Health

Public facts

National carrier-affiliated TPA

National third-party administrator (Aetna / CVS Health) for self-funded employer medical, dental, vision, pharmacy, and related benefits.

Visit meritain.com

Overview

Meritain Health is a national TPA that administers self-funded employee benefit plans. The company dates its start to 1983 (as North American Health Plans), became Meritain Health in 2006, joined Aetna in 2011, and became part of the CVS Health family in 2018. Public pages describe traditional self-funding, captives, navigation/advocacy, and alternative plan designs, plus COBRA, dental-only, vision-only, supplemental health, and an OnPoint Solutions portfolio.

Why it matters It is a large national TPA with Aetna/CVS Health ownership, used when employers want self-funding with carrier-scale network and pharmacy access rather than a boutique independent shop.

Target buyer: Employers of various sizes considering self-funded, captive, or alternative medical funding, and the brokers who place those plans.
Pricing model: Not published; ASO / administrative fees quoted with the self-funded package; No PEPM, implementation, or stop-loss list prices appear on meritain.com.
Availability: National
Research: Last researched 2026-08-23; Public facts category

Key features

National TPA for traditional self-funded plans
Captive arrangements with selected captive managers
Navigation and advocacy options
Alternative health-plan designs (vendor-described)
Administration of medical, dental, vision, spending accounts, pharmacy, and COBRA
OnPoint Solutions portfolio of layered offerings
Prior authorization via Availity (announced 2026)

Integrations

Aetna / CVS Health networks and pharmacy (vendor-described nationwide access)
Availity (prior authorization submissions)
Employer-chosen vendors; preferred-vendor integrations also offered

Overview

Meritain Health administers self-funded employee benefits as a national third-party administrator. Public about copy says the business has operated since 1983, adopted the Meritain Health name in 2006, became an Aetna subsidiary in 2011, and joined CVS Health in 2018. The vendor calls itself one of the nation’s largest TPAs and says it has appeared on Business Insurance’s largest-TPA list every year since 2009.

The homepage positions Meritain for businesses of all sizes, from classic self-funded models to custom approaches. The about page reports support for over 2 million members nationwide, a vendor-stated Net Promoter Score of 57, and a 93% average client retention rate. Those metrics are company-reported.

Meritain is not the insurance company paying claims on a fully insured policy. The employer funds claims; Meritain provides administration.

Key Capabilities

Traditional self-funding with flexible benefit design.
Captive arrangements described as a turnkey path between fully insured and self-funded; Meritain says it works with a select group of established captive managers.
Navigation and advocacy solutions aimed at member experience and steerage to cost-effective care.
Alternative health plans described as a newer option to reduce spend and move away from deductible-based designs.
Plan administration for medical, dental, vision, spending accounts, pharmacy, and COBRA.
OnPoint Solutions, introduced in 2024 and later described as bringing offerings under one umbrella.
Dental-only, vision-only, and supplemental health options named on the self-funding page.
Prior authorization submissions through Availity, announced in August 2026.

Integrations & Ecosystem

Meritain is a subsidiary of Aetna and CVS Health and markets nationwide provider access plus a large pharmacy network. Employers may choose their own vendors; the vendor also offers preferred-vendor relationships. A 2026 news item describes Availity as the path for prior-authorization requests. A public roster of every point-solution or PBM partner was not published on the pages reviewed.

Pricing

Administrative fees are not listed on meritain.com. Pricing is quoted as part of a self-funded or captive package. Stop-loss, network access, and point-solution fees are not published as list prices.

Notes & Limitations

Aetna ASO and Meritain are related CVS Health/Aetna brands; which product a group lands on is a placement question, not documented as a public matrix here.
Vendor NPS, retention, and member-count figures are not independently audited in this pass.
Captive-manager names, network IDs, and PEPM bands are not on the public site.
“National” is inferred from nationwide TPA positioning; a state-by-state product matrix was not found.

Sources

Tags: TPA · self-funded · ASO · Aetna · CVS Health · claims administration