Bold Benefits was formed to create meaningful change in the way health benefits are bought and managed by designing curated health plans that reflect the culture and needs of a population and leveraging data-driven people-centered engagement to deliver healthcare as it should be.
Revolutionizing the TPA Industry:
The TPA Acquisition & Transformation
We're committed to bringing innovation and excellence to the TPA industry. Our acquisition and transformation plan will change the game in a sector of healthcare that has sat stagnant for over 45 years.
Vision
To revolutionize the healthcare industry by offering a first-of-its-kind open source and vendor-agnostic TPA platform that paves the way for affordable, high-quality healthcare to empower employers, healthcare consultants, and providers. We strive to break traditional boundaries and create a unified, efficient, and cost-effective system for building and administering self-insured health plans. We provide innovative healthcare solutions tailored to meet the needs of our clients and make healthcare local again.
Raising $1.25M - $5M for the acquisition and transformation of a 45 y/o TPA serving self-insured employers .
Private Funding $5M - $5.25M
Use of Funds
$4.5M - $5M purchase
$500k - $750k in reserve
SBA Funding
Private Funding injection needed in the amount of $1.25M
Use of Funds
$450k - $500k down
$700k - 750k in cash reserves
Current State of TPA Industry
The TPA industry is highly fragmented, with many players offering similar one size fits all services. The increasing number of point solutions has provided great value but also introduced additional difficulty to navigate, leading to a lack of adoption and a missed opportunity to provide value and savings. Lack of standardization, outdated technology, and rising healthcare costs are key challenges.
Complex
TPA services are complicated and intentionally not transparent. Rising healthcare costs lead to higher prices for TPA services.
Fragmented
Point solutions and vendor integrations create siloed processes, breaks in communication, and a negative experience for employers, employees, brokers, and providers.
Outdated
Old technology systems are frustrating and inefficient for all stakeholders. Most haven't updated their technology in over 25 years. Reactive solutions cost money and lives.
Market Opportunity
The $600 billion self-insured market being ignored by service providers at their own peril
Healthcare is Local
Many clients are dissatisfied with current TPA offerings and seek a more innovative and personalized approach. One size fits all doesn't work in healthcare.
By being open-source and vendor-agnostic, the TPA platform ensures that healthcare can once again be locally focused, truly meeting the needs of employers, employees, and the communities they serve.
Growing Demand
Employers spend between 20% and 30% of employee salaries on employee benefits that could include healthcare, life insurance, retirement, family care, disability insurance, and more. A recent HFS Research study found that more than 50% of employers have up to 17 line-item benefits, and another 25% plan to expand their employee benefits over the next two years.
Seamless Experience
Point solutions offer significant opportunities for proactive data-driven engagement, offering innovative cost-containment strategies for employers.
However, the current legacy TPAs provide fragmented entry points and disruption in the implementation and adoption of these solutions with employees.
Acquisition Plan
Research and Analysis
Conduct a thorough analysis of identified target TPA
Due Diligence and Negotiation
Perform due diligence and negotiate terms of acquisition.
Onsite diligence is scheduled for May 30th-31st
Funding
Identify & Outreach to Potential Investors
Investor Pitch
Negotiate Terms | Due Diligence
Secure Commitments
Execute Financial Close
Integrate & Optimize
Work closely with the acquired TPA to integrate operations, systems, and processes, leveraging synergies to optimize performance and drive profitability. Establish clear goals and KPIs to measure success post-acquisition.
Rebrand, Launch and Promotion
Rebrand and unveil newly acquired business to clients and promote benefits.
Launch to new brokers and employers
Transformation Plan
We will transform the TPA industry through groundbreaking open-source and vendor-agnostic strategy integrating seamlessly with various healthcare providers, technologies, and platforms, further enhancing our ability to customize solutions for each client and collaborating with all stakeholders to provide transparent pricing, outcome-based care, and patient-centric solutions.
Optimized Processes
Automate claims processing for faster turnaround times guided by business rules
Implement real-time data analytics for more informed decision making
Create user-friendly omni-channel communication and access to information for all stakeholders
Tailored Local Solutions
Vetted Vendors will provide a plan framework for brokers to leverage
Provide customized health plans based on client needs and preferences
Ability for brokers or employer to bring their own vendor or solution to be seamlessly integrated into plan design and member journey
Technology Integration
Open Source - Vendor Agnostic
Upgrade technology systems for better performance and security
Seamless integrated platform effectively addresses the challenges faced by employers when administering their health plans
Streamlined onboarding for new clients and new plans with thorough journey mapping ensuring positive rollout with minimal disruption
People-Centered Service
Enhanced employee experience, reduced healthcare costs, and improved plan performance, all delivered through a user-friendly, integrated platform
Leverage population health analytics, medical management, utilization management, social determinants of health, and specialty vendors to meet people where they are and drive true impact
Transparent pricing, outcome-based care, and patient-centric solutions
Leadership Team
Our leadership team and advisors are a remarkable assembly of seasoned professionals with a wealth of experience in constructing and managing cost-containment health plans. Their expertise ranges from developing innovative technology solutions to spearheading cutting-edge healthcare initiatives. Their shared passion for creating groundbreaking solutions is what drives them to revolutionize the way healthcare is purchased, navigated, and delivered.
This exceptional team is steadfast in its commitment to empowering companies and individuals by designing tailor-made strategies that not only cater to their unique needs but also help them make informed decisions. By harnessing the power of advanced technology and data processing, our leadership team has developed a platform that is truly transforming the employee benefits landscape. This customizable platform allows employers, managers, and healthcare providers to collaborate seamlessly, ensuring personalized care and support for employees across the board.
Through their unwavering dedication and innovative approach, our leadership team is consistently at the forefront of healthcare solutions, pushing the envelope and reshaping the industry as a whole. Their collective vision for a happier and healthier workforce has set the foundation for a new era of healthcare accessibility and affordability, making our platform an indispensable asset for businesses and individuals alike.
Next Steps
Join us on our mission to revolutionize healthcare by investing in the acquisition and transformation of this TPA acquisition. Contact us to learn more about our acquisition and transformation plan and how we can help meet the healthcare needs of employers and employees and deliver health insurance that actually works.
Financials of the acquisition target are available.
