Benefits administration software

Running the health plans and health accounts that American employers give their staff

In much of the world, a person's health care comes from the state. In America, it usually comes from the employer. The software that runs that arrangement is an industry of its own, and it has chosen India for much of its engineering.

Take a nurse at the hospital in Ohio from Market Segment 12.1, HR, payroll and workforce management software. Every autumn, the nurse logs in to choose next year's health plan. During the year, the nurse pays a doctor's bill with a special debit card, from an account the salary tops up before tax. That is benefits administration. It covers four things:

Benefits administration covers the autumn enrolment window, tax-advantaged accounts that pay medical bills, continued cover after leaving a job, and the compliance reports the law requires.

The enrolment window

the few weeks each autumn in which employees pick their health plan for the next year.

Tax-advantaged accounts

accounts, filled from salary before tax, from which employees pay medical bills.

Continued cover

keeping health insurance for a while after leaving a job. In America, a law called COBRA requires this.

Compliance reporting

the reports the law requires the employer to file.

The buyers are American employers, and the benefits administrators and health plans that serve them. The largest company in this Market Segment is Alegeus in Bengaluru, which few people outside the American benefits industry have heard of. Its Indian centre has more than half of this Market Segment's job postings.

Every company named here has posted software engineering jobs in India. Famous companies that don't actively hire software engineers in India are left out.

This Market Segment has two sub-segments, and ends with a link to India:

Administering the benefit: running the health plans and the accounts. Most of this Market Segment's weight is here.

Wellbeing: the counselling lines, wellness programmes and perks that employers add on top.

Employer-paid health in India: the Indian version of the same idea, a group health plan bought by the employer and sold as a platform.

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Administering the benefit
Wellbeing
Employer-paid health in India

Administering the benefit

Benefits enrolment and administration, consumer-directed health accounts, COBRA and compliance, benefits brokerage

Back to the nurse from the start of this Market Segment, and the debit card that pays the doctor's bill. Behind that card is an account that the employee controls, filled from salary before tax. The industry calls these consumer-directed health accounts. The two main kinds are the health savings account (HSA) and the flexible spending account (FSA).

The salary tops up the employee's health account before tax, and the debit card that draws on it pays the doctor's bill; Alegeus runs the account and the card under the administrator's own name.

Alegeus

with engineers in Bengaluru, runs the plumbing behind America's consumer-directed health accounts. It runs the accounts, the debit cards that draw on them, and the continued cover after a job ends. It sells all of this white-labelled: the administrators and health plans that buy it put their own name on it. Its Bengaluru centre is its main engineering site. (For its debit card and the payment network behind it, it also appears in Market Segment 17.1, Card networks and payment processing, in Industry Vertical 17, Payments. For the health plans it serves, it also appears in Market Segment 21.6, Health plan claims and care management, in Industry Vertical 21, Insurtech.)

Alight Solutions

with engineers in Delhi and Chennai, is the largest benefits administrator in the United States. It was spun out of Aon. For the largest employers, it runs enrolment, the employee portal and the annual enrolment window. An AI model now answers employees' questions about their cover.

bswift

with engineers in Bengaluru, sells an enrolment platform with decision support: guidance that helps an employee choose between plans. It also handles the compliance reporting that the US health-care law requires.

ThrivePass

with engineers in Delhi, sells the same enrolment and administration to mid-sized employers, with a wellbeing platform attached.

Sequoia

with engineers in Bengaluru, is a benefits broker and adviser to technology companies. It has built its own platform for administration and analytics.

The plan chosen by a model.

Most employees choose their health plan badly. The decision support in bswift's and Alight's products is becoming an AI model. It reads the employee's past medical claims, and recommends a plan. The annual enrolment window, the defining event of this industry, is where the change will be felt first.

Wellbeing

Employee assistance programmes, wellbeing and wellness platforms, perks

Back to the nurse from the start of this Market Segment, after a hard year on the wards. The hospital offers a free, confidential counselling line. The companies in this sub-segment sell what an employer adds beyond the health plan.

Workplace Options

with engineers in Bengaluru, is the largest independent provider of employee assistance programmes: the confidential counselling and support line an employer offers its staff. A case-management system runs underneath.

Two small Bengaluru companies serve Indian employers:

healthi.in

sells a corporate wellness platform, with preventive health check-ups included.

Plum Benefits

presents itself as a benefits and perks platform. It is a different company from Plum, below. (It also appears in Market Segment 13.7, Loyalty and rewards platforms, in Industry Vertical 13, Martech.)

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Employer-paid health in India

Connector to Market Segments 21.4 and 21.6, in Industry Vertical 21, Insurtech

Now picture the same kind of hospital in Hyderabad. In India, an employer does not usually run health accounts for its staff. Instead, it buys a group health insurance plan that covers them all. So the Indian version of benefits software is not an administration platform. It sits inside the insurance itself.

In America the employer runs health accounts that benefits software administers, while in India the employer buys one group health insurance plan and the benefit lives inside it.

Four companies covered mainly in other Market Segments are the Indian answer to the American industry above. Two sell group health plans online:

Plum

with engineers in Bengaluru, sells group health plans to start-ups and mid-sized Indian employers as a platform. Enrolment, claims and doctor consultations are all in one app. It is the largest Indian-founded company in this Market Segment.

Onsurity

with engineers in Bengaluru, sells the same product to small businesses: monthly subscriptions to group cover, for teams of just a handful of people.

Plum and Onsurity are covered mainly in Market Segment 21.4, Insurance aggregators and online brokers (in Industry Vertical 21, Insurtech).

Two run health plans of their own:

Loop

with engineers in Bengaluru, sells group insurance, with its own network of primary-care clinics.

XO Health

sells value-based health plans to employers. A value-based plan is paid for keeping people healthy, not for each treatment given.

Loop and XO Health are covered mainly in Market Segment 21.6, Health plan claims and care management (in Industry Vertical 21, Insurtech).

So the nurse from the start of this Market Segment chooses a plan each autumn, and pays the doctor from a pre-tax account, all through software built largely in India. In India itself, the same need is met in a different way: the employer buys a group insurance plan, and the benefit lives inside it.

Who they hire

Who these companies hire, and for what, is on What HR tech companies hire for.

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