Employee benefits are the second largest expense for companies. And there’s no getting around it. To attract and retain talent, you have to offer benefits. But this mandatory expense has become increasingly painful for small companies. Over the last three years, employee benefits costs have increased an average of 5% a year. Cleveland-based insurtech software company TPA Stream led by CEO Jacob Sheridan has a solution. Their claims harvesting platform gives smaller companies the ability to unlock claims data that then can be used to reduce annual benefits costs by as much as 25%. TPA Stream’s value proposition is resonating with the marketplace: their traction in 2021 was strong and 2022 looks to be more of the same. The VisionTech Screening Committee was impressed so we invited Jacob to present at our May virtual pitch events. Here’s a preview.
BP: Tell me about TPA Stream and what unmet need you saw in the market?
JS: About 10 years ago, one of my co-founders, Eric Sukulac, was working for a small company as a software developer. He used his health insurance, and it became somewhat of an administrative nightmare. He had to submit claims to his company’s third-party administrator (TPA) every month, and when he got reimbursed for his medical expenses, the amount was always wrong. Realizing the system was broken, he set out solve it and brought me and Steve Fuhry, now our CTO, on to solve it.
As we dug into it, we identified a much larger issue which is the fact that small businesses (with less than 100 employees) have no access to their medical, dental, and vision claims data. As a result, these companies typically make decisions based on assumptions and end up overpaying for employee benefits. We saw an opportunity to capture and aggregate companies’ claims data and make it available to health insurance brokers and TPAs to better meet the needs of the small group market.
BP: What’s your solution and what are the benefits?
JS: We launched our first product in 2014, a claims harvesting platform that unlocks hard to access claims data for employers. It’s a gamechanger as it allows companies to customize their benefits to their employee population instead of purchasing a high-cost, off-the-shelf benefits package. TPA Stream helps companies save as much as 25% a year on their benefits, savings that can be put toward something else. We have since followed up with a claims and employee enrollment integration and employer invoicing solution. Back to Eric’s original frustration, employers and employees can use the platform for more visibility into their benefits without the old manual processes.
BP: What kind of response have you gotten?
JS: Across the board—insurance brokers, TPAs, employers—people are super excited by what we offer. The uptake by health insurance brokers alone has been incredible. We now support 250 carriers across the United States.
BP: How big is your addressable market?
JS: There are six million small companies in the United States that represent a $18 billion addressable market.
BP: You seem to have a number of competitors. What is your competitive advantage?
JS: We do have competitors, but no one has what we have, the claims harvesting capability and the data it affords. Our ability to integrate with other systems is largely unique as well. We’re building a new product for brokers that will launch in a few weeks that will give us a “triple moat” against competitors.
BP: What is your revenue model?
JS: It’s a straightforward SaaS model. We sell the software platform to TPAs and brokers.
BP: What is your traction to date?
JS: We’re extremely pleased with the traction to date. We now have 40,000 employers representing 1.8 million members on the platform. In 2021, we hired Greg Brady as VP of Sales and Amanda Metes as our Marketing Director, which has been great. We’re better positioned than ever and expect the next six months to be huge.
BP: How do you plan to use the funds you raise?
JS: We have already built out our technology, so these funds will go to building out our team. The top priority is the sales team, followed by development and operations personnel
BP: Why should VisionTech Angels should invest in TPA Stream?
JS: First and foremost is our team. We have put together an awesome group of people who are dedicated to what we’re doing and driving the next wave of growth. Second, our product gives us an unfair advantage. No other company has a claims-harvesting platform like TPA Stream. Finally, the economics. Our operating model is extremely attractive with high gross margins. It’s a compelling combination.
To learn more about TPA Stream, visit their website. VisionTech Angels’ May Pitch Events will be virtual on Thursday, May 26 at Noon ET and at 6 p.m. ET. Pitch events are open to our members and accredited investors interested in joining our group. To register, check your email for an invitation, go to our Events page where you’ll find the RSVP links, or email Ben Pidgeon at bpidgeon@visiontech-partners.com.