Centivo

What is Centivo?

Centivo is a primary-care-centered health plan administrator for self-funded employers, sold through benefits brokers and consultants. Centivo serves employers with 50 or more employees across select U.S. markets, helping them reduce healthcare costs for their organization and workforce.

Who is Centivo designed for?

Centivo is built for self-funded employers who want better healthcare outcomes at lower cost – and for the benefits advisors who serve them. We work best with mid-market and large employers (50 or more employees) who are ready to move beyond the fully-insured status quo and want a health plan that actually works for their whole workforce.

Where does Centivo operate?

Centivo is available in California, Colorado, Connecticut, Florida, Iowa, Kansas, Missouri, New Jersey, New York, North Carolina, Pennsylvania, Texas, Washington and Wisconsin. Contact us to confirm availability in your specific market.

How does Centivo save employers money?

Centivo employers typically save ~15-30% compared to traditional fully-insured plans. Savings come from three sources: a primary-care-first model that reduces unnecessary specialist visits, imaging, and ER use; the cost advantages of self-funding, where employers pay for actual claims rather than a fixed premium built around risk margins; and lower unit costs we negotiate directly through our health system partnerships. Employees save too – $0 primary care and low-cost generics mean the plan actually works for your workforce, not just your finance team.

Is Centivo a self-funded plan?

Yes. Centivo operates as a self-funded health plan, which means employers pay for actual healthcare costs rather than a fixed premium. Stop-loss insurance protects against catastrophic claims, making self-funding accessible even for mid-market employers. Centivo handles plan administration, network, and care coordination.

How does the primary care model work?

Every Centivo member selects a primary care physician (PCP) who becomes their care coordinator. That PCP manages referrals, follows up after specialist visits, and ensures nothing falls through the cracks. This model reduces fragmented, expensive care and keeps members healthier – which directly lowers employer costs over time.

How do I get started with Centivo?

Start by contacting our team through the form on this page. We’ll connect you with a regional representative who can walk through whether Centivo is the right fit, provide a savings estimate, and explain implementation. Most employers work through their existing broker or consultant – Centivo works directly with your advisor team.

I'm a Centivo member - where do I go for support?

To reach Member Care, you can log into your Centivo account and contact them directly, or call the Member Care number on the back of your ID card. For plan questions, finding a doctor, or accessing your benefits, visit our member resources page.