Sacramento, Calif. – September 23, 2026 -- HealthSherpa is expanding its multi-year partnership with AmeriHealth Caritas to include Marketplace Operations, its enrollment, premium billing and reconciliation platform for individual and family health plans sold on and off the Health Insurance Marketplace.
AmeriHealth Caritas will use the platform to reconcile enrollments and collect premiums
Under the expanded deal, AmeriHealth Caritas will process and reconcile enrollments directly with the Health Insurance Marketplace, collect subsidy and member premiums, and resolve data discrepancies before they affect member bills or coverage status.
Partnership moves beyond shopping and enrollment into daily operational management
The two companies previously worked together on enrollment and agent distribution for AmeriHealth Caritas' Marketplace plans. The new scope adds back-end functions -- accurate premium collection, correct enrollment processing and up-to-date coverage records -- to that existing relationship.
Executives cite operational capacity needs amid Marketplace business growth
Loretta Lenko, President, Exchange at AmeriHealth Caritas, said the insurer needs added operational capacity to sustain service levels as its Health Insurance Marketplace business grows, and that expanding the HealthSherpa relationship into enrollment operations, billing and reconciliation supports that expansion.
Mary DeFilippo, Vice President of Marketplace Operations at HealthSherpa, said the product was built on years of experience in the Health Insurance Marketplace and is designed to address the complexities of the individual and family market.
Deal frees AmeriHealth Caritas resources for network strategy and claims work
HealthSherpa said extending its role across the full operational lifecycle strengthens the back-end functions supporting AmeriHealth Caritas' Marketplace business, giving the insurer additional capacity to focus on network strategy, claims processing and quality-of-care initiatives.
AmeriHealth Caritas operates in 13 states and the District of Columbia, serving Medicaid, Medicare, CHIP and Health Insurance Marketplace members. HealthSherpa has enrolled more than 25 million people in ACA coverage since its founding in 2013.