From Personal Struggles to Industry Change: The Story of Healia

How Did Healia Begin?

Healia was founded in 2022 by Priyang Shah, a seasoned professional with a decade of experience in healthcare, insurance, and software development. Before starting Healia, Priyang played crucial roles in scaling two major companies: Root Insurance and Olive AI. His journey into founding Healia began with a personal experience of choosing the wrong health insurance plan, despite his extensive background in the field. This experience revealed the complexities and shortcomings of existing tools designed to help employees navigate health insurance options.

Priyang identified a significant gap in the market: dual-income families often struggled with choosing the most cost-effective health insurance plan. Traditional tools were either too complex, too simplistic, or too time-consuming. Determined to find a solution, Priyang and his team developed a tool that simplified the process, allowing employees to compare their employer's plan with their spouse's plan easily. This tool became the foundation for Healia's broader mission.

What Problem Does Healia Solve?

The core problem Healia addresses is the financial burden of health insurance on dual-income families and their employers. In the United States, there are approximately 41 million dual-income families, all facing the dilemma of choosing between their employer's plan and their spouse's plan. Regardless of their choice, these families often end up paying high premium contributions and out-of-pocket costs.

Employers, on the other hand, face a similar challenge. If employees enroll in the company's health insurance plan, the employer incurs substantial costs, averaging $17,000 per year per family. If employees opt out of the company's plan, they miss out on a significant employee benefit, which can negatively impact recruitment and retention efforts. Healia's solution is to allow employers to pay for the out-of-pocket costs and premiums for any employee who enrolls in their spouse's plan. This approach saves employers around $10,000 per enrollee and provides a valuable perk for employees: 100% coverage of a family's health costs.

How Does Healia's Solution Work?

Healia's solution is designed to be simple and efficient, operating through three main steps:

1. Account Creation: Healia sets up individual accounts for enrollees, funded by employers for eligible expenses, typically ranging from $6,000 to $10,000.
2. Enrollment: Employees enroll in their spouse's health insurance plan and access the funds to cover healthcare costs.
3. Unused Funds: Any unused funds revert to the employer, ensuring that expenses remain capped while employees benefit from additional coverage.

This process eliminates the need for complicated coordination between employers. Employees simply opt out of their employer's plan and join their spouse's plan, with Healia handling all reimbursements for eligible expenses.

What Makes Healia's Technology Stand Out?

Healia's technology is a key differentiator. The company developed a tool that allows employees to compare the costs and benefits of their employer's plan with their spouse's plan. By uploading a PDF of the spouse's benefits guide, Healia's technology, powered by a large language model (LLM), processes the data and provides a comprehensive comparison. This feature has proven so valuable that companies like GoFundMe, Stew Leonard’s, and Sectigo have adopted it to educate their employees on choosing the best health insurance plan.

The technology's appeal lies in its ability to provide a clear, side-by-side comparison of health insurance options, helping families make informed decisions. This capability not only simplifies the process for employees but also empowers them with the knowledge to choose the most cost-effective plan.

What Has Healia Achieved So Far?

Since its inception, Healia has made significant strides. The company has launched with 14 customers across 11 states, achieving an annual recurring revenue (ARR) of $206,000. This success spans a diverse range of industries, including traditional sectors like manufacturing, food and beverage, and retail. Initially, Healia expected interest primarily from white-collar companies, but the broader appeal demonstrates the universal need for cost-effective health insurance solutions.

Healia's ability to lower healthcare costs and make health insurance more affordable has resonated with businesses across various geographies and industries. This traction underscores the effectiveness of Healia's approach and its potential for widespread adoption.

How Did the Founders Meet and Decide to Start Healia?

Priyang Shah's personal experience with navigating health insurance complexities led to the creation of Healia. Despite his extensive background in the field, he found himself struggling to choose the right plan, highlighting the inadequacies of existing tools. This frustration spurred him to develop a better solution, one that could be implemented quickly and easily.

As Priyang's tool gained traction, he recognized a critical need: most families are dual-income, and existing solutions were insufficient. He realized that a more comprehensive approach was necessary, one that addressed the unique challenges faced by dual-income families. This insight led to the integration of an LLM to analyze spouse's plans, making it easier for employees to compare options and choose the best plan for their needs.

What Is Healia's Long-Term Vision?

Healia's long-term vision is ambitious and transformative. The company aims to create its own health insurance plan specifically designed for dual-income families. This plan would travel with employees as they move between jobs, ensuring continuous coverage regardless of employment changes. Under this vision, every employer would offer the Healia plan, eliminating the need to navigate new plan rules or deductibles with each job change.

This approach would also make health insurance significantly cheaper for employers, as they would only pay for half the costs, with the other half covered by the spouse's employer. Additionally, Healia's size and technology would enable it to negotiate better rates from providers and further reduce costs.

What Impact Could Healia Have on the World?

If Healia succeeds in its vision, it could revolutionize the health insurance landscape for dual-income families. By creating a portable, comprehensive insurance plan, Healia would eliminate the complexities and financial burdens associated with changing jobs and navigating multiple health insurance plans. Families would benefit from consistent, 100% coverage, and employers would see reduced costs and improved recruitment and retention.

Moreover, Healia's technology-driven approach could set a new standard for transparency and efficiency in the health insurance industry. By empowering employees with the tools to make informed decisions, Healia is not only addressing immediate financial challenges but also fostering a more educated and proactive approach to healthcare.

How Is Healia Positioned for the Future?

Healia's unique solution and innovative technology position it well for future growth. The company's early success in diverse industries and geographies demonstrates the broad applicability and demand for its approach. As Healia continues to expand, it will likely attract more customers and partners, further validating its model.

The potential to create a dedicated health insurance plan for dual-income families represents a significant opportunity for Healia. By addressing a critical need in the market and leveraging its technology and expertise, Healia is poised to become a major player in the health insurance industry, driving positive change for both families and employers.

Conclusion

Healia is a start-up with a clear mission: to make health insurance more affordable and accessible for dual-income families. Founded by Priyang Shah, the company offers a unique solution that allows employers to cover out-of-pocket costs for employees enrolled in their spouse's plan. This approach saves money for employers and provides a valuable perk for employees.

With its innovative technology, Healia simplifies the process of comparing health insurance options, empowering families to make informed decisions. The company's early success and ambitious long-term vision position it for significant growth and impact in the health insurance industry. If Healia achieves its goals, it could revolutionize the way health insurance is provided and experienced by dual-income families, making healthcare more affordable and accessible for millions.