Why We’re Looking At This
Gallagher serves employers across hundreds of health plans, dental carriers, vision networks, and ancillary benefit programs. Today, connecting to each carrier individually would require building and maintaining hundreds of point-to-point integrations — a cost and complexity model that doesn’t scale. It was identified that what we need is an intermediary layer: a set of APIs that sit between Gallagher and the carrier ecosystem, normalising data so we can deliver a single, coherent benefit experience to members. Think of it as the Plaid equivalent for health benefits — a connectivity layer that abstracts away the chaos underneath.
What We Found
The market has split into two distinct camps. On one side: API-native companies like Flexpa, Ideon, and Noyo that were built from the ground up as developer-friendly data rails — clean REST APIs, FHIR-based data models, modern OAuth consent flows. On the other: legacy network operators like Optum (Change Healthcare) that process enormous transaction volumes through decades-old EDI pipelines, now layering APIs on top.
The Plaid-equivalent layer hypothesised actually exists — but it’s not a single product from a single vendor. The capability is distributed across multiple specialists, each owning a different slice of the data stack. No one vendor covers claims and plan design and enrollment execution. The architecture that emerges is composable: pick the best rail for each layer and connect them through a proprietary orchestration layer that Gallagher owns.
Recommended Stack
Four layers, each with a lead vendor and a clear responsibility boundary. The layers are intentionally independent — if any single vendor underperforms or gets acquired, the others remain unaffected.
| Layer | Vendor | Role |
|---|---|---|
| Layer A |
Flexpa
|
Member data ingestion & consent. Connects to
payer systems via FHIR Patient Access APIs with member-directed OAuth consent.
Retrieves claims history, EOBs, coverage details, and provider data. This is the pipe
that answers “what has this member actually used and spent?”
|
| Layer B |
Ideon
|
Plan design intelligence. Machine-readable plan data across
medical, dental, and vision — deductibles, copays, coinsurance, formulary tiers, network
configurations. Powers the comparison logic: “here’s what Plan A covers vs Plan B
for your usage pattern.”
|
| Layer C |
Noyo
|
Enrollment execution. When a member accepts a recommendation,
Noyo handles the enrollment change — translating API calls into carrier-accepted
834 transactions. Covers adds, terms, plan changes, and dependent updates with real-time
confirmation.
|
| Layer D |
Arcadia
|
Population analytics & longitudinal modelling. Aggregates
data across the member population for trend analysis, risk stratification, and employer-level
reporting. Helps answer “across all 5,000 members in this group, where are the
biggest savings opportunities?”
|
What This Means For Gallagher
This architecture gives us a path to the mid-market digital engagement solution without building carrier connectivity from scratch. Instead of spending 18–24 months and significant engineering resources on payer integrations, we plug into existing rails and focus our build effort on the recommendation logic and member experience — the parts that create defensible value.
Concretely, this means we could reach a first proof-of-concept with a single employer group in roughly 3–4 months: Flexpa for claims data, Ideon for plan design, and a lightweight recommendation engine on top. Enrollment execution (Noyo) and population analytics (Arcadia) layer in during Phase 2 once the core recommendation loop is proven.
The composable approach also protects us strategically. We’re not locked into any single vendor. If Flexpa gets acquired or Ideon changes pricing, we swap that layer without rebuilding the whole stack. This is the same principle behind the API-first architectures that have worked well in fintech — own the experience layer, rent the plumbing.
What We Don’t Know Yet
This research is based on public documentation, developer docs, regulatory filings, and published case studies. Several material questions remain open and will require direct vendor engagement to resolve.
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Pricing at Gallagher scale. Most vendors don’t publish PMPM rates. Flexpa, Ideon, and Noyo all require sales conversations for enterprise pricing. We need actual quotes based on our member volume to validate the $2.4M–$4.2M Year 1 estimate in the detailed reports.
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Production onboarding timelines. Sandbox access and first-data timelines are documented, but production deployment with real carrier connections is less clear. Flexpa’s FHIR connections depend on payer implementation quality, which varies.
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Broker-of-record data access. Can Gallagher’s broker status unlock employer-level data feeds without individual member consent for each connection? This affects whether the data flow is push (employer-authorised) or pull (member-directed), which has major UX and adoption implications.
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Multi-line aggregation. No single vendor has demonstrated medical + dental + vision + pharmacy data flowing through one normalised pipeline in production. The composable stack assumes this is solvable, but it hasn’t been proven at our scale.
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Optum’s strategic posture. Optum (Change Healthcare) has the deepest payer connectivity but carries significant baggage — DOJ antitrust scrutiny, the 192.7M record breach, and structural conflicts as a UHC subsidiary serving all-carrier clients. Whether to include them at all requires a risk-appetite conversation.
Recommended Next Steps
Three concrete actions to move from research to validation. Each is designed to de-risk the architecture before committing budget.
Full Reports
The research behind this summary lives in four detailed reports. Round 1 maps the full landscape; Round 2 pressure-tests the shortlisted vendors against our specific use case.
Additionally, the initial benefits vendor landscape survey (covering wellness, mental health, and financial wellbeing platforms) is available as a separate reference: