Healia
Healia · Other
Healia is an employer health benefit built on the Total Care Option, an HRA that pays up to 100% of a family's out-of-pocket costs, plus an AI health plan comparison tool.
About Healia
What Is Healia
Healia is an AI benefits platform for dual-income households. Its main product, the Total Care Option, is a health reimbursement arrangement: an employer-funded account that pays families back for medical costs instead of, or alongside, a standard group plan. The company is based in Columbus, Ohio, and was founded by Priyang Shah.
The problem it targets is specific. When both spouses get coverage through work, the household has two plans and no clean way to compare them. Most comparison tools price one person's usage. Healia's AI decision support tool reads both plans and puts real household costs side by side, which usually takes under two minutes.
The limits matter too. Healia sells to employers and brokers, so an individual can't sign up on their own. It works in the US, and it only helps households where a spouse already has access to a health plan. Reimbursement also means paying a bill first and getting money back later, so families need enough cash flow to float a copay for a few weeks.
Getting Started
- The employer adds the Total Care Option to its benefits menu and sets the reimbursement allowance for enrolled households.
- Employees enroll in their spouse's plan during open enrollment, with no coordination needed between the two employers.
- The family opens Healia, enters both plans, and runs the health plan comparison tool to confirm the switch makes financial sense.
- When a medical bill arrives, the employee submits a claim in the app in under a minute and attaches the receipt.
- Healia reviews the claim and sends payment straight to the family's bank account, usually within 48 hours.
Product Information
A quick look at Healia's pricing, supported platforms, and performance.
Best for
The users, tasks, and scenarios where this tool fits best.
Users
- HR and benefits leaders at mid-size employers
- Dual-income families
- Brokers and benefits consultants
Tasks
- Comparing two employer plans for a household
- Covering costs a spouse's plan leaves behind
- Getting medical bills paid back
- Modeling a benefits change before open enrollment
Scenarios
- Open enrollment season
- A year of premium increases
- Recruiting in a tight market
Key features
AI Health Plan Comparison
The decision support tool takes details from both spouses' plans and returns a household view of what each one really costs. It accounts for premiums, deductibles, and typical out-of-pocket spending rather than listing features side by side. Healia says an analysis takes under two minutes, which is short enough to run during an enrollment conversation.
Total Care Option HRA
The Total Care Option is the funding mechanism. An employer sets aside a reimbursement allowance, and Healia pays it out against the family's actual medical costs on the spouse's plan. Coverage can reach 100% of out-of-pocket expenses, and the allowance is fixed per household, so a bad claims year doesn't blow up the budget.
One Minute Claims
Employees file a claim from the app and attach the receipt. Payment goes to a bank account rather than a mailed check. Healia reports that about 95% of claims are handled within 48 hours, which matters for families who are floating a deductible payment in the meantime.
Employer Cost Reporting
The employer side shows what each enrolled household costs and what the same household would have cost on the group plan. That's the number finance teams ask for, and it's the basis for Healia's own claims of up to 76% lower employer costs per household.
Enrollment and Education Support
Switching to a spouse's plan is a strange idea for most employees, so the rollout leans on education. Healia's team runs sessions for HR staff and employees, and in some cases visits worksites. Skip that step and utilization drops, which is the usual failure mode for reimbursement benefits.
Pros and cons
Pros
- Covers costs a family would otherwise absorb, including copays, coinsurance, deductibles, and premiums on the spouse's plan.
- The AI health plan comparison tool answers the household question directly instead of pricing one person's usage.
- Claims reimbursement is fast by the standards of the category, with most claims handled inside 48 hours.
- Costs on the employer side are predictable, because the allowance is set per household rather than driven by claims volume.
Cons
- Employees can't buy it directly. If your company doesn't offer it, there's nothing to sign up for.
- It only fits households where a spouse has access to a plan, so single employees and families with one coverage option are out.
- Reimbursement means paying first. A family without spare cash still feels the deductible before the money comes back.
- There's no public API, so payroll and benefits platforms can't pull reimbursement data automatically.
Frequently asked questions
An employer-funded health reimbursement arrangement called the Total Care Option, plus the software that runs plan comparison and claims. The employer pays; the family gets reimbursed.
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