Pinnacle Excellence
See how Pinnacle turns thoughtful strategy, precise execution, and dedicated service into a health plan that works better from every angle.
Benefits don’t work better by accident.
Pinnacle Health Solutions is an independently owned health benefits company for self-funded employers. We bring the essential parts of a health plan together under one accountable partner, making the plan easier for employers to manage and easier for members to use.
Excellence at Pinnacle is practical. It means clear ownership, careful execution, and a team that stays responsive long after the plan launches. Our flexible model gives clients the choice of a fully integrated Pinnacle advocacy solution or the freedom to keep the partners and programs that already work for them.
People before policies. Relationships that last. Care in every detail.
Performance that reflects our standards
Since 1996, we’ve helped employers simplify complex benefits to support healthier workforces. Every number reflects the trust we’ve earned over three decades.
Providing TPA services
Members
Client retention
Average account management tenure
Claims financial accuracy
Services built for more control and less complexity
From day-to-day administration to long-term strategy, we connect the moving parts of benefits into one coordinated experience for employers and members.
Health plan administration
One partner. Every benefit. From enrollment to COBRA and everything in between, we handle the details, adapt to your needs, and keep your health plans working for your employees.
Pharmacy benefits management
A clearer, more clinically informed approach to pharmacy benefits, powered by OrionRx.
Care management
We don’t wait for health issues to show up in claims. Our wellness programs connect members with support early, helping employers build a healthier workforce.
Integrated solutions
“Custom” shouldn’t mean complicated. We design and run coordinated plans with clear ownership, timelines, and ongoing support, so employers can manage them easily and members aren’t left guessing.
Legal & compliance
Our in-house legal & compliance experts reduce risk and remove guesswork. We manage ERISA, ACA reporting, and plan documentation so employers stay compliant and plans stay on track.
Employer & member experience
We act as an extension of your HR team, helping members navigate plans, resolve issues quickly, and get the support they need to make the best use of their benefits.
Analytics & insights
We turn plan data into clear, usable insights through always-on reporting, custom analytics, and predictive tools, so employers and benefits consultants can move faster and act with confidence.
Excellence across the plan experience
Pinnacle Excellence brings the full plan experience into focus. Every stage is supported by clear ownership, thoughtful coordination, and consistent follow-through, from implementation through ongoing service.
Strong execution starts with connected teams
Our specialists work as one team, so clients do not have to coordinate us. From implementation and claims to member support and renewal planning, the right people stay connected and accountable.
A confident start
We turn approved plan decisions into a smooth launch. A dedicated coordinator keeps the work organized, confirms integrations, and helps everyone stay aligned through go-live.
Strong performance over time
After go-live, we keep the plan running accurately and look for practical ways to improve performance. Our operational, clinical, and analytics teams work together to address costs, care needs, and emerging trends.
A better experience for everyone
Benefits create value when people can understand and use them. We connect service, advocacy, digital tools, and partner support around the member while giving employers a clearer view of the plan.
Flexible integration with trusted partners
Pinnacle works with national, regional, and alternative networks, plus a broad range of stop-loss, HRIS, eligibility, pharmacy, clinical, advocacy, and reporting partners. Bring the relationships that already work. Tap into ours where they add value. We’ll make the pieces connect.
OrionRx
Pharmacy is one of the biggest cost and member-experience levers in a health plan. With OrionRx, consultants can bring clients a pharmacy strategy that connects more closely to administration, reporting, clinical support, and member service.
What that means for clients
- Pharmacy and medical benefits can be coordinated under one roof
- Integrated plan administration can reduce data gaps and handoffs
- Dedicated pharmacy teams provide clinical support and guidance
- Real-time pharmacy insights help support smarter plan decisions
- Employers receive responsive plan management and proactive service
One clear view for every audience
Benefits information should be easy to reach, wherever and whenever it is needed. Our secure, mobile-first portals give members, employers, and benefits consultants quick access to the information that keeps care and plan decisions moving.
Why partner with Pinnacle?
Partnering with us means having the freedom to build the right plan and the confidence that it will be carried through with care. We stay focused on your goals, accountable for the details, and committed to making the experience work better over time.
Independence with purpose
We answer to clients—not an insurance carrier, private equity timeline, or required vendor stack. That gives us room to make thoughtful choices around each plan.
Experience that guides action
Thirty years in self-funding has taught us where details matter, where plans get stuck, and how to keep good ideas moving from strategy to reality.
Service built around people
Technology should make service easier, not harder to find. Our teams stay accessible, accountable, and ready to help solve what comes next.
Contact Us
Have questions about self-funding, customizing your healthcare packages or administration benefits, or need additional support? We’re all ears.
Customer service (for immediate help)
6501 Irvine Center Dr
Suite 100
Irvine CA 92618
Health Management
Provider Contracting
For benefits consultant, reach our sales team directly using our Benefit Consultant contact form.
Request an RFP to find out how we can support your growth and deliver excellence for your clients.
How can we help you?
Our team will respond as soon as possible, typically within 1 business day.
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