Simple pricing: a platform fee plus a per-member-per-month (PMPM) rate. No per-claim fees. No nickel-and-dime add-ons.
For ministries and self-funded groups up to ~2,500 members.
For scaling ministries and self-funded groups, 2,501–10,000 members.
For large groups, TPAs, national carriers, and platforms at 10,000+ members.
Every plan gives you the full platform. Plans differ in capacity, SLAs, and implementation scope.
| Feature | Starter | Growth | Enterprise |
|---|---|---|---|
| Member capacity | Up to 2,500 (500 min) | 2,501–9,999 | 10,000+ (no ceiling) |
| Platform fee | $3,500 / mo | $7,500 / mo | Custom |
| PMPM rate | $5 | $3.25 | <$2 (volume discount) |
| Per-claim fee | $0 | $0 | $0 |
| Monthly minimum | 500 members ($6,000/mo) | 2,501 members ($15,628/mo) | Custom |
| Setup fee (one-time) | $15,000 | $30,000 | Custom scope |
| Enrollment + member portal | ✓ | ✓ | ✓ |
| Claims adjudication | ✓ | ✓ | ✓ |
| Payments | ✓ | ✓ | ✓ |
| Electronic claim intake & remittance (EDI) | — | ✓ | ✓ |
| Auto-adjudication engine | Manual | ✓ | ✓ |
| CRM + marketing suite | Basic | Full | Full |
| Multi-tenant | — | — | ✓ |
| HIPAA compliant infrastructure | ✓ | ✓ | ✓ |
| SOC 2 compliant infrastructure | ✓ | ✓ | ✓ |
| HIPAA BAA | Included | Included | Included |
| SOC 2 Type II report | Included | Included | Included |
| Support | Priority + SLA | Dedicated team + solutions engineer | |
| Custom integrations | — | At cost | Included |
| White-label options | ✓ | ✓ | ✓ |
| Custom uptime SLA | — | — | ✓ |
Per-member-per-month. Instead of charging per claim or per transaction, Claimaro charges a small flat amount per enrolled member each month. It's the standard pricing model in health plan administration and aligns our incentives with keeping your membership healthy.
The platform fee covers fixed infrastructure costs — hosting, security, compliance, support. The PMPM scales with your community. Together they give you a predictable total cost that grows linearly with your book of business.
Setup is a one-time fee that covers org provisioning, plan configuration, branding, data migration, team training, and integration with your existing stack (payment processor, TPA, accounting system). Starter is $15K, Growth is $30K, and Enterprise is custom-quoted — each is a fraction of the $25K–$3M that legacy and mid-market TPA platforms charge.
No. Unlike legacy TPAs, we don't charge per-claim, per-EOB, or per-835. The PMPM includes all claim processing.
Yes — the minimum floor still applies, but many customers start at 200–500 members and grow into the capacity. We'd rather onboard you early and grow together than make you wait until you hit a member count.
Sharing ministries and qualifying non-profits get a discounted PMPM. Talk to us on a demo call for specifics.
Annual contracts are standard, with month-to-month available at a higher rate. Implementation fees are always one-time.
You own your data. We'll export a full data package (members, claims, transactions) in standard formats so you can migrate anywhere. No ransom, no games.
Book a 30-minute call. We'll size the right plan for where you are today — and map out how pricing scales as you grow.