Dallas–Fort Worth has earned its reputation as a leader in employer-driven innovation when it comes to healthcare. For years, national brands like Whole Foods and Home Depot have looked to Texas and Dallas/Fort Worth as a model for innovative health plans and strategies for controlling healthcare costs, which we are especially known for with our regions adaptation of custom networks and direct contracts with hospital systems that blend high-quality care with aggressive cost containment.
DFW has long focused on curating selective provider networks that offer premier care at little or no out-of-pocket cost. These strategies, once considered outliers, are now informing the broader direction of the self-funded employer space.
As we move into 2025, we’re seeing a new layer of evolution. The era of unchecked venture capital has cooled, forcing many health tech companies to prove they can do more than just disrupt. They have to deliver. That’s led to a thinning of the herd, but it’s also surfaced a cohort of vendors who’ve matured, stabilized, and now offer scalable, proven solutions. Some have deep roots in the DFW region; others have adapted to meet the high standards that North Texas employers demand.
The result? DFW continues to set the tone for the rest of the state, and often the country, when it comes to blending innovation with practicality. Employers here should take note: the future isn’t just about what’s new, it’s about what’s working. And in DFW, we’ve got both.
Customized Solutions in DFW
Self-insured health coverage continues to dominate in North Texas when it comes to cost control, plan flexibility, and high-impact customization. Employers in DFW are increasingly embracing strategies that give them more influence over their healthcare spend, without compromising on quality or access.
Incentive Networks
DFW has long been home to some of the most forward-thinking employer health plans in the country. National brands with roots here, helped pioneer incentive-based networks that blend top-tier local care with national reach. These plans reward employees who choose high-performing providers by offering the highest quality of care care at little or no cost to the plans’ members while still allowing access to broader networks when needed.
This strategy doesn't just deliver a better experience for employees; it drives real savings. By steering utilization toward preferred providers, employers pay less in claims and can often negotiate lower premiums on their stop-loss coverage. And the best part? What started as a large-employer model is now more accessible than ever. Today, even employers with as few as 25 enrolled employees can implement similar networks through flexible partnerships with progressive third-party administrators.
Combining this kind of high-performance network with a national safety net has emerged as one of the most effective ways to deliver low-cost health plans while reducing employees’ out-of-pocket expenses. For companies willing to go a step further, adding a customized pharmacy solution can accelerate those savings even more.
Direct Primary Care (DPC)
The DFW region is quickly becoming a hub for Direct Primary Care, and not just for small, independent clinics. Multi-location DPC networks are expanding rapidly, making it easier than ever for North Texas employers to adopt this model at scale.
With DPC, everything runs on a flat monthly membership, meaning no claims, no deductibles, and no billing surprises. Employees get unlimited access to primary care at no additional cost than the membership fee, while employers reduce the frequency and severity of higher cost claims hitting their insurance. It’s a win-win model that supports employee wellness and drives financial efficiency.
As more employers carve out primary care from their insurance plans, they’re able to purchase lower-cost stop-loss coverage that only needs to protect against higher-cost specialist, hospital, and pharmacy claims. And thanks to improved technology and availability to aggregate multiple different local and regional DPC practices under a single invoice, it’s easier than ever to offer consistent, high-quality care across a dispersed workforce.
These innovations are giving employers a powerful new playbook for smarter, more sustainable health benefits.
Turn-Key Solutions Gaining Traction in North Texas
Curative
Now in its fourth year of operations, Curative is evolving from a regional newcomer to a credible, statewide contender in the health insurance space. Their expansion into North Texas and other major markets signals a clear investment in long-term sustainability and a welcome flexibility for employers with teams spread across cities.
Curative offers both fully-insured and self-funded platforms, giving larger employers more choice in how they structure their plans. What sets them apart is their focus on member engagement. Their approach to provider and pharmacy steerage is thoughtful and proactive, but they go a step further by rewarding employees who complete their onboarding intake within the first 120 days of the plan year with access to free care options. In short, they understand that driving impact starts with open communication, and they’re putting real value behind that belief.
Sana
Sana brings both innovation and introspection to the table. With Jay Parkinson’s influence (formerly of Sherpaa and Crossover Health) behind the evolution of SanaCare, the company is doubling down on clinical support by building more capabilities in-house and reducing reliance on a long list of third-party vendors. That shift should not only improve the member experience but also create a stronger financial foundation in today’s more disciplined investment environment.
Sana’s pricing remains competitive, especially compared to traditional carriers, and their ability to offer no-cost access to a wide range of care options continues to position them as a strong choice for employers looking to offer a better member experience at a sustainable cost. Plus, they have been able to mature their offering to take away the traditional pain points associated other vendor who also offer hypbrid PPO, Open Network or Reference Based Pricing strategies.
High Plains Health Plan
High Plains Health Plan has been quietly building a reputation as one of the more innovative direct-contract health plans available to North Texas employers, especially for those who want predictable costs and strong member engagement.
Their approach centers on a tiered network model, offering $0 deductibles and copays when employees use their direct-contracted “Tier One” providers. For care outside that network, they offer a national PPO wrap, giving employees nationwide coverage without losing the cost advantages of their local partnerships.
What’s especially appealing for employers: plan designs are flexible, quoting is fast, and eligibility starts at just five enrolled employees. HPHP’s savings story is compelling too, some clients report reductions of 25–75% on major care categories, from surgeries to prescriptions.
Their in-house concierge team helps guide employees to the most cost-effective options, and employers benefit from a model that actively steers members toward value without sacrificing access. For North Texas companies looking to move away from traditional carriers without building a plan from scratch, HPHP offers a ready-made solution that’s earning attention for all the right reasons.
Karias Health
Karias Health is making captive insurance more accessible, and more human, for mid-market employers. Their all-in-one solution combines group captive management, cost containment, and a consumer-first member experience in a single platform that removes the need for multiple vendors.
The centerpiece is the Total Kare Captive, which delivers full fee transparency and returns 100% of surplus back to captive members. Built on the Kore Kare Platform, employees get personalized care navigation tools, point-of-care decision support, and health literacy resources in one clean digital interface.
What sets Karias apart is its mission: to realign incentives, reduce waste, and rebuild trust in healthcare. They’ve wrapped that vision in a broker-friendly model with no fee stacking, disclosed costs, and white-glove support that includes onboarding, client strategy calls, and finalist meeting prep.
For North Texas employers who’ve outgrown fully insured plans but want more than a TPA and network rental, Karias offers a modern, values-driven path to smarter health benefits
Savvos SmartPay
Savvos SmartPay is rethinking how healthcare gets paid for and North Texas employers are starting to take notice. Built around a direct-payment model, SmartPay eliminates traditional claims processing by paying providers instantly at the point of care. That shift not only reduces overall costs but removes the paperwork and billing confusion that frustrates both employers and employees.
Employees receive a digital Savvos payment card and app that makes scheduling and paying for care seamless, often with $0 out-of-pocket costs for everything from routine primary care to advanced imaging and inpatient services. For situations where instant pay isn’t possible, a tiered backup plan kicks in with traditional coverage.
For self-funded employers looking to simplify benefits, eliminate network confusion, and improve member experience without sacrificing access, Savvos offers a modern alternative that aligns cost control with employee satisfaction. Their “health plan that doesn’t feel like a health plan” promise might deliver on that for companies ready to think differently.
Aetna
Aetna might not be the flashiest name on a “what’s hot” list, but in North Texas, they’ve earned their place through smart product design and aggressive pricing. For employers who want the brand-name credibility of Aetna, Blue Cross, Cigna, or UnitedHealthcare, especially when it comes to employee peace of mind, Aetna often wins out.
Their level-funded product for employers with 2 to 100 employees consistently over-delivers, offering benefits that feel more like large group plans. And for employers with 100+ employees, Aetna’s fully-insured options have become increasingly price-competitive over the past couple of years.
In the self-funded space, Aetna has also been strengthening its value proposition. With a strong portfolio of TPAs under the Meritain brand and the ability to rent out their PPO network for customized plan designs, Aetna continues to be a flexible, high-value partner for North Texas employers seeking tailored, forward-thinking solutions.
Justworks
If you’ve spent any time around North Texas over the past few years, chances are you’ve seen Justworks’ name, whether on billboards, digital ads, or event sponsorships. Their visibility is high, and so is their relevance when it comes to PEO-based health insurance options.
Justworks stays in the conversation by offering Aetna-based health plan options that perform surprisingly well in our market. From a pricing perspective, their plans often align closely with what you'd get directly through Aetna. That means the real question becomes: do their HR tech and payroll service fees, roughly $100 per employee, offset the insurance value or enhance it?
For smaller employers looking for streamlined administration and solid benefits, Justworks can be a good fit, especially if the employee population is healthy enough to qualify for their best rates. In those cases, companies not only benefit from favorable upfront pricing, but may also unlock long-term savings through dividends tied to plan performance. For the right fit, this can be a smart way to bundle administrative simplicity with competitive healthcare coverage.
Final Thoughts
North Texas continues to lead the way in innovative, employer-driven healthcare solutions. From flexible self-funded models to high-performing incentive networks and expanding Direct Primary Care options, DFW employers have more tools than ever to control costs while improving employee access and satisfaction.
As market dynamics shift, especially with tighter investment conditions, the true test for vendors will be their ability to adapt, scale, and deliver real value over time. The opportunity is there for companies that choose partners aligned with their goals and willing to evolve with the landscape.
Generous Benefits specializes in helping DFW employers cut through the noise and build smart, sustainable benefit strategies. If you’re ready to explore what’s working and what’s next, we’re here to guide the way!
