Nearly half of insured Americans skip care they need because they can’t afford it, even though their employer is spending an average of $27,000 per family on health coverage each year. That stat alone says something has gone badly wrong with how employer health benefits actually work. Nara Health is betting that the problem isn’t the insurance itself, it’s the administration layer built around it.

The Chicago-based company has raised $14 million across a pre-seed and seed round led by Khosla Ventures, with participation from Long Journey Ventures and Superior Studios. The funding follows what the company describes as $600 million in processed claims and more than 25,000 members now on its health plans.

What Nara Health actually does

Nara Health is a third-party administrator, the kind of company that sits between employers and the healthcare system, handling claims processing, benefits administration, and member support. But the standard TPA model is largely manual, fragmented, and slow. Prior authorizations take three to five days. Members sit on hold. Claims data arrives 60 or more days after the fact, long after anyone can act on it.

Nara’s pitch is to replace that model with an AI-native platform that brings benefits administration, claims processing, care navigation, and member support into one system. The company also pairs that platform with alternative plan designs, including direct provider contracts, reference-based pricing, cash pay arrangements, and direct primary care, approaches that can reduce employer healthcare spending by 15% or more while giving employees clearer pricing.

The operational numbers Nara cites are worth noting. Member calls are answered in an average of five seconds. Prior authorizations are turned around the same day. One employer customer, Advanced Medical Pricing Solutions, reported a 55% reduction in benefits costs year-over-year after switching from a level-funded plan to self-insurance with Nara as its TPA.

The data advantage Nara is building on

Most TPAs work from claims data that reflects what happened weeks or months ago. Nara’s platform synthesizes near-real-time signals across medical claims, prescription data, electronic medical records, and member interactions from calls, texts, and emails. The goal is to flag care needs and coordinate responses before they become expensive downstream problems.

CEO Sidhartha Sinha, who has a background spanning hospital design, care delivery, and AI products for health systems and insurers, describes the core problem as coverage limiting care rather than enabling it. His co-founding perspective is clinical as well as technical, and that combination is part of what attracted Khosla Ventures to the deal.

“Sid and his team have the clinical chops to know exactly where those dollars are getting wasted, and the technical depth to actually rebuild the systems that decide how they’re spent,” said Samir Kaul, Founding Partner and Managing Director at Khosla Ventures. “That combination is rare.”

Why this matters for the employer benefits market

Self-funded and level-funded employer health plans have become increasingly common as companies look for more control over their benefits spending. But choosing a self-funded model without the right administrative infrastructure often means exchanging one set of problems for another. The TPA market has historically struggled to keep up with the technology expectations employers and employees have developed in other areas of their lives.

Nara’s approach targets a few specific pain points:

• Same-day claims adjudication rather than multi-week processing cycles
• Near-real-time data synthesis across clinical, pharmacy, and member communication channels
• Alternative plan design expertise built into the platform, not bolted on separately
• Member support infrastructure that actually answers when someone calls

So the question isn’t whether employers want lower costs and better member experience. They clearly do. The harder question is whether an AI-native TPA can maintain that performance as it scales beyond 25,000 members. The $14 million raise will go some way toward answering it.

More information is available at narabenefits.com.