# Included Health Financial Model

LGBTQ+-focused employee health benefit - vetted provider directory, care navigation, and advocacy support, sold B2B to employers.

- Canonical: https://finamodel.com/startups/included-health
- Excel download: https://finamodel.com/startup-models/included-health.xlsx
- Category: Health-tech
- Model type: SaaS ARR / Valuation
- Funding round: pre-Seed
- Funding: $2.3M
- Founded: 2020
- Geography: United States (national provider directory, members referenced across Northeast, Southwest, South) [DECK, slides 7, 10].
- Customer: B2B2C

## About the company

Included Health is an LGBTQ+-focused employee benefit offering provider discovery, care navigation, and advocacy. It helps employees find appropriate care and navigate health-system decisions through a service tailored to populations that can face barriers in conventional care.

The company is sold directly to employers as a recurring health-benefit service. Revenue depends on employer clients, covered employees, PEPM fees, engagement, and renewals, while actual navigation demand and member experience determine care-delivery capacity and margin.

The model forecasts employer clients, covered employees, PEPM fees, engagement, care-navigation cost, and renewal. It includes member-support staffing, employer acquisition, technology costs, outcomes commitments, gross margin, operating cash flow, cash burn, and runway.

## What's included

- 5-year monthly revenue build with stage-appropriate growth assumptions
- Full P&L, headcount plan, and operating-expense schedule
- Cash-flow statement, runway, and burn-rate tracking
- Valuation via exit multiple with a DCF cross-check
- Returns analysis with MOIC and IRR
- Unit economics including CAC, LTV, payback, and cohort retention

## Product & value proposition

Included Health is a B2B employee benefit platform specifically for LGBTQ+ employees, offering:
- **LGBTQ+-affirming provider directory** - national, in-network, vetted providers (PCP, OB/GYN, Trans Health, Mental Health); 1,500+ providers at time of deck.
- **Care navigation** - Transgender Center of Excellence, specialty provider matching, Rx coverage/affordability support, billing & claims support; members connected to providers within 48 hours.
- **Support system** - Advocates/coaches program, monthly newsletter, ongoing provider education.
- **Empowerment & inclusion support** - workplace coming-out guidance, family planning, mental wellbeing.

Value proposition to employers: soft ROI (talent acquisition/retention, D&I, PR) and hard ROI (healthier workforce, reduced unnecessary healthcare costs, increased productivity).

## Market

- **Problem prevalence:** 40% of LGBTQ+ community had a negative healthcare experience; 40% postponed/avoided care; 45% had difficulty finding a provider; 60% had difficulty finding a therapist or mental health provider; 3–4x higher care avoidance vs. non-LGBTQ+ patients.
- **Demand signal:** 89% of survey respondents would like to use a service like Included Health; ~1,800 survey responses across 6 EHIR (Employer Health Innovation Roundtable) member companies.
- No TAM/SAM/SOM dollar figures provided.

## Revenue model

- **Channel:** B2B - sold directly to employers as an employee health benefit.
- **Pricing:** Not explicitly stated. Model implies a per-employee or per-LGBTQ+-employee PEPM (per-employee-per-month) subscription, consistent with voluntary/supplemental benefit norms. No pricing figures in deck.
- **Early adopter structure:** Wave 1 and Wave 2 cohorts of employer clients, each limited in number (Wave 2: 3 spots) - suggests concierge / founder-led sales at this stage.
- No revenue, contract value, or pricing figures disclosed.

## Traction & metrics

- Services live (no launch date given)
- Wave 2 Early Adopter Enrollment open; Q3 launch; only 3 spots available
- 1,500+ providers in vetted directory
- Proprietary research study: 1,800+ responses across 6 EHIR member companies
- No revenue, paying-customer count, MRR/ARR, or growth rate disclosed.

## Competition / moat

- No explicit competitive landscape slide.
- Implied moat: first-mover positioning ("first comprehensive platform for your LGBTQ+ employees"); proprietary vetted provider directory (1,500+ providers); EHIR research partnership adding credibility and employer distribution.
- Competitive differentiation: LGBTQ+-specific focus vs. general health navigation tools (e.g., Health Advocate, Accolade, Quantum Health).

## Team & funding ask / use of funds

- **Team:** Dr. Burton named as lead/advisor on proprietary medical journal publication. No other team members or bios in deck.

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## Recommended financial model

- **Archetype + why:** B2B SaaS / employee-benefits PEPM model. Revenue is recurring, employer-contracted, and scales with number of covered employees. Closest analogs: Accolade, Quantum Health, Spring Health - all B2B health navigation sold on PEPM basis. A 3-statement model is premature given pre-revenue stage; a driver-based P&L forecast with ARR build is appropriate.

- **Forecast horizon & granularity:** 3–5 years; monthly for Year 1–2 (early adopter ramp critical to model), annual thereafter.

- **Key drivers & assumptions:**

| Driver | Value |
| -- | -- |
| PEPM price per employer employee (all employees covered) | $5–$15/employee/month |
| OR: per-LGBTQ+-employee PEPM (LGBTQ+ ~5–7% of workforce) | $50–$100/LGBTQ+ member/month |
| Average employer size (employees) | 1,000–5,000 |
| Number of employer clients at launch (Wave 1 + Wave 2) | ~6–9 |
| New employer clients per year (Year 2+) | 10–25 |
| Average contract length | 1 year, auto-renew |
| Gross margin | 60–70% |
| Care coordinator cost per active member | $20–$40/member/month |
| Provider directory COGS (vetting, maintenance) | Allocated overhead |
| S&M as % of revenue (early stage) | 30–40% |
| R&D / product | 15–20% of revenue |
| G&A | 15–20% of revenue |
| Churn (employer-level) | 10–15% annually |

- **Scenarios (Base / Bull / Bear - which variables flex):**
  - **Bear:** Slow employer adoption (5 new clients/yr), low PEPM ($5), high care coordinator costs - path to profitability >5 years.
  - **Base:** Moderate ramp (15 new clients/yr), mid PEPM ($10), stable COGS - breakeven Year 3–4.
  - **Bull:** EHIR network effect accelerates sales (30+ clients/yr), higher PEPM or upsell to larger employers, strong retention - profitable Year 3.
  - Flex variables: PEPM price, employer client count, average employer size, care coordinator headcount per member.

- **Required sheets / outputs:**
  1. Assumptions dashboard (all drivers in one place)
  2. Employer ARR build (clients × avg employees × PEPM × utilization rate)
  3. Revenue schedule (MRR/ARR by cohort)
  4. COGS build (care coordinators, directory ops)
  5. P&L (Revenue → Gross Profit → EBITDA)
  6. Headcount plan (care coordinators scale with members; S&M/G&A/R&D)
  7. Cash runway / burn (no funding ask disclosed, but critical for pre-revenue stage)
  8. Scenario toggle (Bear / Base / Bull)

## Frequently asked questions

### Is the Included Health financial model free?

Yes. The Included Health model is a free Excel download with live formulas.

### Can I change the assumptions?

Yes. The workbook is editable and its live formulas recalculate when assumptions change.