Spine

Companies, especially startups and mid-market teams, currently rely on commission-driven brokers or PEOs to handle health benefits, compliance, and people operations. Brokers sell one-size-fits-all plans driven by commission incentives and respond on business hours with manual compliance reminders, while PEOs require co-employment lock-in, generic support pools, and forced HRIS and payroll stacks. As these companies scale past early headcount, premiums spike at renewal and HR teams end up fielding constant benefits questions, filing deadlines, and onboarding paperwork themselves. The page frames this as wasted time and unnecessary healthcare spend that could otherwise be optimized.

Spine positions itself as a 3-in-1 replacement covering benefits, compliance, and people ops through one team, working on top of a company's existing HRIS and payroll (Rippling, Deel, Gusto, ADP). Its AI analyzes workforce data to recommend right-sized plans across 200+ carriers and plan types (fully insured, level-funded, self-funded, ICHRA, QSEHRA, 401k, dental/vision, HSA/FSA), paired with a dedicated human consultant. Employees get 24/7 concierge support via the Heal app for claims, provider search, and medical bill negotiation. On compliance, Spine monitors 10,000+ jurisdictions for ACA, ERISA, COBRA, Form 5500, multi-state tax, and hiring filings, and handles notice resolution for IRS/DOL/state correspondence. For people ops, Spine runs payroll cycles, onboarding (I-9, E-Verify), offboarding, and day-to-day HR records, delivered through tools like Slack. The service is described as free to employers, with Spine paid by carriers similar to a traditional broker, and it also runs a partner network called The People Layer connecting clients to 50+ vetted fractional HR practitioners.