Manipal Education and Medical Group (MEMG) is in advanced stages of a deal to replace TTK group in Cigna TTK Health Insurance, people with direct knowledge of the matter said.

Manipal will be the fourth healthcare group to get into health insurance. Apollo, Max and Religare were among the early promoters of stand-alone health insurance companies. Star Health and Aditya Birla Health are the only companies that do not have a healthcare business among the stand-alone health insurance companies. Manipal has been eyeing a health insurance for a while, and the deal to pick up TTK promoters’ majority stake fits in with stated plans to build an integrated healthcare services portfolio. Manipal Health Enterprises runs a chain of hospitals with about 5,000 beds to be among the top-five in the sector.

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