Guides to choosing a health plan TPA
What a third party administrator does, how health plans are funded and priced, and what to ask before you sign. When you are ready, search 134 TPAs by state, services and plan type.
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What is a TPA in health insurance?
What a third party administrator does for a health plan, who uses one, and how it differs from an insurance carrier.
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Self-funded health plans and the TPA's role
What self-funding is, how common it is by firm size, how it differs from fully insured coverage, and what a TPA does for a self-funded plan.
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Level-funded health plans: who administers them
How level-funded plans work, how common they are at small firms, who administers them, and the contract terms to check before you sign.
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Reference-based pricing and the TPAs that offer it
How reference-based pricing works in a self-funded plan, what it means for members, and what to ask a TPA that offers it.
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TPA vs ASO: two ways to run a self-funded plan
How a carrier's administrative services only (ASO) contract compares with an independent TPA for running a self-funded health plan.
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What a TPA costs: fees and how they are quoted
The fees a health plan TPA charges, which ones are quoted separately, how percentage-of-savings fees work, and what federal disclosure rules require.
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How to choose a TPA: questions to ask
A selection process for plan sponsors, the questions to put in a TPA RFP, the contract terms to negotiate and the red flags to watch for.
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Switching TPAs without disrupting claims
A practical guide to changing TPAs: timing, the current contract, data transfer, stop-loss run-in and run-out, member notices and a checklist.