We are self-insured for employee medical coverage. We contract with a TPA to process claims and with a reinsurer for specific and aggregate stop-loss coverage. We are looking to switch TPAs. However, our contact years for the TPA and reinsurer are different. I've been advised that switching TPAs in the middle of the reinsurance contract cycle is a nightmare. Has anyone faced this situation? If so, can you offer any experiences or advice to someone who's considering it?

First contact the reinsurer, preferably the underwriter that handled your group, and ask them if the TPA you are switching to is approved by them or if they will approve the change. Then make sure the TPA you are changing from will provide you with the deductibles and out-of-pocket maximums in a timely manner so you can have a smooth transition from a claims processing stand point.