Third Party Adminsitrators

[Guest paulwla]

How do you find out about their speed, accuracy and reputation? Anyone with bad or good experiences please respond.

[Joe Priselac]

What kind of TPA are you looking for? Are you looking for some one to administer a self-insured medical/dental plan or flexible spending accounts, COBRA or a total outsourcing of benefits administration? These are very different services and require different capabilities. Once you focus on what you need you look at the capabilities that the respective candidates claim to have. Ask for a list and interview current customers.Having said all that there is always the unexpected that can happen to change the anticipated quality of service such as the departure of key personnel or a sale of the TPA. We have helped clients to "shop" for TPA services and have had both good and bad experiences. Like with everything else in life, buyer beware.

[Guest paulwla]

For medical, COBRA, dental, vision, FSAs, the whole enchilada. Your advice to interview customers is the only answer so far. I wish there was a consumer's report. My broker recommends 5 0r 6, but I'd like to know which TPAs have the best reputations.

[Guest Patricia Ibbs]

OUr clients are mostly health TPAs and there is a great variance in expertise among them. I would ask questions about establishing trusts for medical plans, where they obtain their language for new regulations, stop-loss coverage, 5500 reports, etc. The point is, some of these firms know only how to adjudicate claims and write checks, but don't know good business practices, ERISA requirements, HIPAA compliance and the like. Ask the difficult questions, not just about claims turnover. Find out who their legal consultant is, who their medical consultant is, who is in charge of compliance. Do they know the cafeteria requirements so they can help you in that direction? What claims manual do they use and how often is it updated? Who furnishes their UCR screens? Hope some of this will help.

[Guest Jerry99]

When our coalition went shopping for a TPA we set up a committee that was made up of corporate benefit managers and HR managers who, day in and day out, worked with TPA's.

They assessed each TPA who submitted bids to our RFP on the basis of costs, performance

guarentees and their willingness to be subject to financial penalties if standards are not met, systems, staff expertise, turnover rate of staff, 24 hour administrator

capabilities (medical & work comp.), on-site

reviews of their facility, references (both from current clients and from the last 5 clients who no longer use their services)and various other criteria.

Jerry Custer

Heartland Healthcare Coalition