Third Party Administrators, or TPAs as we're known in the industry, offer administrative and consulting services to health plan sponsors. A health plan sponsor may be an insurance company, a self-funded employer group, a union-negotiated program offered through a Taft-Hartley arrangement, or an association of employers.

Health Plans, Inc. is one of the few TPAs in the United States that provides services to all of these markets and, as such, we are positioned to meet unique challenges and opportunities.

Why do some Firms Self-Fund Their Employee Benefits?

Because they can realize substantial savings compared to Blue Cross and other insurance companies. They've found they can effectively reduce their healthcare costs by as much as twenty cents on the dollar-without diluting benefits.

Compared to traditional indemnity insurance or Blue Cross plans, a self-funded benefit plan reduces or eliminates expensive state-mandated benefits, insurance company profits and premium taxes. In addition to the cost savings, self-funding offers an employer improved cash flow, flexibility in benefit design and greater access to claim cost information.

Health Plans, Inc. also provides services to the growing market of American small businesses. Small businesses represent the fastest growing segment in the American economy; 70% of all new jobs created last year were in firms employing less than 100 people.

All in all, Health Plans, Inc. focuses on developing products that fit a special need and successfully balances the requisites or demands of the marketplace with the skills required for smooth administration and claim processing.

TPA services include:

Claim processing

With the recent implementation of our multimillion dollar claim management enhancement, accurate and rapid claim processing is assured.

Fund or premium accounting

Health Plans, Inc. employs an experienced staff of premium accounting specialists that are committed to providing smooth, personalized administration.

Provider utilization management

Our sophisticated electronic system detects and controls utilization by effectively screening provider billing practices. In turn, our clients realize significant savings.

Risk related services, such as excess-loss and reinsurance services

By arranging for appropriate excess-loss and reinsurance coverage, Health Plans, Inc. can help employers that self-fund their employee benefits effectively reduce their healthcare costs.