As a TPA, You’re Responsible to More Than Your Brokers and Employers
You’re responsible to their participants. The employees and policyholders that are relying on you to assist them with enrollment and claims reimbursement/substantiation — whether they’re aware of you or not. You’re also responsible to those covered under their benefit plans.
Whether a broker introduced you to an organization, or the organization reached out to you directly for benefits administration, you effectively become an extension of them. You become a reflection of the broker that referred you, and you become a reflection of the employer for whom you’re managing employee benefits.
That’s an important position — one that more than just the organization paying for your services is aware of. And in the busy world that benefits administration often is, it’s one that can be easy to overlook — or worse, let slide. Even if you’re working behind the scenes with minimal interaction aside from automated communications, your work translates into an experience for participants.
Let’s review some TPA best practices to keep your TPA–partner relationships strong and productive.
Make Your Broker the Hero
Many organizations, even those with substantial HR departments, don’t have in-depth knowledge of benefits plans and how to establish them. That’s why they work with brokers — to identify the right employee benefit plans and facilitate the relationship between the employer and plan providers.
But, the broker won’t be heavily involved with the employer apart from quarterly check-ups, customer service calls, and some concierge-type services throughout the year.
That’s where you come in.
As the benefits administration partner, you’re responsible for ensuring the timely completion of a number of tasks for plan participants on behalf of the employer. These range from participant enrollment to substantiation and reimbursement of employee claims (and the many tasks between).
You can see how your performance could affect the dynamic between the employer and the broker, as well as the plan provider. The broker will stay in touch with the employer to make sure things are going well for participants — and to see how you’re working out. They act as a sort of an account manager, ensuring the client stays happy and addressing any issues as they arise.
If things aren’t going smoothly in your TPA–partner relationship, you can be sure that the employer will let the broker know, and that you’ll be hearing from the broker. As a service provider, it’s your responsibility to not only treat the employer and their participants well but to ensure the employer remains assured in their decision to trust the broker’s recommendation to work with you.
Another way you can ensure strong TPA–partner relationships is helping the broker negotiate better rates for the employer. Make sure you’re providing them with historical claims data so they can better negotiate on behalf of the employer for better rates.
Take care of your broker, and your broker will take care of you.
Keep Employers — and Employees — Confident in Your Services
This is where you have the opportunity to shine: supporting the needs of employers and plan participants. Whatever employer group size you’re working with, make sure you’re taking care of the people who rely on you for information and communication. Ensure you’re serving as a proper reflection of the employer and communicating seamlessly with plan participants to provide a positive experience.
While many factors contribute to your overall impression as a TPA, having a benefits administration system in place that can seamlessly collect important information and keep all parties informed should be a top priority — particularly when you’re receiving information from multiple HR platforms with different ways of formatting data. Make sure you’refilling in the gaps.
You might be wondering how you can do all this if you’re already using a benefits administration platform that doesn’t automate data collection and standardization.
Good news: There’s no need to go through the costly and time-consuming process of evaluating and purchasing a new benefits administration platform. Tools are available that can help you integrate into existing platforms to provide a high level of service to your partners as well as save a significant amount of time over the course of a year.
And any opportunity to improve your model to ensure your relationships with brokers, employer groups, and plan participants stay strong or gets stronger is an opportunity worth taking.
First-Class Service in Third Party Administration
That’s the key to success of your TPA and providing a positive experience that not only satisfies your partners but also rewards your business in the long-term. But we’re just getting started. There are more great insights to come on how you can set your business up for real, long-term success.
Check back soon to learn more TPA best practices and how TPA Stream can help you achieve your goals.