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In the United States, a third-party administrator (TPA) is an organization that processes insurance claims or certain aspects of employee benefit plans for a separate entity. [1] It is also a term used to define organizations within the insurance industry which administer other services such as underwriting and customer service.
In October 2022, Trustmark finalized the sale of its subsidiary, Trustmark Health Benefits, to Health Care Service Corporation (HCSC). [8] Health Benefits is a third-party administrator of health benefits that designs and offers custom plans for mid- to large-sized self-funded customers. In January 2023, Trustmark celebrated 110 years in business.
The Affordable Care Act has had huge ramifications on self-funded health plans; market reforms have invalidated many plan designs that were previously used, and now that employees are required to have health insurance and many employers are required to offer health benefits as well, [3] the self-funded industry has enlarged.
However, the benefits of a PEO extend beyond offering health insurance to employees. HR technology, payroll processing, and value-added features are all PEO advantages. The best PEO health ...
Over 500 clients including third party administrators, health insurance plans and financial institutions leverage Alegeus' deep expertise and proven technology in benefit administration and ...
In the United States, a pharmacy benefit manager (PBM) is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans.
In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...
In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. [1] It is an organization that provides or arranges managed care for health insurance , self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care ...
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