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Healthcare Approach

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Michigan, Indiana, Ohio,
Wisconsin, Illinois & Kentucky

Licensed Third Party Administrator

What is a third party administrator?

A Third Party Administrator (TPA) is a person or organization that processes claims and performs other administrative services in accordance with a service contract, usually in the field of employee benefits. More specifically, a TPA is neither the insurer (provider) nor the insured (employees or plan participants), but handles the administration of the plan including processing, adjudication, and negotiation of claims, record-keeping, and maintenance of the plan.

We provide special attention to the management and needs of employee benefits which includes claims, billing, collection, client services and more. We are specialists in the administration of certain health insurance plans including:

Health Reimbursement Arrangements [HRA]

    What is a Health Reimbursement Arrangement (HRA)?

A Health Reimbursement Arrangement or HRA is a type of Medical Reimbursement Plan or MRP that allows the employer to contribute tax-free dollars to a designated employee account or accounts. These accounts are for employee reimbursement of out-of-pocket medical expenses (including insurance premiums and deductibles). Eligible medical expenses are approved and reimbursed either by the employer or a third party administrator.

    What are some examples of an HRA?

A Health Reimbursement Arrangement or HRA can have virtually an infinite number of plan design options. However, the three most fundamental options include the following:

First Dollar HRA: This plan reimburses expenses from the first dollar up to the accumulated balance in the HRA account. The employee pays the remaining expenses up to the amount of the health insurance
plan deductible.

The Bridge HRA: This plan pays for eligible expenses after the employee pays an initial amount established by the employer.

Shared HRA: The Shared HRA shares the cost of covered expenses subject to the health insurance
plan deductible.

Additionally, plans can be designed with a combination of these three plans giving the employer significant flexibility to design a plan that is appropriate for their workforce.

Consolidated Billing

Multiple lines of insurance from different carriers? Simplify the process by sending one Invoice to your clients. Employers can save time and resources by receiving one invoice and sending one payment.

Cobra Administration

Employers with over twenty employees must comply with federal guidelines. We offer support or full service Cobra Administration.

Self-funded Insurance Programs

Whether self- funding a health insurance plan, a prescription plan, or a dental plan we can help. Our TPA can provide discounted programs, manage the accounts, advise and create the perfect plan for your clients.