Third Party Administrators (TPA)

What is a Third Party Administrator (TPA)?

A TPA is an organization that manages employee group benefit plans on behalf of an employer.  Professional TPAs like The Benefits Trust have the expertise to administer the entire claims process – a task historically handled by conventional group insurance carriers.

Third Party Administrators Ontario

 

Employers contribute funds monthly into the Trust administered by The Benefits Trust.  With these funds we do three things:  pay insurance premiums to protect against risk, process and reimburse employee claims, and pay administration fees, advisor compensation, and taxes.  At the end of each month we provide a financial statement showing the funds contributed, funds paid out, and surplus or deficit status.

What Services Does The Benefits Trust Provide?

The Benefits Trust is responsible for a full suite of services including maintenance of eligibility records, premium administration and billing, benefits plan documentation and communication, and claims adjudication.  Operating since 1994, we are one of the longest serving professional full service Third Party Administrators in Toronto and the GTA.

There are a number of advantages to a third party administered solution from The Benefits Trust:

  • Custom benefits plan designs for small and mid-sized businesses.
  • Insurance products purchased from over a dozen insurance suppliers including specialty insurers.
  • Budgeted Administrative Services Only (ASO) contracts.
  • Consolidated billing for insurance benefits, health and dental care, health care spending accounts, and short term disability benefits, with a single point of administrative contact for all benefits.

For small and mid-sized businesses, The Benefits Trust can provide group insurance administrative services more cost effectively and with more flexibility than traditional insurance carriers.

Our Third Party Administrative Services Include:

  • Daily claims adjudication and payment.
  • Employee inquiries handled by our client service specialists.
  • Maintenance of accurate employee benefits records.
  • Monthly billing statements (by division and by department as required), identifying benefits costs for each employee in each division.
  • Account changes and billing adjustments carried out by The Benefits Trust.
  • Formal benefits plan documentation to satisfy all legislative requirements concerning private health services plans prepared by The Benefits Trust contract specialists.
  • Complete Administration Manual which clearly outlines procedures and provides forms for notification of employee status changes.
  • Monthly financial status reporting, including the current month, year to date, and prior year to date for on-going monitoring and trend analysis.
  • Employee communication materials such as benefits booklets, announcement memos.
  • Wallet certificate cards provide each member with their contract number and individual certificate number, coordinated with electronic dental claims processing (EDI dental).
  • Pay-direct prescription drug cards if desired.
  • Our team of specialists at The Benefits Trust and our advanced systems can help meet and exceed your company’s needs.

For more information about Third Party Administration services, contact us today.

 

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