About Third-Party Administrators

As benefits plan administrators, we help keep group health benefits plans simple for our customers. All the little details and moving parts that go into benefits plans? We take care of that.

What is a Third-Party Administrator (TPA)?

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

How Does It Work?

Each month, employers contribute funds into the Trust, administered by The Benefits Trust. With these funds, we do three things:

1.  Pay insurance premiums to protect against risk.

2.  Process and reimburse employee claims.

3.  Pay administration fees, advisor compensation, and taxes.

At the end of each month, we provide a financial statement showing the fund contributed, the funds paid out, and the surplus or deficit status.

WHAT SERVICES DOES THE BENEFITS TRUST PROVIDE?

We offer a full range of services including maintaining eligibility records, premium administration and billing, benefits plan documentation and communications, and claims adjudication. We’re one of the longest serving professional full service Third-Party Administrators in Toronto and the GTA.

Advantages of TPA Services at The Benefits Trust

  • Custom benefits plan designs for small- and mid-sized businesses.
  • Insurance offerings from our network of insurance suppliers, including specialty insurers.
  • Self-funded or Budgeted Administrative Services Only (ASO) contracts.
  • Consolidated billing for insurance benefits, health and dental care, healthcare spending accounts, and short-term disability benefits from a single point of administrative contact.

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 clearly outlining 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.

Still Have Questions? We’re Happy to Help!

Reach out and one of our team members will connect with you shortly to answer all inquiries you have about benefits plans for your company.

Call us at 1-800-487-2993

Email us at [email protected]

Regular Hours of Operation:
Monday – Friday: 8:30am – 5:00pm

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