Claim Reporting — Benefits of having a TPA

January 16, 2018 | Varipro

Providing claim reports is a federally required service for all TPAs (Third Party Administrators) in the U.S. These reports provide employers and plan providers with details on every claim for included coverages within their employee benefits.
 

Claim Reports include detailed reviews and insight of:

1. Plan Performance
2.  Analysis of Cost Drivers
3. Plan Modeling
4. Trend Reports
5. Bench Marketing

What are the benefits of receiving claim reports?

Of course, there are a plethora of benefits that come along with receiving claim reports from a TPA. If employers choose, they can use this information to better optimize their self-insured healthcare plan. Benefits of receiving claim reports include:

1. Claims transparency: Employers and plan participants are given a clear understanding of how their benefits are being used and how funds are being spent. Additionally,  making employees aware of how claims affect the entire group.
2. Well-informed decisions: By receiving clear and easily understood insight on claim activity, employers can make knowledgeable decisions. In addition, allowing them to remove or add coverages, optimising their plan as best as possible.
3. Cost Savings: By further customizing health care plans, employers can remove unnecessary costs, and increase profitability for their organization as a whole.
4. Wellness Strategy: Having a first-hand look at claim and coverage activity gives employers clear insight into the health status and habits of their employees, which they can then use that information to further develop and incentivize employee wellness programs.

 

 
Though claim reporting can be extremely useful for employers, it is not a federal requirement for traditional insurance companies. Unfortunately, due to the lack of rule, that has become the norm throughout the insurance industry. Which, is all the more reason to consider self-funding your employee health insurance. If you would like more information about receiving claim reports from a TPA, contact Varipro today, your employee benefits specialists.