Self-insured employers need a broker who can deliver solutions that address their top concerns—and brokers need a partner that can make that happen.

If you’re a health benefits broker seeking a third-party administrator (TPA) that can make your life easier and help keep your clients happy, you don’t just need someone to process claims. You need a partner to deliver:

• Exceptional compassionate care for your members 
• Sustainable savings from the plans you provide
• Data-supported decision making for employers and members

You need a partner that can help you stay informed and prepared, while also providing the services your clients need. Start by seeking a TPA that can provide these five things.

If you’re a health benefits broker seeking a third-party administrator (TPA) that can make your life easier and help keep your clients happy, you don’t just need someone to process claims. You need a partner that can help you stay informed and prepared, while also providing the services your clients need. Start by seeking a TPA that can provide these five things.

1. Education. In a constantly changing healthcare landscape, being the broker who always has the right answer is not an easy job. Brokers have a responsibility to be up-to-date on the latest information for their client—so you need a partner who can siphon through changing legislation, regulations and best practices and keep you informed about what you and your client need to know.

2.  Risk mitigation. For most employers, taking on the risk of employees’ healthcare is the biggest concern when it comes to deploying a self-insured plan. You need a partner that understands how to mitigate risk—not only by helping you determine the right amount of stop-loss insurance to purchase, but also by designing a customized plan for each employer based on its unique patient population and specific risks.

3.  Decision support. Healthcare is a uniquely human concern, and healthcare decisions are financial as well as emotional and physical. The right administrator will provide compassionate, personal support and information for members, guiding them to make decisions that take into account both cost and humanity.

4.  Integration. Your clients don’t want a solution that is difficult to implement or requires staff and plan members to learn new systems. You need a partner with a system that is easily integrated into commonly used platforms, easy for employers to administer and seamless to the membership.

5.  Cost reduction. The ability to better control costs while providing competitive health benefits for employees is the goal for most employers that pursue a self-insured health plan. To truly help them meet this goal, a TPA cannot operate in a vacuum, processing claims and providing customer service to members. The right partner must also have an eye on the employer’s bottom line. With a deep understanding of the employer’s income statement, and constant attention to how healthcare costs may affect it, the right partner can focus on implementing the latest and best cost-cutting measures while still meeting the needs of the employer.

Lucent Health combines best-in-the-industry claims management with a compassionate, human-focused, data-driven care management solution. Find out more about Lucent Health and our approach to care management. Contact us today.

Editor’s Note: This post was originally published April 2020, but new research has been cited, and new information has been added.