category
Administrators that handle claims and related services for self-funded plans, captives and insurers, under a written agreement with the party that bears the risk.
5 active providers in this category.
How are these providers ranked?TPAs work for whoever carries the risk — a self-funded employer plan, a captive, a risk retention group or an insurer. Depending on the line, that means claims intake, adjudication and payment, loss reporting, eligibility and enrollment, COBRA and spending-account administration, cost containment, and reporting to stop-loss or reinsurance carriers. Health benefits, workers' compensation and liability claims are different businesses, so start from the lines you actually need administered.
An administrator does not take on the risk. Under the NAIC model law that many states follow, a TPA must act under a written agreement with the payor, hold funds in a fiduciary capacity and keep records the payor can inspect, and an insurer remains responsible for the TPA it uses. For a self-funded health plan, the employer's duties as plan sponsor stay with the employer. See self-funded health plan solutions for how those roles fit together.
Which states license you for our lines? What turnaround and accuracy standards will you commit to, and how are they reported? Can we reach our claims data directly, in what format, and do we keep it if we leave? Who prepares stop-loss or reinsurance filings? How are fees set — per claim, per employee or a percentage — and what costs sit outside them?
AmeriTrust Group is a commercial property and casualty insurance underwriter and insurance administration services company providing specialty insurance programs, claims and risk management services, and administrative services for self-insured groups, alternative risk vehicles and public entities.
CBCS, LLC is an independent property and casualty Third-Party Claims Administrator providing national workers’ compensation, auto liability, general liability, physical damage and cargo claims services. It supports self-insured employers, large-deductible programs, captive programs, risk retention groups and program managers, with additional nurse case management, medical cost containment, loss-control and reporting capabilities
Old Republic is a specialty insurance group providing property and casualty insurance, title insurance, alternative-risk financing, captive fronting and reinsurance, claims administration, risk control and other specialty insurance services.
U.S.-based independent third-party administrator providing property and casualty claims administration, workers’ compensation, liability and property claims management, managed care, loss control, and administration of individual and group self-insured programs.
Alan Gray, LLC is a Boston-based claims and audit advisory firm founded in 1988, providing claims auditing, forensic accounting, third-party administration, legal expense management, and quantitative risk analysis services to insurers, reinsurers, MGAs, TPAs, law firms, captives, and self-insured organizations. The company operates as part of Premia Holdings Ltd. and owns subsidiary A.G. Risk Management, Inc.