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Evaluating Your Third-Party Administrator: Are You Getting What You're Paying For?

Are you monitoring your third-party administrator to ensure they are giving you what you are paying for?Many employers - both private and municipal - offer benefit programs to their employees; focusing on maximizing the benefit offerings while minimizing the associated costs. To aid them in structuring and administering these programs, they secure the services of a third party administrator. Such third party administrators or 'TPA's' strive to deliver administrative services in accordance with their service agreements, but also make efforts to avoid taking on a fiduciary role or offer guidance beyond that which they are contractually obligated to provide. Some fall short of even this benchmark, failing to deliver and exposing their clients (and themselves) to legal liability, whilst others go above and beyond - creating exceptional value for their clients. This information will enable any and all entities responsible for identifying, selecting, and monitoring their TPA to track performance and assess results, as well as identify opportunities to create additional value in collaboration with their TPA. The material will explain how to avoid regulatory and other pitfalls, while ensuring every aspect of a successful benefit plan is being handled.


Runtime: 86 minutes
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Why Lorman?

Over 31 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Agenda

Introductions

  • Speakers
  • Industry Involvement

Third Party Administrators

  • Industries (Where Are TPAs Used?)
  • Dynamic
    • Affiliation
    • Network
    • Claims Process
    • InHouse vs. Subcontractors
  • Industry Trends (Growth and Characteristics)

TPA Benefits

  • Scenarios Where the TPA Added Value
  • Data
    • Types
    • Uses
  • Customization - the Good

TPA Pitfalls

  • Recent Cases Involving Conflicts and Mistakes
  • Issues for Which There Is No Recourse
    • Alignment vs. Conflict With StopLoss
  • Customization - the Bad

TPA Assessment and Monitoring

  • Reviewing the ASA
    • What to Look for
    • Right to Audit
  • Reports
    • Type of Info TPAs Should Share

TPA Communication

  • What a TPA Does
  • What a TPA Does Not Do
  • What the Client Needs to Communicate

Other Entities Involved

  • Insurance
  • Vendors
  • Brokers
  • Employer
  • Employees
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More Program Information

Why Lorman?

Over 31 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Credits

OnDemand Webinar

This course was last revised on May 2, 2018.

Call 1-866-352-9540 for further credit information.

  • SHRM 1.25
     
  • Lorman Education Services is recognized by SHRM to offer Professional Development Credits (PDCs) for the SHRM-CPSM or SHRM-SCPSM. This program is valid for 1.25 PDC(s) for the SHRM-CP or SHRM-SCP. For more information about certification or recertification, please visit www.shrmcertification.org.
     

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

Audio & Reference Manual

  • Arizona CLE 1.5
     
  • CA MCLE 1.5
     
  • CT CLE 1.5
     
  • GA CLE 1.5
     
  • HI CLE 1.5
     
  • IL CLE 1.5
     
  • ME CLE 1.5
     
  • MT CLE 1.5
     
  • NJ CLE 1.8
     
  • NV CLE 1.5
     
  • VT CLE 1.5
     
  • WA CLE 1.5
     
  • WV MCLE 1.8
     
The CLE Code is ONLY a requirement when applying for CLE Credit in California (for participatory credit), Kansas, New Jersey or New York. Other states do not need to supply the CLE Code to apply for CLE credit.

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

MP3 Download

  • Arizona CLE 1.5
     
  • CA MCLE 1.5
     
  • CT CLE 1.5
     
  • HI CLE 1.5
     
  • IL CLE 1.5
     
  • ME CLE 1.5
     
  • MT CLE 1.5
     
  • NJ CLE 1.8
     
  • NV CLE 1.5
     
  • VT CLE 1.5
     
  • WA CLE 1.5
     
  • WV MCLE 1.8
     
The CLE Code is ONLY a requirement when applying for CLE Credit in California (for participatory credit), Kansas, New Jersey or New York. Other states do not need to supply the CLE Code to apply for CLE credit.

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

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More Program Information

Why Lorman?

Over 31 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Faculty

Ron E. Peck, Esq.

Ron E. Peck, Esq.

The Phia Group, LLC

  • Senior vice president and General Counsel and has been a member of The Phia Group, LLCís team since 2006
  • As an ERISA attorney with The Phia Group, he has been an innovative force in the drafting of improved benefit plan provisions, handled complex subrogation and third party recovery disputes, health care direct contracting and spearheaded efforts to combat the steadily increasing costs of health care
  • Considered to be not only one of the nationís top ERISA lawyers, he is also viewed as one of the nationís premier self-funded health plan consultants and health benefits attorneys; lecturing at and participating in many industry gatherings including but not limited to The National Association Of Subrogation Professionals (NASP) Litigation Skills Conference, Society of Professional Benefit Administrators (SPBA), the Health Care Administratorís Association (HCAA), The Health Plan Alliance, and SIIA
  • Curently serves as The Phia Groupís senior vice president and General Counsel, and is also a dedicated member of SIIAís Government Relations Committee
  • J.D. degree, Rutgers University School of Law; B.S. degree in policy analysis and management, Cornell University
Adam V. Russo, Esq.

Adam V. Russo, Esq.

The Phia Group, LLC

  • Co-Founder and Chief Executive Officer of The Phia Group LLC; an experienced provider of health care cost containment techniques offering comprehensive claims recovery, plan document and consulting services designed to control health care costs and protect plan assets
  • The Phia Groupís overall mission is to reduce the cost of plans through its recovery strategies, innovative technologies, legal expertise, and focused, flexible customer service
  • Founder and managing partner of The Law Offices of Russo & Minchoff, a full-service law firm with offices in Boston and Braintree, MA
  • Practice is devoted to representing employers, plan fiduciaries, third-party administrators and carriers in employment and employee benefits matters throughout the United States
  • Frequent speaker and author on health care and employee benefits topics at webinars, conferences and seminars across the country
  • 2018 Chairman-Elect of the Board of Directors for the Self-Insurance Institute of America, Inc. (SIIA) and serves on the Board of the Massachusetts Association of Health Underwriters (MAHU)
  • Admitted to the Massachusetts Bar, the U.S. Court of Appeals for the First Circuit and the Supreme Court of the United States
  • J.D. degree, Suffolk University Law School; masterís degree in finance, Frank Sawyer School of Management at Suffolk University in Boston; undergraduate degree in political science and public relations, Suffolk University
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Why Lorman?

Over 31 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

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Product ID: 402055
Published 2018
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