Shopping For An Insurance Broker or TPA

The How-To, When-To & What-To-Do Of Insurance Switching

Welcome to the HealthFirst Blog! This is the place99538017 to go when you want the latest on group health insurance — from information on wellness programs, to the need-to-knows about employee benefits, to best practices when considering a third party administrator (TPA) switch for your company.

This post is about the latter subject — what you should do when you’re considering a switch in insurance brokers or programs for your company, and when you should do it. As with most things in life, you have to prepare before you take action. Before you look for something, you have to know what you’re looking for, right? The same concept applies to shopping for benefit management services.

FIRST, consider your timeline. Most insurance renewal happens in July and December. Don’t wait until a month before renewal — June or November, respectively – to start your search! This is when brokers and TPAs are busiest. Wouldn’t it be nice to get their full and focused attention on your company? Start your search 4-6 months before it’s time to renew. Last minute decisions usually aren’t the best, and you definitely want the best for your employees!

SECOND, consider your needs. Before setting out on your TPA trek, do some internal investigation into your employees’ needs and compile a list of the following:

  1. Number of employees in your company who are eligible for coverage
  2. Demographic data of insurance-eligible employees, including marital status and number of dependents
  3. Number of “high risk” employees — those who have pre-existing conditions, health problems or who lead dangerous and risky lifestyles
  4. Get information on other coverage your employees have, whether it’s their own plan or they’re sharing their spouse’s
  5. Survey your team on what they want out of their group health insurance, including benefits, coverage levels and possible wellness programs or flexible spending

THIRD, consider a representative. Pick an employee, preferably someone who has high-level knowledge of insurance, to attend meetings with prospective insurance brokers. This way, the choice isn’t just coming from HR — the employees are represented as well.

FOURTH, consider doing some research. Group health insurance can be complex, so make sure you’re not in the dark when talking to these insurance experts! You don’t have to be an expert yourself, of course — just develop a basic understanding of your insurance and employee benefit options so you can make a well-informed broker choice.

FIFTH, consider your choices … and begin your search! You’ll be glad you started this insurance search-and-shop process 4-6 months out — not only ensuring enough time to complete the aforementioned prep steps, but also ensuring enough time to thoroughly compare brokers and TPAs. But how do you start the search? Whom do you consider and what do you ask when interviewing?

HOW TO START:

  • Ask for referrals from friends, family and other HR personnel in your area or your particular industry. A positive referral from someone you trust is the best place to start.
  • Go online! Check out forums and HR blogs for impartial opinions and testimonials. You can always check out the testimonials section of a particular broker’s website, but keep in mind that these reviews are going to be biased and most likely overwhelmingly positive. 

WHOM TO CONSIDER:

  • Independent health insurance brokers and TPAs are going to provide the highest level of variety and customization for your group health insurance. If you choose an agent who works for a specific insurance provider, he is going to be limited in the number and types of policies he can offer you. With an independent administrator, you get access to several insurance providers and a much wider range of policies.
  • Brokers who are familiar with your type of business will have the high-level knowledge and insight to know what’s best for your team’s coverage.

WHAT TO ASK FOR:

  • Rate guarantees and comparison rates
  • What happens when an employee becomes high risk — rate increases or caps?
  • Quote data on similar group demographics
  • How they handle billing, claims and services
  • Information on different types of health insurance they offer (HSA, PPO, HMO, POS, managed care, basic or major medical fee-for-service, etc.)

It may seem like a scary and convoluted process, but once you find that broker or third party administrator who offers the best benefit management services for your team, you’ll be glad you put the time in!

And while we have to mention that the HealthFirst Switch should be at the top of your consideration list, we’ll also say that HealthFirst shouldn’t be the only TPA on your list! You have to shop around — and start the process 4-6 months before renewal — to truly make the most appropriate broker choice for your company’s group health insurance.

To expand upon our advice for the HR department, next week’s post is going to address everything you need to know about HIPAA compliance. Is your TPA or broker hip to HIPAA? Check back soon or subscribe to find out!

With HealthFirst, you get more benefits and insurance knowledge with less complexity and confusion. Finally, group health insurance that makes sense and doesn’t waste your time or energy.

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