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Five Things to Look for in a TPA Partner

Are you curious about self-funding but don’t know where to start? It can be daunting to think of taking the plunge into a new way of funding your health plan. A crucial step is finding the right TPA that you can trust to handle the ins and outs of your health plan and show you the right options that fit your unique needs.  

At PAI, we provide you with the information and resources you need to feel confident about your options and a team of self-funding experts that you can lean on for guidance every step of the way. 

Here are 5 things to consider when looking for your TPA partner. 

  1. Are they focused on innovative solutions?

    If your TPA's response to questions about what kind of innovative solutions they offer is, “There’s nothing new in the self-funding world.”, it may be time to run. The healthcare space is rapidly evolving, and you want a TPA partner who not only understands this but is working to stay ahead of the curve. We are always willing to think outside of the box when it comes to finding the perfect solutions for any kind of client. No matter if you’re a large employer with complex needs or a small group that wants to keep things simple. It comes down to making sure that your benefits are expertly matched to your member population receiving the best care while keeping your bottom line in mind. 
  2. Who are their point solution and vendors partners? 

    You know the saying that you can tell a lot about a person by the company they keep? Well, the same is true when looking for the right TPA. Who they choose to partner with will say a lot about their values and will also directly impact the kind of service that you receive. Make sure that your TPA’s point solution partners are fully vetted and meet the highest quality standards. At PAI, we carefully vet all vendor solutions to ensure that they meet the same expectations that clients hold us to. The mission that we hold close in everything we do is to develop relationships that create value for our clients. 
  3. Will they work well with your benefits advisor to provide customized plan options? 

    Another important part of self-funding is finding the right broker partner who can coordinate with your TPA to create customized plan options. Assembling the right team sets you on the path to self-funding success, so ensuring that everyone is on the same page with the same goals in mind is key. Part of our over 40-year success story is our philosophy of collaboration and our belief in the power of relationships. 
  4. Is their goal to find low-cost and high-quality care options? Or are they only looking for the lowest price? 

    In some cases, when you’re shopping around for a certain product, finding the lowest price is the best strategy. This is not always the case when shopping for your benefits. A TPA who only points you in the direction of the lowest cost option may not have your best interests in mind. We understand that employers have budgets that need to be considered, but finding personalized plan solutions that combine the best in cost and care quality is a balancing act that we are very familiar with at PAI. As a matter of fact, it’s our specialty! 
  5. Do they have a national presence and licensing in multiple states? 

    Our journey has taken us from a small 10-member team with clients only located in South Carolina, to a 315-member team with clients in multiple states and licensing to administer benefits in all 50 states. Our depth of knowledge and talent makes us an industry leader in the TPA space. The ability to successfully expand into new markets is a testament to our expertise and allows us to take our vision of “making benefits better” to clients all over the US. 

PAI is perfectly positioned to take on the ever-changing landscape of the industry. We are dedicated to helping our clients successfully navigate the world of self-funding and beyond. Our innovative solutions, fully vetted partnerships, and commitment to finding the right customized options for our clients are at the heart of everything we do. Contact us to learn more.

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