A TPA built on cost control, flexibility, transparency, and customer service. 

PAI was founded in 1981, marking 45 years in the TPA business. Over the course of our 45 years in business, PAI has evolved from being a tiny South Carolina TPA with less than a dozen employees, to being recognized on national level as an innovative, diversified, nationally-licensed administrator of self-funded and fully insured plans with a proven history of helping clients bend the cost curve and providing white-glove customer service through seasoned account executives who have been in the industry for decades. That transformation did not happen overnight, nor did it happen by chance. It was built on a foundation of service, innovation, and a willingness to expand into new markets.

Our mission, to make benefits better, may seem at face value to be a simple concept as you stop to think about how healthcare continues to get more complex and more expensive, but that doesn’t stop us from pursuing it. PAI has been building and evolving, and continues to integrate with innovative partners who support us in this critical mission.

Flexibility and Cost Control 

One of the main advantages of a self-funded health plan is that the employer group can customize their benefits to best meet the needs of their employees, while also having the flexibility to design them plan in such a way that they provide excellent benefits for lower costs. Our team partners with employer groups, and their consultants, to identify the solutions that save the group money over time and truly support the members. 
Solutions can include:

• Advanced Primary Care: Utilizing a Primary Care group (either in brick-and-mortar clinics or virtually) helps ensure employees are proactive in their health, seeking care from the appropriate settings by avoiding unnecessary ER visits, and going to high-quality, low-cost specialists for care outside the primary care setting.
• High performance networks: Partnering with local, high performance or tiered networks that have a strong presence in the community can lower administrative costs without sacrificing access to care.
• Carve out specialty drugs: PAI integrates with multiple pharmacy benefit manager programs and supports tailored pharmacy plan designs.
• Pre-vetted point solution partners: While PAI can work with any point solution the group wants, we have partners who have a proven ROI and have been vetted by us for reliability and security.

Data & Transparency

Employers can view a member’s eligibility and claims information through the My Benefits Manager® Employer Portal. We also offer our clients access to PAI Analytics®. PAI Analytics provides:

• Dashboard with summary graphics
• Benchmarking to compare against national data
• Segmentation of risk categories, making higher risk more visible
• Utilization metrics
• Chronic condition tracking to target wellness program education
• Distribution of your group’s health care expenses
• Month to month medical trend analysis

PAI also believes in transparency and auditing, providing:

• Open communication and cooperation with outside auditing entities
• Transparency In adherence to compliance regulations and audit findings
• Documentation and reporting of all outcomes

Service

Our biggest differentiator is our people, and it always has been.

We’ve built PAI around our relationships with consultants and our groups, allowing us to grow while keeping a white-glove service approach. When you work with us you’re connected to a seasoned, dedicated account executive who knows your plan, understands your population, and has been in the industry for years.

Our teams handle fewer cases than most TPAs, so they can focus on each group — working through the details, solving problems, and staying ahead of issues instead of just reacting to them. They provide quicker responses, more attention, and a stronger focus on better outcomes over time. They bring experience and stay close enough to understand what’s happening day-to-day.

We hear all the time, “You make us feel like we’re your only client.”

That’s not by chance; it comes when you have a team that truly knows your business and takes time to support you.

Looking Ahead

As health care evolves, so is PAI. Current investments include:

• A new administration system that will better allow us to automate workflows and plan designs, ensuring a high standard of quality and effectiveness
• Upgraded customer service modules: New technology will allow our customer service advocates to focus on the call — not the screen — and provide more accurate answers without sacrificing efficiency.
  •  If members don’t want to call, a chat feature will also be available
• Redesigned client, consultant, and provider portals: The next version My Benefits Manager will offer a better user experience to members and include easier access to more information.

We Make Benefits Better

For 45 years, PAI has remained focused on one goal: helping employers deliver better benefits by balancing cost control with meaningful access to care. Through flexible plan design, data-driven insights, and thoughtfully vetted solutions, we help groups avoid the unintended consequences of excessive cost-shifting while still managing long-term claims spend. Our commitment to transparency, innovation, and hands-on service ensures that every client has the tools, support, and partnership needed to navigate an increasingly complex healthcare landscape. As we look ahead, PAI will continue to evolve — staying grounded in experience while investing in the people, technology, and strategies that make benefits better for every client we serve.