Medical Third-Party Administrator Evaluation, Selection and Contracting Best Practices

Why Choose a Third-Party Administrator? A health plan's designated fiduciaries are responsible for monitoring the overall operations of the plan. Because the designated fiduciaries themselves are generally not equipped to handle day-to-day administration of the plan, they must designate certain administrative responsibilities to third parties. [...]plan fiduciaries must follow ERISA's duty of care when evaluating and selecting a third-party service provider. [...]once a TPA is selected, fiduciaries will work with the broker/consultant to confirm that the contract conforms with the RFP response and contains market-standard terms and conditions. step 1 - retaining a broker/ Consultant Plan fiduciaries often rely heavily on the advice of brokers and consultants in selecting TPAs. [...]the Consolidated Appropriation Act, 2021 prohibits contracts from containing restrictions on a party's access to de-identified claims information.