A Third Party Administrator (TPA) for employee health benefits is a person or organization that performs administrative services (e.g. claim processing, adjudication, record-keeping), usually on behalf of an employer that self-insures health benefits.
Most TPAs operate as an entity independent from the health insurance carrier and the insured (employees or plan participants).
Currently, more than 40 states have a TPA licensing requirement and several more have similar minimum requirements.
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Disclaimer: The information provided on this website is general in nature and does not apply to any specific U.S. state except where noted. Health insurance regulations differ in each state. See a licensed agent for detailed information on your state. PeopleKeep, Inc. does not sell health insurance.