Five Things Your TPA Should Do During Renewal Season
Health plan renewal season always brings around a unique kind of puzzle. With many moving parts to consider, keeping track of them all will undoubtedly keep you busy. With that in mind, it’s a good idea to make sure your third-party administrator (TPA) is on top of things.
A TPA plays a critical role in helping their organization navigate each renewal season. They can evaluate the performance of benefits plans, using analytics to optimize them for the best outcomes. They’re also able to negotiate better terms with vendors and identify cost-saving opportunities all while ensuring regulatory compliance. Ultimately, by leveraging their industry expertise and data-driven insights, TPAs can make all the difference during renewal season—so long as you have one that knows what they’re doing.
To call a renewal season successful, you’ll want to make sure your plan remains compliant, cost-effective, and efficient. Here are five of our TPA to-do’s during renewal season to help ensure that success.
Examine Your Plan Regularly
Making sure that your plan is working is the primary duty of your TPA. It’s even better when your TPA keeps a constant eye on your plan to make sure it’s truly the right fit for your company as it is. Regular plan reviews help ensure that your benefits align with both your company’s goals and your employees’ needs—and let your TPA know if a change needs to happen.
Your TPA should…
- Conduct thorough audits of your current plan to assess performance.
- Identify areas of improvement such as costs, coverage gaps, and efficiency.
- Ensure the plan is compliant with current regulations and industry trends.
Partner with Industry Leaders
Your TPA should be a partner, one that you trust to help you and your company continue running smoothly. In turn, your TPA should have a few strong partners of their own in their pocket. Collaborating with the top industry leaders gives your TPA an edge, allowing them to bring the most up-to-date and effective strategies to the table when it comes to your benefits.
Your TPA should…
- Maintain relationships with key industry players including insurers, health providers, and more.
- Leverage partnerships to gain insights into emerging trends, technologies, and cost-saving opportunities.
- Keep ahead of the curve and integrate best practices and innovative solutions into your plan during renewal.
Review and Update Compliance Requirements
Earlier, we mentioned that keeping you safely in compliance is a duty of your TPA. In today’s healthcare landscape, with regulations constantly changing, that duty is more important than ever. Keeping your plan compliant isn’t just a legal obligation your TPA should worry about, but it protects your company from potential fines or lawsuits.
Your TPA should…
- Stay informed about changing healthcare laws, tax regulations, and other relevant compliance issues.
- Review and update your plan documents accordingly.
- Ensure that all necessary filings are completed on time and in full.
Administer Different Types of Plans
A key part of ensuring a smooth renewal season? Flexibility. From managing widespread, diverse employee needs to different regulatory requirements, your TPA needs to be able to administer a plan that fits. It also helps to know that your TPA isn’t stuck in place—the more flexible your TPA is, the more likely you are to get a plan that works best for you.
Your TPA should…
- Ensure the ability to administer a wide range of plans.
- Tailor the approach for different plan types to provide the best value and experience for employees and employers alike.
- Offer strategic advice on how to optimize each plan type for specific employee groups.
Clearly Communicate Changes
Part of being a reliable TPA partner—a big part—is clear communication. This is even more important during renewal season when plans are being evaluated and altered. Clear communication helps ensure that employees understand their benefits, which leads to higher satisfaction and better engagement with the plan.
Your TPA should…
- Provide timely and clear communications to employees about any changes to the plan.
- Help design educational materials or training sessions for HR teams, employees, and other stakeholders.
- Ensure ongoing support to answer any questions employees may have about the renewal process.
At BRMS, we pride ourselves on serving as a trusted and valued partner to our clients. From our personalized service to our cutting-edge technology, we make sure you head into each renewal season feeling prepared and supported. With over thirty years in the industry, we have significant experience in the ups and downs of renewals. Our longevity gives us a firm footing in the steps we take with you next, approaching renewals with tested and true strategies. We’re here to be a true partner—supporting you with superior customer service, and backed by our own strong partnerships with networks and vendors that make a difference on a plan’s bottom line.
Interested in how we can help you get through this renewal season on top? Reach out today and let’s talk.