The use of third-party administrators (TPAs) is one of the hottest trends in insurance today. According to the Society of Professional Benefits Administrators (SPBA) 66 percent of all U.S. workers are covered under self-funded plans, most of which are managed by independent, third party administrators. But what do you look for in a TPA? If you’re an independent agent, here are some things to consider.

Where to start

Your best sources for TPAs are the SPBA and the Self-Insurance Institute of America. Most high-quality TPAs belong to one of those organizations, which can act as initial filters. Also, don’t forget word of mouth. Contact other brokers for their opinion about the TPAs they’ve dealt with.

Your first step is to determine the needs of your clients. Who are your target customers? And what types of workers do they have? Determine if your customers are fully insured, minimum premium or self-funded. Then, find out what size of self-funded groups they have: small (50-200 employees), mid-sized (200 to 2,000) or large (more than 2,000). This is important because TPAs that serve only large corporations may not be inclined to give proper attention to a company group of 75 employees. Employees kept waiting for insurance cards for two months after enrolling, for example, will complain to their chief financial officer or human resources administrator. They, in turn, will be upset with you.

Next, look for a commonality among the types of customers prospective TPAs serve. Are most of their clients in the manufacturing industry? Or do they serve companies in the technology or government sectors?

Determine whether your target customers are in a single state or if they are spread out. Also, find out what capabilities are important to them. Do they need a provider with online capabilities? Do they need a TPA that can provide self-service for employees? Are they looking for one that provides real-time information on claims?

Once you have a clear understanding of your target customers and the types of employees they have, you can start looking for a TPA that will meet your needs. But not all TPAs are created equal. In fact, if your target customers have multiple needs, you may need to work with more than one TPA.

Questions to ask

Now that you have a list of prospective PTAs it’s time to ask some questions at your initial meeting.

- How many employees is the TPA currently serving?

- What types of clients does it serve?

- Does is have a profile customer? If so, does the profile match yours?

- Is the TPA’s style a good fit with your roster of clients?

- Which provider networks does the TPA work with?

- What prescription benefit manager does it work with?

- What markets does it have for employer stop-loss insurance?

- Ask for specific information on areas such as claim turnaround time, claims accuracy, inventory control and call-to-answer rate.

- How do they audit and verify the quality of their claims?

- Ask for references.

Find out if the TPA has the ability to accept electronic claims, which streamlines the claims process. Also determine if the TPA manages paper, or if it has its claims scanned and then uses electronic data interchange (EDI). In addition, ask about the TPA’s auto-adjudication capabilities. Scanning, EDI and automation will indicate capabilities that will lead to better service.

Does the TPA’s claim system have claims-editing capability, and if so, what types of edits are included? A good system will have duplicate claim checking, upcoding and unbundling. For example, the claim system should be able to tell if the claim was unbundled and whether the sex of the claimant matched the service performed.

Next, investigate the TPA’s Internet capabilities. At a minimum, these should include enrollment and claims status. If some of your customers are not tech-savvy, find out if the TPA offers interactive voice response capabilities for enrollment and claims status.

Your next step is to ask about the types of reports your TPA can provide. You’ll often find that certain reporting capabilities are provided in the base service, while others are available at an extra cost. You’ll want to find a TPA that provides reporting capabilities as a base service. Ask if there is an added cost for additional reports.

Lastly, find out if the TPA has call tracking. You’ll want requests for service to be automatically delivered through the hall-tracking system. Find out what its service unit can complete without the assistance of other departments. This will cut down on lost time for your clients.

You have done it! You have cleaned up your finances, figured out what’s what, built up a wealth account, and you have even begun investing. There is no more debt, your time is freed up, and you have a nice little nest egg. Then it happens – WHAM!!! You are involved in a major car accident and are seriously injured. Or maybe you are diagnosed with a serious illness. Either way, not only can you not work for a while, but you have heaps of medical bills. Are you prepared? If not, then all the hard work you have done to get yourself on stable financial ground and begin building wealth, is gone. If you can’t pay those bills and you are sued, then faster than you can blink your assets will be sucked up to pay what you owe.

How would you feel if this happened to you? Really use your imagination and try to place yourself there. What is it worth to you to ensure that this never happens? What would you do to protect yourself?

What is protection? INSURANCE! Yes, it is easy to say, “I don’t really need it right now,” or, “I can’t really afford it yet. I’ll wait until I’m making more money.” No matter how tight money is, it will be far worse if anything happens to you and you are uninsured. Just remember – you DO need it. The premium (charge you pay on a monthly/yearly basis) for insurance will protect you and family from financial loss in the event of accident, illness, fire, flood, or any other type of natural disaster.

Insurance is unavoidable if you own a car and/or a house. To qualify for a mortgage, you will be required to have home insurance because the bank wants to protect their investment. Just be sure to research insurance companies or make use of an insurance broker (you don’t pay for their services, the insurance companies do) and make sure you have appropriate coverage. You don’t want it to be too high and you don’t want it to be too low. It should be based on the estimated rebuilding costs of your house, not on current market value. With car insurance, you will most likely have to show proof of some basic coverage to register the vehicle. Make sure you are comfortably covered in case of an accident and also for when you rent a car so you don’t need to pay extra premiums.

It is also crucial that you have health insurance. Since the majority of artists do not have coverage from a regular employer, they need to purchase individual coverage. You can choose between fee-for-service insurance – allows you to choose any physician although it is generally extremely expensive, or managed care – lower costs but limited choices with regards to doctors and hospitals to which you have access. It is also recommended that you obtain a policy that:

• will cover a major medical problem

• will handle at least 80% of your costs after the deductible

• is guaranteed renewable (they can’t drop you or hike your premium cost if you get sick)

• has a maximum lifetime benefit of at least $1 million

• doesn’t have large numbers of limits and exclusions

Recognize that insurance companies can be sneaky – read policies carefully.

Other types of insurance include renter’s insurance, life insurance, and disability insurance. Renter’s insurance is important because your possessions are not covered under the homeowner’s policy of the person from whom you are renting. It also protects you from liability, either in you own home or elsewhere. Life insurance is something you need only if you have dependents. Don’t let someone sell it to you otherwise. Disability insurance is important to have in place if you have a regularly paying job in the event that you become sick or injured and cannot work for a period of time.

Things to consider when shopping for insurance include:

1. How high a deductible you want to select. Higher deductibles will result in lower premium costs. Just make sure you can actually afford to cover the deductible. If you visit the doctor regularly for example, having a high deductible might not make sense.

2. Get quotes from several insurance agents. Don’t be pressured into buying just because you have been given a quote. Talk to both independent agents (they can sell policies from different insurance companies) and captive agents (they represent one company). Getting referrals from friends and family members who are happy with their service and rates is a good way to shop. Then you know your insurance provider is tried and true.

3. Explore companies that will sell a policy directly to you. This may be cheaper since they avoid paying agents’ salaries.

4. The Consumer Reports Buying Guide can be an excellent resource for narrowing down your top choices.

5. If you are considering a lesser known company because of good rates, make sure you check them out carefully. Investigate qualifications, check with state insurance department, and research the company’s financial stability. You don’t want to be paying premiums for months or even years, only to discover that the company has gone out of business and will not pay your claim.

6. Always ask if you are eligible for any discounts.

It all comes down to protection and the feeling of security that goes along with it. If you do not have insurance, you may be putting your whole future on the line. No one wants life’s difficulties to pop up, but we can’t avoid them forever and if they are big, then you could be financially ruined. And who wants the financial stress added to an already stressful situation of illness, injury, or losing your house or possessions? Again, really take the time to imagine how you would FEEL if any of this happened to you and you weren’t ready. You owe it to yourself and your loved ones to be prepared. Don’t let all your hard work go to waste. Get insurance and have peace of mind.

Before you call or ask for a quote, have your auto policy in hand. Inform the agent of your deductible amounts and limits of liability, medical payments, uninsured motorist, towing and labor and rental if needed. This way you are comparing exact coverages in comparing premiums.

Multi line Discounts

All insurance companies give discounts for multi line policies. Meaning that if you have your auto, homeowners, life, health or business insurance with the same company, these discounts will be applied to all policies. If you are satisfied with a certain company, it could be to your advantage to have them quote all your insurance needs. Many times you can save hundreds of dollars with multi line discounts.

Auto Deductibles

The comprehensive and collision deductible amount for your auto policy will greatly impact your premiums. Simply, the lesser the deductible, the higher the premium. The greater the deductible, the lower the premium. Comprehensive and collision deductibles can range from zero to one thousand dollars. Having the highest deductible can save you hundreds of dollars yearly on auto insurance.

Homeowners Deductibles

Deductible means that the insured pays the first part of every loss up to the amount of the deductible. This reduces the cost of insurance by reducing the number of small claims. It is wise to carry a large deductible on your Homeowners policy in order to lower the cost of insurance.

Note: Did you know that an insurance company can and will cancel your homeowners policy for filing too many claims within a certain period of time. Many people tend to view their homeowners policy as a home maintenance policy. Filing too many claims (regardless of the size in dollar amount) will result in a policy cancellation. When this happens, you will pay double to triple the amount for another homeowner policy. Most insurance companies will cancel a policy if the policyholder files three or more claims within a calendar year.

Homeowners Scheduled Personal Property:

The homeowners policy is designed for use by the "average" homeowner. Many homeowners have needs that exceed the coverage limits of the homeowners policy.

Any item that is valued for more than the policy limit, needs to be listed in a scheduled personal property endorsement. This includes jewelry, furs, cameras and equipment, musical instruments, silverware, golf equipment, fine arts, postage stamps and coins.

Many insurance companies now offer an option for Identity Theft protection, that can be added to your homeowners policy. It is a good idea to check the availability of the identity theft option with your agent.

Do You Need A Personal Umbrella Policy?

A Personal Umbrella insurance policy can provide more extensive Liability coverage than a personal lines policy. A Personal Umbrella policy is simply a Liability extension to one's homeowners or auto policy. Some insureds need more extensive Liability coverage to protect assets. A Personal Umbrella pays when ones homeowners or auto liability has been exhausted. For instance, if you carry $100,000 liability on your homeowners or auto insurance and are found liable by the court for $300,000. A Personal Umbrella policy pays the difference between your homeowners or auto liability limit.

Whole Life vs term Life

Insurance companies are investors, they invest your premiums into funds that yield much more profit than the cash value of your whole life or universal life policy. Take your money and do the same. Invest into a mutual fund.

You can buy term insurance for pennies on the dollar compared to universal life or whole life. Take the difference you would have to pay between a whole life policy versus a twenty year term life policy and invest the savings in a mutual fund.

Where life is, there risk is also. No life on earth has been lived by anyone without having to undergo natural threats such as disease, catastrophes and yes, even death.

The principle of insurance is to manage those unpreventable risks by investing early and preparing to meet them. Insurance companies are there to calculate the premiums that you would receive in times of need.

Insurance dates as far back as the third and second millennia where Chinese and Babylonians who traded practiced it. The Chinese merchants ‘insured’ their products by distributing them in several ships rather than putting them all into one. This way, in case the ship capsizes, there are other goods that would remain intact. This is insurance in its simplest form.

Health and life insurance all began with the Greeks and Romans. Dating back to 600 AD, they practiced insuring ‘help’ among members of their community who experience death in their families. This is a type of service as a form of insurance. Once a member of their community passes away, all other members (called benevolent societies) help in the burial and also in taking care of the departed one’s family.

The insurance we know of today has many types:

1. Automobile insurance—covers legal liability claims and damages to the car. Even lost cars are covered. In the United States alone, car insurance is an ever-growing business. And to the people, it is a necessity because you can only operate a vehicle on public roads if it is insured.

2. Aviation insurance—is a type of insurance that covers Spares, Hull, Deductible, Liability threats and Hull War.

3. Boiler insurance—an insurance for breakdowns.

4. Casualty insurance—covers accidents but not tied to specific properties.

5. Credit insurance—pays back loans when something bad happens to the client (examples are disability, loss of employment, or death).

6. Financial loss insurance—covers a policy holder in case of illnesses or injury that caused him to lose his job.

7. Liability insurance—covers all legal claims against the policy holder.

8. Purchase insurance—provides protection to goods or any products that consumers purchase.

9. Marine insurance—this covers damages or even the loss of merchandise at sea.

10. Pet insurance—is insurance for pets against illnesses and accidents. This could also include health care and burial.

11. Life insurance—provides finances to loved ones in case of death.

There are many more types of insurance out there today. You will be surprised at the names that people have come up with such as in the case of Terrorism insurance. You see, insurance evolves, just as our society evolves.

Contrary to common belief, you do not ‘enjoy’ your insurance money only when you lose a limb or when you die. You can, in fact, there are certain life insurances that accumulate values (in cash) which can be claimed by the insured if he chooses to surrender the policy.

Other people use insurance to save money. This is because insurance money or the so called ‘interest’ is non-taxable, so more and more people are saving through insurance.

Insurance has gone a long way when we are speaking of global growth. Many economies have boomed because of the help of insurance. Japan and the United States are the leading insurance providers in the world today.

Although insurance companies sprout everywhere, it is still wise to do a thorough research about the companies that you are considering to get insurance from. Keep in mind that it is your future that these companies are working on so better be wary!

Medical savings plans protect you against terrible medical expenses and help you stay ahead of any future medical event. It also helps to reduce health care costs. Today there are different medical savings plans that have been introduced to the benefit of the people and that includes the health saving account (HSA). The health saving account HSA is designed to reduce to reduce the health care cost for both employers and employee and also the health saving plan at is design to cover current and future medical expenses, the health saving account HSA offers tax free saving account for medical expenses ails help to reduce the current health care cost.

For medical plan type health savings account cover the cost of high deduction plans and also the health savings account is not a use is it or loss it policy instead if you don't spend the fund it will be carried over to next year since insurance is used to cover risks, the health insurance plan provide safety values in place to cover the extraordinary medical expense or costs. Individuals under the age of 65 years who buys a qualified high- deductible policy can open an HSA and also you can make contribution to the health insurance saving plan but if you are above 65 you are qualified for medical care, this means you cannot take part in the health saving account.

However if you are in the age bracket of 54 and 64 then you can contribute an additional tax deferred amount which can be converted to an IRA which means the individual retirement account, also if you withdraw funds for medical expenses it will not be taxed. Bear in mind that the health saving account contribution will not affect your IRA limits instead it helps because its another way to save for taxed -deferred retirement. For Medical savings plan the health saving account comes with a complete debit card and checks like saving account and also if the fund saved and spent on medical expenses or purposes all the capital gains , withdrawals and contribution will remain on taxed.

What are the nature and details of such a plan?

The health saving accounts is lumped with HDHP with expenses. When you meet the HDHP requirements, the HDHP plans covers 100% of medical expenses and this medical expenses include hospitalization, prescription, lab test and emergency room visit and also withdrawal from the health saving account cannot be used to pay high deductible health plan premium unless you are unemployed and also withdrawals from the health saving accounts are not taxable if they are used for medical expenses, but if they are used for non medical purposes or expenses then they are not only taxed, you will have to pay a10% penalty on the funds. Small business or organization who wants the best saving plans for his employees can use the health saving account because it provide basic medical coverage.

What are the Benefits of such a plan?

Employee does still have to get the high deductible health plan to participate but it is the employer and the employees that can both contribute to the account on a tax deferred basis. Even if the employee leave the company if or she is entitled to take the account with him. If the employee decided to use the fund for non medical expenses like going on vacation, buying a house or a car, they will have to pay the penalty and taxes on the withdrawal but the company has limited legal rights and resources to stop them. This means that the company cannot control how the employee use the money some of the benefit of having a medical saving plan through the health saving account, this means that the HSA plan provide tax free medical expense and the health savings account can be moved from one employer to another, the health saving account is also free of tax for employee contribution, it also facilitates employees health care customers better the health saving account also match with a high- deductible health savings plans.

Also available are Discount medical savings plans which also provide a means of building up reserves against extraordinary medical expenses in the future, so even if you are healthy there is a provision that helps reserve funds for later use. Another wonderful benefit that the discount health saving account offer is that it is tax deferred, so one use scarce resources for problems needing immediate attention.

Health insurance serving plan provide the best possible medical coverage for medical expenses. Medical savings plans also provide you with the best and affordable medical insurance that have a high deductible facility, so it is a advisable for you and also beneficial for you to get a Medical savings plan for you and your family today.