TPA Administration Services

Employer Contributions, Employer Payments, Member and Retiree Eligibility

Post employer contributions and payments or other revenue received such as past due, settlements or stipulation payments for the following benefit fund accounts.

  • Annuity
  • Cobra
  • Dental
  • Disability
  • Dues
  • Education
  • Health and Welfare

  • Health Reimbursement Account
  • Hearing
  • Industry Advancement
  • Legal Services
  • Labor Management
  • Optical
  • Political Action

  • Pension
  • Prescription
  • Supplemental Unemployment
  • Supplemental Benefits
  • Training
  • Market Recovery
  • Vacation

Design and produce reports similar to what the Funds currently receive.

Provide a secure remote portal connection to securely access the Fund data being maintained.

Provide employer delinquency and eligibility shortage reports around the 20th of the month to identify members potentially losing eligibility.

Provide employer payment reports and employer delinquencies - 30, 60, 90, 120 days, etc.

TPA Corporation currently generates weekly electronic member and retiree eligibly files in either vendor proprietary or HIPAA 834 formatted eligibility files for the following benefit providers and benefit administrators:

  • America Health Care
  • Anthem
  • Aetna
  • BMR - Rx
  • Blue Cross Blue Shield
  • CPS - Optical
  • Catamaran - RX
  • Davis Vision
  • DDS Dental
  • Empire
  • Horizon
  • Optum RX
  • Magnacare
  • Seledent
  • Medicare Section 111
  • Vision Screening

 

 




Review eligibility discrepancy reports, address data issues and submit correction files, if necessary.

Establish settlement agreements rates and rules for posting negotiated employer settlement payments.

Send letters, correspondence and information requests to plan participants - Cobra notices, FLMA applications, COB information requests, requests for birth certificates, marriage certificates, divorce letters, college verification, etc.

Generate all tax related forms and electronic government or employer required reporting, including 1099', W2's, tax withholdings, 1094's, etc.

Provide the fund with a suite of monthly eligibility, disability, cobra, workers compensation, stop loss, retiree, accountant and actuarial reporting.

Provide demographic and eligibility data for benefit premium renewals, to new or potential benefit providers or for benefit provider transitions.

Make weekly on-site visits during the transition phase and scheduled routine visits as required thereafter.