TPA Services
Summary of Third-party Administrator
(TPA) Services provided by EGP
- Monthly itemized premium and administrative fee billings.
- Monthly and year-to-date claim history reports.
- Self-funded employer benefit fund account maintenance.
- Monthly report of excess-loss protection status.
- Complete claims administration of employer-funded claims.
- Provide employee claim worksheet copies to employer.
- Master Plan Document, Summary Plan Description and employee booklets.
- Master group insurance policy for insured benefits and the group insurance certificates.
- Reporting to the IRS of charges paid to medical providers for shared funded and insured payments.
- Plan identification cards for employees and dependents.
- Annual Reports:
- Health prognosis evaluation risk (risk protection).
- Claims History.
- Breakdown of payments to medical providers and employees.
- Annual excess-loss protection status.
- Summary of total annual plan costs.
- Breakdown of employee medical expenses.
- Other Available Services:
- Health prognosis evaluation risk (risk protection).
- Occupational health and wellness consulting.
