Third Party Administrators Services

The Vendor is required to provide third party administrator (TPA) services, including claims administration, customer service, reporting, and other professional services for its health, dental, and life insurance plans offered by and through office.
- Partners with a contracted subrogation administrator responsible for identifying and managing claims that qualify for subrogation recovery.
- The administrator works directly with members, attorneys, and other relevant parties and coordinates with the supplier to ensure proper adjudication of claims.
- The right to recover funds from members, dependents, tort Feasors, liability carriers (including underinsured and uninsured motorist policies and medical payment policies), and other identifiable sources in amounts equal to any and all claim payments made on behalf of a member or dependent for injuries caused by a third party’s wrongful act or negligence, as outlined in division administrative rules (part 15).
- Claims meeting subrogation criteria shall not be eligible for reimbursement until released by the subrogation administrator.
- The administrator to approve exceptional claims and eligibility matters when circumstances require.