Direct Care Administrators

Direct Care Administrators

It is my privilege to introduce Direct Care Administrators and its role in serving the self-insured health benefits industry.

Direct Care Administrators was established 16 years ago to meet the demand for better information for employer groups, stop loss carriers and brokers. Managing a health benefit plan is always about access to current information. Our technology for receiving and paying claims is continuing to change as new and better methods are developed. Because the plan management and claims payment system is proprietary it is state of the art. We listen to the clients needs and identify how they can be met. The ability to respond quickly to their ever-changing needs is what makes us unique. We view our role as a partner with self-funded employer benefit plans.

Employers self-fund in order to pay for their employees medical costs by paying providers directly and/or reimbursing employees, rather than paying a fixed premium to an insurance company. The advantages of self-insuring are many, but one of the most compelling is to save money. The decision to self-insure mandates that a company seek help to make sure the benefit plan works properly. Over 70 million Americans rely on a Third Party Administrator to handle the collection and payment of their medical expenses.

Why use an independent party to administer benefits rather than an integrated company like the fully insured companies?

A TPA that is independent answers to the plan and its participants without regard to outside influence. Trusting benefit plan dollars to someone must be taken seriously. That trust begins by complete and total disclosure with data that substantiates every dollar that goes in and goes out of the plan. Being independent means every component of the plan, from the broker to the stop loss carrier, is a menu item and the value that each component brings to the plan is evaluated and measured to meet the employer and the employee needs monthly. If your TPA is a partner, they must be trusted like any other third party vendor. That trust must involve transparency in revealing everything about the plan. The ACA has additional regulations companies must comply with but some of the regulations do not apply to self-insured groups. As a result more companies than ever are considering self-insurance. Kaiser reports that the number of self-insured companies is up 13% form 2011.

In choosing a partner to assist in making decisions for your benefit plan it is good to know that it is not about price but it is a comforting that great service and technology can also be affordable.

I will be pleased to demonstrate how Direct Care Administrators can be your partner.


Pete Peterson

Direct Care Administrators