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There are many administrative options for employers in EmCap programs, ranging from local
firms to national healthcare organizations. Each EmCap program will likely have only one Third
Party Administrator (TPA), so potential TPAs are required to go through an extensive evaluation process.
In addition to offering excellent administration and client services, potential EmCap TPAs must
demonstrate a history of working with employers to improve the health of their population and lower costs.
This includes strong clinical and reporting capabilities, as well as the ability to lead discussions about
plan construction and risk management tools.
TPAs and ASOs are typically evaluated upon:
- Breadth of networks
- Depth of network discounts
- Medical and population health management programs
- Integrated wellness programs
- Plan design evaluation and construction
- Claims adjudication
- Claims, analytical, and predictive modeling reporting capabilities
- PBM relationships and financial structures
If you would like additional program information, we require
a Non-Disclosure Agreement.
If you would like to pursue either forming an EmCap program or providing administrative services for an
EmCap program, please contact us.
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