A type of contract with an insurance company or a third-party administrator that provides an employer with administrative services such as claim payment. It does not provide coverage for the risk of insurance protection. The usual expenses covered include claims processing, plan design advice and printing benefit booklets. These contracts are usual [..]

An arrangement under which a third party, for a fee, processes claims and handles paperwork for a self-funded group. This frequently includes all insurance company services (actuarial services, underw [..]

A group health self-insurance program for large employers wherein the employer assumes responsibility for all the risk, purchasing only administrative services from the insurer. Such administrative [..]

The hiring of a firm (usually a health care vendor) to handle certain administrative tasks. The firm does not assume any risk but merely carries out the specialized functions that the employer cannot [..]

An arrangement in which an employer contracts with a third party, typically a health care carrier, to administer the health care plan for the employer who assumes the benefit plan claim risk.  In an A [..]

Common to health welfare plans, where an organization employs an outside organization to provide administrative services for self-funded plans. The ASO Contract or provider provides claim and policy a [..]

A fee-based program in which an insurance company or other third-party administrator performs administrative, clerical or managerial services only and does not assume any risk. Services usually include claims processing, but also may include other services, such as actuarial analysis, utilization review, etc. Businesses or self-funded health plans [..]

When a third-party administrator (see “Third-party administrator”) provides services such as processing and paying health benefit claims for an employer.

An arrangement in which an organization funds its own employee benefit plan but hires an outside firm to perform specific administrative services. For example, an organization may hire an insurance company to evaluate and process claims under its employee health plan while maintaining the responsibility to pay the claims itself.

an arrangement under which a third party, for a fee, processes claims and handles paperwork for a self-funded group. This frequently includes all insurance company services (actuarial services, underw [..]