TPA is the abbreviation of the third-party manager of group medical insurance, which refers to the third-party management company of medical insurance. Its business includes providing new contracts and security services, handling claims, providing customer service, network of medical service institutions and arranging medical expense settlement services. It is a company that provides third-party management services to health insurance companies or insurance companies engaged in medical insurance, especially medical expense insurance. Its business includes providing new contracts and preservation services, handling claims, providing customer service, network of medical service institutions and arranging medical expense settlement services.
So what does tpa stand for?
Originated in the United States, it refers to the third-party intermediary agencies providing consulting and management services for medical insurance plans carried out by insurance institutions.
In practice, TPA can be divided into two categories: one is that insurance companies provide third-party management to enterprises or social security institutions as third-party managers, and the other is that professional service companies provide third-party management services to insurance companies as intermediaries between insurance companies and medical institutions.
TPA does not bear risks, and its only risk is the risk of loss, that is, when the actual cost is higher than the management fee charged, TPA needs to bear the excess management fee by itself.
The third-party management business originated from the American insurance industry in the early 20th century. At that time, in order to alleviate the labor-capital contradiction in China, several states in the United States successively promulgated the Law on Industrial Injury Compensation, which stipulated that employers should take full responsibility for the injuries suffered by employees in the workplace. Some employers provided employees with industrial injury compensation protection through self-protection. Insurance companies used their own advantages to provide employers with industrial injury compensation management services, and some industry associations in the Midwest of the United States provided retirement and old-age security for employees in the industry. Employers and employees don't trust each other on the question of who will manage the pension fund and who will distribute the pension, so they choose companies independent of employers and employees-insurance companies, banks or companies allowed to invest to manage the pension. In 1950s, some enterprises managed employees' pensions individually or collectively. 58660.68868688666