Presenters: Mary Powell and Sarah Kanter
As health care costs continue to rise, an increasing number of employers are transitioning to self-funded health plans. Successfully negotiating the terms of a third-party administrator (TPA) agreement is essential—both for cost containment and for ensuring appropriate legal protections. In this session, Mary Powell and Sarah Kanter will examine key contractual provisions and offer practical guidance on the following topics:
- The Independent Dispute Resolution (IDR) process and its impact on plan costs, including contractual strategies for mitigation
- “Shared Savings” fee arrangements: understanding the mechanics and limiting exposure
- Identifying and addressing ancillary fees, including prepayment integrity fees and overpayment recovery charges
- Medical rebate provisions: ensuring proper allocation and transparency in TPA reporting
- Performance guarantees: evaluating whether metrics are meaningful
- Additional critical provisions, including artificial intelligence safeguards, data access rights, limitation of liability, and indemnification clauses
Please direct your questions or comments to: webinars@truckerhuss.com.
Click here to register to attend.
MCLE: This program is eligible for Continuing Legal Education (CLE) credit. Please contact Catherine Jemera at cjemera@truckerhuss.com to receive a CLE certificate of completion.
SHRM: Trucker Huss is recognized by SHRM to offer professional development credits (PDCs) for SHRM-CP® or SHRM-SCP® recertification activities. This program is valid for 1.0 hours of PDC for SHRM-CP® or SHRM-SCP®.
HRCI: This program has been approved for 1.0 (HR (General)) recertification credit hours toward aPHR™, aPHRi™, PHR®, PHRca®, SPHR®, GPHR®, PHRi™ and SPHRi™ recertification through the HR Certification Institute.
