TPA Solutions

To produce a medical quote, EHIM needs the following information to quote our services.

For a NEW Group that is not currently self-funding any portion of their medical plan, we need:

• A complete description of the group’s current program, including all riders, fixed dollar copays, etc.
• Current and/or renewal rates for the group’s currently enrolled plan
• Census of the number of single, two-person, family, family continuations:
• Birth date or age
• Gender
  

• Renewal date
• A complete description of the plan the group may want to purchase, including all riders, fixed dollar copays, etc.
• Rates for all programs chosen and/or quoted
• Desired agent commission ($2.50 PEPM is standard)

If a census is not available, a premium statement may provide enough information. A rate sheet and/or renewal information may be provided in lieu of #2 listed above.

For a Group that currently has an HRA or wrap program in place, we will need:

• All of the above information
• Current administration fees
• Current TPA’s termination process

In order to expedite your request, an electronic format of claims data is helpful. For more information, please contact us.