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The decision to move administration of the State Health Plan to Aetna from Blue Cross Blue Shield of North Carolina, which has been the third-party administrator for more than 40 years, came in a ...
Third-party administrator. In the United States, a third-party administrator ( TPA) is an organization that processes insurance claims or certain aspects of employee benefit plans for a separate entity. [1] It is also a term used to define organizations within the insurance industry which administer other services such as underwriting and ...
Pharmacy benefit management. In the United States, a pharmacy benefit manager ( PBM) is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans.
Self-funded health care, also known as Administrative Services Only ( ASO ), is a self insurance arrangement in the United States whereby an employer provides health or disability benefits to employees using the company's own funds. [1] This is different from fully insured plans where the employer contracts an insurance company to cover the ...
Seema Verma (born September 26, 1970) [2] is a General Manager and Senior Vice President at Oracle Corporation. She is the former administrator of the Centers for Medicare & Medicaid Services in the Donald Trump administration. During her tenure, she was involved in efforts to repeal the Affordable Care Act, as well as reduce Medicaid benefits ...
The Employee Benefits Security Administration (EBSA) is an agency of the United States Department of Labor responsible for administering, regulating and enforcing the provisions of Title I of the Employee Retirement Income Security Act of 1974 (ERISA). At the time of its name change in February 2003, EBSA was known as the Pension and Welfare ...
The United States Department of Health and Human Services ( HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of the U.S. people and providing essential human services. Its motto is "Improving the health, safety, and well-being of America". [3]
In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...
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