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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 ...
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 ...
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 ...
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.
Health care reform was a major concern of the Bill Clinton administration headed up by First Lady Hillary Clinton. The 1993 Clinton health care plan included mandatory enrollment in a health insurance plan, subsidies to guarantee affordability across all income ranges, and the establishment of health alliances in each state. Every citizen or ...
EmblemHealth was created in 2006 through the merger of Group Health Incorporated (GHI) and the Health Insurance Plan of Greater New York (HIP). GHI and HIP had been operating as separate companies in the New York region since 1937 and 1947, respectively.
Medicare is a federal health insurance program in the United States for people age 65 or older and younger people with disabilities, including those with end stage renal disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). It was begun in 1965 under the Social Security Administration and is now administered by the Centers ...
The public health insurance option, also known as the public insurance option or the public option, is a proposal to create a government-run health insurance agency that would compete with other private health insurance companies within the United States. The public option is not the same as publicly funded health care, but was proposed as an ...