Reduce your costs and effort with our expert TPA services
Use the TPA trusted by employers, Funds, health systems, carriers, and other TPAs
The team at Brighton Health Plan Solutions has been providing comprehensive third party administrator services for more than 30 years. Our self funded clients appreciate our technical proficiency in claims administration, clinical knowledge, and superior customer service.
Thinking about making
the switch to self funding?
Learn about our Level-Funded program that eases funding through predictable monthly payments.
We can manage your plan, process your claims, and reduce your claim and administrative expenses. We can save you money on health plan administration, no matter which health insurance carrier you’re using.
Employers, Funds, and even other TPAs use our third party administrator services either in conjunction with our proprietary health plans and networks, or with health plans and networks from any other vendor or health insurance carrier.
Unparalleled TPA expertise and flexibility
Custom plan design
No two clients are alike. We work with you collaboratively to tailor your health plans to your budget, members, and healthcare goals.
High-touch account management
We treat every client as our most important. Our dedicated teams will go above and beyond for you.
Create® Technology platform
Our state-of-the-art healthcare technology includes a highly configurable open enrollment platform, member and administrator service tools, and a mobile app with real-time data feeds. The proprietary software allows members to maximize their benefits and allows you to more easily manage them.
Claim adjudication and processing
We administer your health plan any way you want, and can accommodate special arrangements such as benefit tiering. We process more than 10.1 million claims each year with 99% accuracy, and use strong auditing tools. Our average client retention rate of more than 10 years attests to our expertise in claims adjudication and claims processing.
Using our advanced technology platform, you receive actionable data in real-time. Easily run reports for at-a-glance information on key demographic and utilization metrics that help you discover trends and control costs.
Provider network management
An expert team configures, maintains, and audits our proprietary networks and your custom networks to ensure they meet adequacy requirements and our clients’ standards. To better serve their patients, our providers connect to our online provider portal and interact with our US-based provider customer service staff.
Enrollment, eligibility, and ID cards
Through our Create Technology platform, enrollment and onboarding are a breeze. We manage all eligibility files for you, and handle ongoing hours reconciliation and contribution accounting.
We produce tailored ID cards, and deliver them by mail and through our mobile app. Even if you produce your own ID cards, we can make them available digitally through our advanced technology platform.
Superior customer service
Our Concierge customer service team loves to help our members understand their plan, navigate to the right care, resolve billing matters, and more.
They will help your members find providers, schedule and coordinate doctor appointments, navigate their benefits and bills, and more.
Custom communication materials
We design custom enrollment materials and communications, and coordinate meetings and webinars to help educate your members on their health plan options and engage them in their benefits.
Competitive Stop Loss coverage
Our strong relationships with Stop Loss partners help our clients achieve competitive Stop Loss insurance coverage. Or we can integrate seamlessly you’re your preferred Stop Loss vendor.
Entrust your COBRA administration to the experts
COBRA is a complex benefit with strict regulations. Remain compliant and avoid penalties by offloading COBRA administration to a TPA with expertise and keen attention to detail. We can assume the responsibilities for your COBRA benefit – including preparing and distributing all documentation and communications, monitoring election periods, and collecting monthly premiums.