What's a TPA (Third Party Administrator) In Health Insurance | Pazcare
TPA in health insurance, Advantages of TPA, Role of TPA, Top TPA companies
September 21, 2022
Table of contents
Group health insurance is an insurance plan that is bought for a group of people. This group can either be an association, group of friends or corporation. However, group health insurance is more common with employers (organizations) like you; and is often known as corporate insurance which is bought by the employer for the staff of an organization and their dependents.
The group health insurance premium is comparatively less and is primarily calculated based on the number of people insured under the plan, and the group cumulative risk. This insurance is often selected by you (the employer) and the premium cost is either completely paid by you or can be divided between you and your employees, where you (the employer) often bear the bigger chunk. Group medical insurance like most health insurance is valid for one year. The group health insurance coverage ceases to exist the day your employee leaves the organization.
Individual health insurance is an insurance plan that any individual buy for themselves and their families. Under individual insurance, the family includes parents, spouses, and children. The premium is calculated based on multiple factors like age, gender, medical history, lifestyle habits, etc. The policy is often purchased after an insurance agent's recommendation.
The policy coverage might seem more comprehensive. Especially because the policyholder has the freedom to choose individual insurance and can be customized as well by paying a little extra for added benefits (riders). However, the premium for individual insurance is on the higher side. The policy is not affected by the employment status and remains valid until the policyholder wants.
Here is a comparison table between a group health insurance policy and an individual health insurance policy based on certain key factors.