Hou-Wen Jeng
Abstract
This paper addresses a few of the most important pricing issues faced by a third party administrator (TPA) whose main responsibility is claims handling for self-insured employers and self-insured groups. Such pricing issues include the development of service fees using claim closure information, the selection of service durations, and the design of incentive (either activity-based or financially-based) service contracts. Formulas for pricing new and open claims are provided.
Key words and phrases: self-insurance, service length, new claims, open claims
Hou-Wen Jeng