Many insurers use a third-party administrator for GP, specialist and dental benefits. The TPA manages the panel of clinics, issues medical cards or the app employees use, and handles the clinic bills.
For employees, the TPA is often the name on the card and the number to call about outpatient claims. Hospital claims usually go to the insurer itself.
When comparing plans, the TPA’s panel and app can matter as much as the insurer’s name.