As an ERISA attorney, my retainer agreements are pretty straight and clear. Governed by the laws that govern attorney behavior, I have no choice. Yet, Third Party Administrators (TPAs) don’t have guidelines to live by.
While fee disclosures have made fees a little more clear, they haven’t done that much for contracts for TPA services. TPAs should offer clear contracts for their services, as well as some formulas for fees that they may not be able to easily calculate, such as deconversion fees and other ancillary work. They also need to be clear on what services they will provide and when, as when they will get paid.
One of the biggest disputes is when a client fires their TPA and there is a discrepancy on what work still needs to be done and what is being charged.
