TPA
Also called Third party administrator. Updated
Who carries the risk and who does the work
The insurer and the TPA are two different companies with two different jobs. The insurer underwrites the policy and pays the claims out of its own balance sheet. The TPA does everything the member ever sees: prints the card, holds the list of clinics and hospitals, answers the approval call at eleven at night, and settles with the provider afterwards.
This is why a UAE health insurance plan is identified by both names. "Takaful Emarat on NextCare" and "Takaful Emarat on NAS" are the same insurer with two different administrators, two different provider lists, and two different service experiences. A client who has had a bad time with one TPA has an opinion about the TPA, not about the insurer.
Why the TPA changes the price
The TPA owns the network, and the network is most of what a member is paying for. A plan administered on a restricted network of clinics costs less than the same plan on a network that includes the large private hospitals, because the claims that come out of it are cheaper. So the TPA name on a rate chart is not a service note — it is part of the product being priced.
The TPAs a UAE broker meets
NextCare, NAS Administration Services, Mednet, Neuron, Almadallah and insurer-owned administrators such as Dubai Care all appear on UAE health rate charts. Several insurers work with more than one, and the same insurer's plan can be quoted on any of them.
Where the TPA sits in a quote
A quote has to name the TPA, because "Silver" on its own does not identify anything a client could buy. In Rabt the insurer, the TPA and the plan name together identify the plan, and the network sits underneath as a separate thing that plan is sold on.
Where this comes up
Related terms
In Rabt
Every one of these is a field in Rabt
Co-pay, network, age band, waiting period — Rabt holds them as data on the plan, so a quote states them the same way every time and a comparison can line them up.