TPA Services

Your Self-Insured Plan, Supercharged

Already self-insured or level-funded? Enough! Health TPA administers your plan with Member Premium Reserve accounts held in each employee's name, Care Approved Card access, and self-pay pricing. Same employer funding structure — dramatically better employee experience.

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What a Third Party Administrator Does

A Third Party Administrator handles the day-to-day operations of your self-insured health plan — claims processing, compliance, employee communications, and reporting. Enough! Health TPA adds the Member Premium Reserve architecture — custodial accounts held in each employee's name, funded by premium allocation — on top of standard TPA services.

ICHRA, Captive Group, or TPA?

TPA

Self-insured + Enough! Health administration

Employer retains insurance risk (self-insured). Enough! Health administers. Best for: employers already self-insured who want to add the Member Premium Reserve without changing their funding structure.

Captive Group

Fully-insured through Enough! Health

Employer transfers risk to Enough! Health (fully-insured). Best for: employers who want the Reserve architecture without taking on self-insurance risk.

ICHRA

Individual allowance model

Employer provides monthly allowance. Employees buy individual plans. Best for: employers who want maximum employee choice and budget predictability.

Not sure? Our implementation team will recommend the right structure for your headcount, risk tolerance, and state. Talk to an advisor →

What's Included in Enough! Health TPA

Reserve account administration (individual employee custodial accounts)

Care Approved Card issuance and management

Self-pay pricing access and provider rate negotiation

Claims processing and adjudication

Stop-loss reinsurance coordination

ACA and ERISA compliance management

Employee onboarding and education

Monthly reporting and analytics

$60 per employee per month

All-inclusive TPA administrative fee. No hidden fees.

Stop-loss reinsurance is priced separately based on your plan's attachment point and employee demographics.

employers@joinenoughhealth.com

Implementation Timeline

1
Phase 160–120 days

TPA Licensing

Enough! Health obtains TPA license in your state if not already licensed. This is a one-time regulatory step.

2
Phase 22–3 weeks

Employer Onboarding

From signed agreement to employee enrollment: plan document preparation, Reserve account setup, Care Approved Card issuance, employee education.

ERISA Compliance Built In

Each employer's plan operates as an independent plan document and plan trust. Enough! Health TPA does not operate as a Multiple Employer Welfare Arrangement (MEWA). Each employer's plan is fully independent, legally separated, and ERISA-compliant.

Frequently Asked Questions

What is a self-insured plan?

A self-insured (or self-funded) plan means the employer bears the financial risk of paying employee health claims, rather than paying a fixed premium to an insurance company. Employers typically purchase stop-loss insurance to protect against catastrophic claims.

Do we need to change our stop-loss coverage?

Not necessarily. Enough! Health TPA coordinates with your existing stop-loss carrier or can recommend providers. Adding Member Premium Reserve accounts does not fundamentally change your stop-loss structure.

How does the Reserve work with self-insurance?

Instead of the employer simply paying claims as they come in, a defined share of the monthly per-employee funding is allocated to individual employee Reserve accounts. Claims are paid from the Reserve first, then Plan Coverage, then stop-loss.

Where is TPA available?

Contact us to learn if TPA services are available in your state.

Already Have a TPA? Switching Is Straightforward.

If you are already self-insured with another TPA, switching to Enough! Health TPA administration follows a standard transition process. We handle the heavy lifting: data migration, stop-loss carrier coordination, eligibility file transfer, ERISA compliance documents, and employee communications.

We Handle

  • Claims data migration
  • Eligibility file transfer (834 EDI)
  • Stop-loss carrier notification and written consent
  • SPD amendment and SMM distribution
  • New Care Approved Card issuance
  • Member portal setup
  • Provider notification

You Handle

  • Forward one employee announcement email
  • Attend one benefits session
  • Sign the administrative services agreement

Zero coverage gaps

Run-out arrangement with your current TPA covers all pre-transition claims.

Stop-loss continuity

We coordinate directly with your stop-loss carrier — written consent obtained before any transition begins.

ERISA compliance

We draft all required documents — SPD amendments, SMM, plan document updates — and file them on your behalf.

Data ownership

All your claims data is YOUR data. We extract it from your current TPA and migrate it into Enough! Health systems securely under HIPAA protocols.

Already self-insured? Let's talk.

We'll walk you through how TPA with Reserve administration fits your current plan structure.