Which of the following is NOT typically a function of a third-party administrator?

A third-party administrator (TPA) primarily serves roles in managing the administration of healthcare plans and claims processes, especially for self-funded insurance plans. The typical functions of a TPA include managing claims, providing administrative services to self-funded plans, and handling payments for insured claims, all of which are integral to their responsibilities in assisting clients with plan management.

Determining policy premiums is not generally one of the functions of a TPA. This process typically falls under the purview of insurance carriers or underwriters, who assess risk and set pricing accordingly. TPAs operate based on established agreements and guidelines, focusing instead on the processing and administration of claims rather than the financial underwriting of the policies themselves. Therefore, identifying the role of a TPA helps clarify their responsibilities and emphasizes that premium determination is a separate function handled by different entities within the insurance system.