Who we are.
Insight Benefit Administrators is a full-service, independent third party administrator. We provide the resources and capabilities of a national TPA and the service-minded accessibility of a hometown firm. Solution-based plan designs and consistent high-quality benefit administration, along with effective cost management solutions, keep your benefit dollars under control while contributing to the health and well-being of covered individuals.
At Insight, our priority is serving our clients, participants, providers and business partners who place their confidence in us. Our goal is to be your single source third party administrator providing seamless benefit solutions through high technology and implementation of the industry’s leading benefit management services — all backed by the industry’s best customer service.
Our Mission
When you partner with Insight Benefit Administrators as an agent/broker, client, covered member, or provider, you can be sure that you will get our best. We believe that knowledge – yours and ours – is power and understanding is critical. Our success demands that we provide the best products and services at the best price while being fully responsive, transparent, honest, accurate and timely.
For our clients:
- Actively seek feedback from you, your employees and the agent/broker community
- Continually evaluate our product and service options
- Ensure that you and your employees have a thorough understanding of your benefits
For our employees:
We promote freedom of opinion, ideas and expression. We provide opportunities for professional growth. We work hard to provide exceptional service to our customers while maintaining essential work-life balance.
For the communities we serve:
Our social mission is to provide educational and financial support for pediatric dental care to underinsured and uninsured children. (To learn more contact Howard Lancaster at howardl@insightba.net.)
We welcome your questions and suggestions. Use our Contact Us page to reach any one of us.
Community Outreach
We know that many people in and around our community face, first-hand, significant challenges with finding and paying for health care. For us, pediatric dental care is personal. As a way to raise both awareness and funds for this important aspect of care, we partner with Exalta Health, a Grand Rapids-based organization made up of local physicians, nurses, social workers, pastors, and business people who serve the underprivileged with faith-centered medical care.
To learn more, please visit Exalta Health.
If you would like to discuss how you can contribute to our/their efforts, please contact Howard Lancaster.
Why Choose Insight?
We’re glad you want to know.
Insight Benefit Administrators is a Michigan TPA located in Grand Rapids, Michigan. We administer Health and Welfare Benefits for employers across the United States for employers located anywhere in the U.S.
Through experienced operations, innovations in claims management, flexible and creative plan designs and best-in-class vendor partners, Insight brings a unique value proposition to our clients and our membership.
Insight continually looks to engage plan design solutions that are easy for members to navigate and translate into immediate savings for our clients.
We’re set up to give you the attention you deserve.
- Our President and executive staff are involved in every new client implementation and we meet with our clients regularly
- Our size allows us more agility and quicker response time
- Our average claim turnaround is just 3 to 5 business days
- We ensure transparency in all claim data and pricing
We perform extensive claim scrubbing for every bill type.
- We employ a Network Navigator (Over 60 networks)
- We audit all claims and bills for all claim types
- We offer flexibility in Coordination of Benefit rules
- We continually audit dependent eligibility
- We are more restrictive with auto adjudication parameters
- We regularly monitor for Third Party Liability
Our benefit design strategies are focused on cost containment. Our approach includes:
- Customized Diabetes Management programs
- “Right Tier” Copay structure for pharmacy benefit management
- Specialty Pharmacy Carve-Out alternatives
- Dialysis negotiations for additional discounts
- Promoting free-standing high-tech radiology procedure alternatives
- Promoting free-standing surgical procedure alternatives
We employ Integrated Claim and Case ManagementTM (ICCM) for:
- Redirecting initial or subsequent care
- Identifying new potential high dollar claims through data sharing
- Managing high dollars with targeted Case management*
- Performing Medical Necessity Reviews*
- Negotiating conditional lasers
- Benchmarking Stop Loss review of certain high cost claimant claim profiles
* All Pre-Certification, Case Management and Medical Necessity Review is performed by Triple URAC Accredited Case/Care management providers.
We make it easy for you.
- Insight clients each have a personalized, private web portal
- Members can enroll online and always find benefit and claims information too
- You can make changes and additions to your census online
- We’ve chosen the technology that’s best in class for speed, accuracy and quality outcomes