Trusted guidance, seamless self-funding

How Blue Cross and Blue Shield of Kansas outperforms traditional TPAs with bundled services and integrated support

For employers considering self-funded health coverage, one key decision is who you partner with to administer the plan. While traditional third-party administrators (TPAs) can offer flexibility and control, they may fall short in critical areas like claims handling, provider access and member support.

At Blue Cross and Blue Shield of Kansas (BCBSKS), our self-funded solution provides the best of both worlds: the control you want with the strength, stability and transparency of a fully integrated partner.  When you bundle administration, claims processing, provider access, care management and customer support under one trusted name, you get a seamless experience for you and your employees backed by Kansas’ most comprehensive provider network.

Here’s how BCBSKS stacks up against a traditional TPA and why bundling with us means better results from day one.

What’s the difference? TPA vs. BCBSKS

1. Network strength and cost control

Many TPAs lease access to provider networks, which can be limited, more expensive or inconsistent across geographies. This can lead to unexpected billing issues, out-of-network charges or reduced access to care.

With BCBSKS, you gain access to Kansas’ most comprehensive and cost-effective provider network, backed by deep relationships with hospitals and clinicians across the state. In fact, Blue Cross and Blue Shield of Kansas contracts with 96% of all eligible providers, including 99% of medical doctors and 100% of hospitals in Kansas. That means your employees benefit from negotiated rates, broad access to care and a seamless experience in Kansas AND nationwide. You can easily search for in-network doctors, hospitals and facilities using our online provider directory. 

2. Administration you can trust

Claims processing, adjudication and compliance aren’t areas where you want surprises. Some TPAs outsource these functions, leading to slower turnaround, more errors and less accountability.

BCBSKS offers integrated administration including:

• Accurate, timely claims processing
• Built-in compliance with ERISA, ACA and state laws
• Support with stop-loss integration and billing
• Access to pharmacy, behavioral health and wellness programs

This means fewer headaches for your human resources team and a better experience for your employees.

3. Better experience for members

With a TPA, your employees may not know who to call for help, or worse —may bounce between vendors. This can frustrate employees and eat up valuable time for human resources.

With BCBSKS, your employees and human resources staff have one point of contact. Our local customer service team is ready to assist with:

• Benefits questions
• Claims support
• Prior authorizations
• Care management and navigation

Because your employees already recognize and trust the Blue Cross name, they're more confident when they need care or support.

4. Flexibility with guidance

Yes, TPAs offer flexibility, but they don’t always provide strategic insight. That leaves many employers unsure how to design benefits that actually support their workforce and financial goals.

BCBSKS takes a consultative approach, helping you:

• Analyze your group’s health data
• Identify cost drivers and trends
• Choose a benefit design that balances cost and care
• Implement wellness and engagement strategies

5. Accountability and alignment

With a traditional TPA, your organization is often managing multiple vendors — networks, pharmacy benefits managers (PBMs), wellness programs, stop-loss insurers — and trying to make the pieces fit.

BCBSKS provides an integrated solution. We work with you from start to finish and take ownership of your plan’s performance, not just its parts.

You gain:

• A unified team aligned with your goals
• Fewer administrative burdens
• A health plan that runs smoothly for you and your employees

The bottom line:

Choosing a self-funded plan doesn’t mean you have to piece everything together on your own. And it doesn’t mean sacrificing control for support.

With Blue Cross and Blue Shield of Kansas, you get:

• The transparency and flexibility of self-funding
• The strength of a trusted, local partner
• The tools, data and support to help you succeed

Let’s talk about what’s right for you

Curious how self-funding compares to your current plan? Your Blue Cross representative can review your group’s data, goals and risk profile to help you decide if it’s the right move.