DOL Compliance & Audit Readiness
How to Prepare Your TPA for a DOL Audit Before the Notice Arrives
TPAs don't fail DOL audits because of fraud. They fail because they can't reconstruct the story of a claim before the clock runs out. Here is the five-step framework audit-ready operations use to clear examinations in hours, not weeks.
Mar 2026
The Hidden Cost of Running a TPA in 2026: Plan Builds, Eligibility Calls, and the Margin Problem Nobody Talks About
Your operations team is spending 28% of profits building plans for clients who leave in under three years. Your claims staff is fielding eligibility calls that should never reach a human. Here's the math — and what the highest-margin TPAs are doing differently.
Coming Soon
Why Stop-Loss Carriers Are Winning More Disputes — and What TPAs Can Do About It
Carriers have gotten more sophisticated. The TPAs keeping their stop-loss revenue have one thing in common: documentation that starts at the rule level, not the claim level.
Coming Soon
Version Control for Health Plans: Why "We Updated the SPD" Isn't Enough
Plan documents change. Claims logic should change with them — with a complete history of which rule applied to which claim on which date.