Understanding Third Party Administrators in Insurance – What Every Employer Shou

1. The Ultimate Guide to Group Health Insurance in California for Small Businesses (2025 Edition) Brought to you by‘Bedrock TPA’ Helping employers simplify health benefits with smarter solutions. Introduction: Why Group Health Insurance Matters More Than Ever For small businesses in California, offering group health insurance isn’t just a nice-to-have —it’s essential for attracting and retaining top talent. With rising healthcare costs, regulatory changes, and employee expectations evolving in 2025, navigating group coverage options has become increasingly complex. This guide breaks down your options, responsibilities, and solutions — all in simple terms — to help you make the best decision for your company and your employees.

2. Chapter 1: Understanding Group Health Insurance in California Group health insurance allows employers to offer health coverage to a group of employees (and often their families). In California, small businesses with as few as two employees can access robust group plans. Key Benefits for Employers:     Tax advantages Competitive hiring edge Higher employee retention Access to broader provider networks (e.g., PPO plans in California) For Employees:    Lower premiums than individual plans Consistent coverage options Easier verification of benefits process through employer plans Chapter 2: Health Plan Options for Small Businesses California offers a range of group plan structures: PPO (Preferred Provider Organization) Plans Popular among businesses wanting flexibility in provider choice. PPOs allow employees to visit out-of- network doctors (at a higher cost) and typically don’t require referrals. POS (Point of Service) Health Plans POS plans combine features of HMOs and PPOs. Employees choose a primary care provider (PCP) and need referrals for specialists, but enjoy some out-of-network benefits. PEO (Professional Employer Organization) Health Plans A PEO health plan allows small businesses to outsource HR and benefits administration, accessing large- group pricing and shared risk pools. While a PEO health insurance plan can offer cost efficiency, it may reduce flexibility compared to working with a third party administrator.

3. Chapter 3: Rising Trend — Working with a Third Party Administrator (TPA) In 2025, many California employers are moving away from traditional carriers and exploring custom health plan solutions through third party administrators in insurance. What is a Third Party Administrator? A third party administrator(TPA)is a company that manages group health benefits on behalf of employers. TPAs allow for more flexibility and transparency compared to big insurance providers. Benefits of Using a TPA:     Custom plan design Cost containment strategies Tailored employee support Simplified verification of benefits process Third party administrators in California, like Bedrock TPA, specialize in navigating state-specific laws and offer hands-on service for small and mid-sized employers.

4. Chapter 4: Compliance & Cost Control in 2025 Employers must comply with both federal (ACA) and state-specific regulations. California employee benefits consultants can help small businesses:    Avoid penalties Select compliant group health plans Understand the implications of offering coverage for elective procedures like insurance for cosmetic surgery Note: Most standard health insurance plans do not cover elective cosmetic procedures. However, medically necessary procedures may be eligible for cosmetic surgery insurance under certain plans. Chapter 5: Choosing the Right Partner — What to Look For Not all providers are created equal. Whether you're considering a traditional insurer, PEO, or thirdparty administrator health insurance solution, here are key traits to prioritize:      Experience with California regulations Transparent claims management Responsive customer service Access to employee benefits consultants A strong reputation among third party administrators in California Chapter 6: Getting Started with Group Health Insurance Here’s a simplified process to guide you: 1.Assess your needs Size of workforce, budget, industry risks, and employee expectations. 2.Compare your options PPOs, POS, PEOs, self-funded plans, and TPA-managed plans. 3.Consult an expert A qualified California employee benefits consultant can help you balance compliance, cost, and coverage. 4.Implement and communicate Once you select a plan, make sure employees understand their options, including how to access care and use verification of benefits tools.

5. Final Thoughts: A Smarter Way Forward Group health insurance doesn’t have to be confusing or expensive. With the right plan structure and the right partner — whether a traditional carrier, PEO, or third party administrator — your business can offer great coverage while controlling costs. At Bedrock TPA, we’re committed to helping California employers simplify benefits with smarter, more transparent solutions. Whether you need help designing a plan, navigating compliance, or understanding options like cosmetic surgery insurance, we’re here to support your team. Need a Quick Review of Your Current Health Plan? Get a Free Health Plan Audit from Bedrock TPA