Five Things Your TPA Should Do During Renewal Season

Health plan renewal season always brings around a unique kind of puzzle. With many moving parts to consider, keeping track of them all will undoubtedly keep you busy. With that in mind, it’s a good idea to make sure your third-party administrator (TPA) is on top of things.

A TPA plays a critical role in helping their organization navigate each renewal season. They can evaluate the performance of benefits plans, using analytics to optimize them for the best outcomes. They’re also able to negotiate better terms with vendors and identify cost-saving opportunities all while ensuring regulatory compliance. Ultimately, by leveraging their industry expertise and data-driven insights, TPAs can make all the difference during renewal season—so long as you have one that knows what they’re doing.

To call a renewal season successful, you’ll want to make sure your plan remains compliant, cost-effective, and efficient. Here are five of our TPA to-do’s during renewal season to help ensure that success.

Examine Your Plan Regularly

Making sure that your plan is working is the primary duty of your TPA. It’s even better when your TPA keeps a constant eye on your plan to make sure it’s truly the right fit for your company as it is. Regular plan reviews help ensure that your benefits align with both your company’s goals and your employees’ needs—and let your TPA know if a change needs to happen.

Your TPA should…

• Conduct thorough audits of your current plan to assess performance.
• Identify areas of improvement such as costs, coverage gaps, and efficiency.
• Ensure the plan is compliant with current regulations and industry trends.

Partner with Industry Leaders

Your TPA should be a partner, one that you trust to help you and your company continue running smoothly. In turn, your TPA should have a few strong partners of their own in their pocket. Collaborating with the top industry leaders gives your TPA an edge, allowing them to bring the most up-to-date and effective strategies to the table when it comes to your benefits.

Your TPA should…

• Maintain relationships with key industry players including insurers, health providers, and more.
• Leverage partnerships to gain insights into emerging trends, technologies, and cost-saving opportunities.
• Keep ahead of the curve and integrate best practices and innovative solutions into your plan during renewal.

Review and Update Compliance Requirements

Earlier, we mentioned that keeping you safely in compliance is a duty of your TPA. In today’s healthcare landscape, with regulations constantly changing, that duty is more important than ever. Keeping your plan compliant isn’t just a legal obligation your TPA should worry about, but it protects your company from potential fines or lawsuits.

Your TPA should…

• Stay informed about changing healthcare laws, tax regulations, and other relevant compliance issues.
• Review and update your plan documents accordingly.
• Ensure that all necessary filings are completed on time and in full.

Administer Different Types of Plans

A key part of ensuring a smooth renewal season? Flexibility. From managing widespread, diverse employee needs to different regulatory requirements, your TPA needs to be able to administer a plan that fits. It also helps to know that your TPA isn’t stuck in place—the more flexible your TPA is, the more likely you are to get a plan that works best for you.

Your TPA should…

• Ensure the ability to administer a wide range of plans.
• Tailor the approach for different plan types to provide the best value and experience for employees and employers alike.
• Offer strategic advice on how to optimize each plan type for specific employee groups.

Clearly Communicate Changes

Part of being a reliable TPA partner—a big part—is clear communication. This is even more important during renewal season when plans are being evaluated and altered. Clear communication helps ensure that employees understand their benefits, which leads to higher satisfaction and better engagement with the plan.

Your TPA should…

• Provide timely and clear communications to employees about any changes to the plan.
• Help design educational materials or training sessions for HR teams, employees, and other stakeholders.
• Ensure ongoing support to answer any questions employees may have about the renewal process.

At BRMS, we pride ourselves on serving as a trusted and valued partner to our clients. From our personalized service to our cutting-edge technology, we make sure you head into each renewal season feeling prepared and supported. With over thirty years in the industry, we have significant experience in the ups and downs of renewals. Our longevity gives us a firm footing in the steps we take with you next, approaching renewals with tested and true strategies. We’re here to be a true partner—supporting you with superior customer service, and backed by our own strong partnerships with networks and vendors that make a difference on a plan’s bottom line.

Interested in how we can help you get through this renewal season on top? Reach out today and let’s talk.

August is Children’s Health Month! Children need proper support and nourishment to grow strong, so helping them form good health habits and ensuring regular care is important. Fortunately, about 97% of children from ages 5 to 11 report having a usual source of healthcare*. Let’s work to make sure parents are using that healthcare and getting children the support they need to grow up happy and healthy!

At BRMS, we’re working to spread awareness about the importance of sun safety through helpful tips and insights!

• 1.9% of children from ages 5-11 are in fair or poor health.*
• About 21% of children from ages 6-11 have obesity.*
• Around 6.5% of children have missed over 11 days of school due to illness, injury, or disability.**
• Nearly 44% of children under the age of 18 received the flu vaccine this year.**
• Around 1 in 5 children around the ages of 3-7 have been diagnosed with a mental or emotional health condition.***

Put Active Playtime First
Just like adults, it’s vital for children to get enough exercise so they develop strong bones, muscles, and coordination. Most children should aim to get 60 minutes of physical activity a day at minimum. Some fun activities can include biking, swimming, dancing, or even just running around outside. Be sure to encourage active playtime and movement each day.

Keep Plates Colorful for Mealtime
Balanced nutrition is important for children’s health, as it bolsters their growth and supports their wellbeing. Making sure there’s a variety of colorful fruits and vegetables is a good way to keep mealtime healthy and provide essential vitamins, fiber, and antioxidants. Keep snacks like apples, carrots, or yogurt on hand, and consider cutting out sugary and processed foods.

Create a Bedtime Routine
The best way to make sure children have a good day starts with ensuring they have a good night’s sleep. Sleep supports growth, mood regulation, and concentration in children, which makes it especially important that they get the proper amount. Most children need around 9 to 12 hours of sleep each night, so try creating a calming and consistent bedtime routine that eliminates screen time at least an hour beforehand.

Cut Down on Sugary Drinks
Getting the right amount of fluid and staying properly hydrated improves children’s energy levels and brain function. Unfortunately, a fair amount of the drinks out there for kids are chock-full of sugar. Avoid unhealthy sugar rushes (and crashes) by opting for water first! Keeping a fun, reusable water bottle on hand can help encourage regular hydration throughout the day.

Unplug the Screens
From movies and TV shows to video games and smartphones, children spend a good amount of time in front of screens. Too much of this screen time can disrupt sleep, affect posture, and interfere with the amount of physical activity needed each day. Setting clear limits to decrease the time children spend in front of screens, and designating tech-free zones like the dinner table, can help promote better focus and social interaction.

In order to grow into their full potential, children need the encouragement of the adults around them. From eating balanced meals to getting active during playtime, there are plenty of fun ways you can help support the health and well-being of children in your life. Join BRMS as we work to promote and empower happier, healthier futures!

 

Sources

* https://www.cdc.gov/nchs/fastats/child-health.htm
** https://wwwn.cdc.gov/NHISDataQueryTool/SHS_child/index.html
*** * https://www.cdc.gov/children-mental-health/data-research/index.html

They’re everywhere, from your pharmacies to your inbox. GLP-1s are hard to ignore, and with their growing popularity, that’s not likely to change anytime soon. They’ve become somewhat synonymous with a magic bullet for weight loss, and for (mostly) good reason. But they aren’t exclusively used for weight loss, and if you’re planning on staying ahead in the industry, it’s a good idea to make sure you know exactly what GLP-1s are all about.

What are GLP-1s?

GLP-1 is an abbreviation of Glucagon-like peptide-1, a type of peptide hormone that causes the pancreas to produce more insulin after meals.¹ GLP-1 drugs are a class of medications that mimic that hormone, helping regulate blood sugar levels and making you feel full. They also suppress the release of glucagon, which raises blood sugar, and help prevent rapid spikes in blood glucose after meals. This makes them an effective option for treating diabetes—which is what they were originally intended for.

The History of GLP-1s

GLP-1s might be experiencing a spike in popularity now, but they were first discovered back in 1984.¹ Originally developed as a solution to treat type 2 diabetes, the first GLP-1 to be approved by the FDA showed up in 2005. These GLP-1 drugs introduced to the market were Exenatide (Byetta) and Liraglutide (Victoza), which offered longer-lasting effects. These medications quickly gained attention for their ability to reduce the risk of diabetes-related complications.

During clinical trials and observed in actual use, an unexpected side effect emerged—many patients started to see consistent and significant weight loss. Originally, this was seen as an added bonus for diabetic patients who often struggle with obesity, but it soon became clear that GLP-1s could be further developed specifically for weight management.

This discovery led to the development of newer, longer-acting GLP-1 drugs like Semaglutide (sold under the brand names Ozempic and Wegovy) and Tirzepatide (Mounjaro), which have been approved for chronic weight management in individuals with or without type 2 diabetes.

The Rise in GLP-1 Popularity

Over the past few years, GLP-1s have gained significant attention, from a combination of media coverage, celebrity endorsements, and growing interest in effective weight management solutions. Where the drugs were once a niche treatment, we now see them becoming a mainstream health and wellness tool.

It isn’t hard to figure out why. By presenting a way to both control blood sugar and promote weight loss, GLP-1s are reshaping both diabetes and obesity treatment. The second use is what’s gained GLP-1s widespread media attention, only further amplified by the U.S. Food and Drug Administration (FDA) when they approved certain GLP-1 medications specifically for chronic weight management. It’s one thing to have the support of the general public, but it’s another to have the FDA’s stamp of approval—and it opens the door for use beyond diabetes treatment.

The results? According to recent polls, around 1 in 8 U.S. adults report to having used a GLP-1.² Further research shows that the number of overweight patients without diabetes using GLP-1s has risen by nearly 700%, from 2019 to 2023 alone.³ And that number is only set to rise further in the future.

Current GLP-1 Applications

Currently, medications such as semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) have been FDA-approved for improving blood sugar control in type 2 diabetes and for chronic weight management in individuals that are overweight or obese. Those are two reasons for employers and health plans to at least have GLP-1s on their radar. But as demand continues to skyrocket for these drugs, high price tags are following. Balancing access to GLP-1s with affordability is prompting discussions around coverage policies, prior authorizations, and value-based care models. As demand makes it difficult to keep the drugs stocked, stakeholders are closely watching how GLP-1s will continue to reshape the healthcare landscape.⁴

Future Considerations and Recent News

It’s no question that GLP-1s are going to be part of discussions moving forward. New studies have shown that GLP-1s could have potential to treat Parkinson disease, Alzheimer disease, osteoarthritis, and other disease. While there is no definitive evidence on the effectiveness of the drug as a treatment, the studies show a promising potential for GLP-1s as much more than just a weight loss drug.⁵

A recent (May 12) executive order from President Trump signals a potentially major shift in how drug prices—particularly for high-demand medications like GLP-1s—are set and regulated in the U.S. The administration is taking direct aim at American patients paying significantly more than consumers in other developed nations for the same drugs. For GLP-1 medications, which are already under scrutiny for their skyrocketing prices, this could result in substantial downward pressure on pricing. If enforced, the order could force manufacturers to either lower domestic prices to match those in peer countries or face aggressive regulatory and enforcement action.

The undeniable impact GLP-1s have had on the market, along with their potential for future growth, raises a number of questions around sustainability, cost-effectiveness, and care marketing. Employers and brokers both need to consider this moving forward—how can a health plan meet the demand for GLP-1 drugs while staying on budget?

By providing strategic oversight, data-driven insights, and flexibility of plan design, a TPA can play a crucial role in helping manage use of GLP-1s—and control any skyrocketing costs. As TPAs have access to extensive claims data and analytics, they’re well-equipped to identify trends in the use of GLP-1s and assess the best, most affordable path forward.

We might not know exactly where GLP-1s are headed in the future, but we know they’re not going anywhere. Get the jump on any rising costs by aligning with a key TPA partner for stability and success.

Reach out today to stay in the loop and let’s evaluate your own benefit design options.

Sources

• 1. https://innovativerxstrategies.com/rx-history-glp1s/
• 2. https://jamanetwork.com/journals/jama/article-abstract/2819949
• 3. https://doi.org/10.1136/bmj.q1645
• 4. https://medicine.iu.edu/blogs/bioethics/on-the-increase-in-use-of-glp-1s
• 5. https://www.pharmacytimes.com/view/five-unexpected-new-uses-for-glp-1-receptor-agonists

The sun’s rays grow much stronger in the summer, and the risk of getting skin cancer does as well. In fact, more Americans are diagnosed with skin cancer than every other cancer combined.* Fortunately, there are easy ways you can stay safe from the sun and still enjoy the great outdoors! Whether you’re spending summer at the beach or in the peace and quiet of your front porch, make sure you’re protecting yourself from UV rays.

At BRMS, we’re working to spread awareness about the importance of sun safety through helpful tips and insights!

• 1 in 5 Americans will likely develop skin cancer by the age of 70.*
• Over 90% of skin cancer is caused by UV exposure.**
• Your risk for melanoma doubles if you get 5 or more sunburns.*
• More than 9,500 people are diagnosed with skin cancer each day in the U.S.*
• If caught early, the 5-year survival rate for melanoma is 99 percent.*

Sunscreen, Sunscreen, Sunscreen
Sunscreen is your best friend when it comes to protecting your skin, but there are a few key tips to keep in mind. Look for one with an SPF of 15 or higher to guard against UV rays and apply a generous layer to all exposed skin, even those tricky spots like your back and shoulders!
Sunscreen wears off over time so reapplying regularly, ideally every two hours or as needed, is essential.

Pay Attention to the Time of Day
Depending on the time of day, UV rays can be stronger and cause more damage to your skin. In the United States, the sun is most powerful from 10 am to 4 pm. If you’re going to be outside during those hours, make sure you have proper sun protection on and be mindful of the UV index, which forecasts the strength of UV rays each day. If the UV index reaches 3 or higher, take extra care to protect your skin from the sun.

Stick to the Shade
Sunscreen is key for protecting your skin, but don’t underestimate the value of shade. Sitting under a tree or covered area can significantly reduce UV exposure and help you stay cool, especially during peak sun hours. If natural shade isn’t available, bring an umbrella, canopy, or wear sun-protective clothing. Remember that shade alone isn’t foolproof, so always combine it with other sun protection for full coverage.

Watch Out for Water, Cement, and Sand
UV rays aren’t just dangerous from above; those rays can also bounce off of various surfaces such as water, cement, and sand. In fact, dry beach sand can reflect 15 to 18% of the sun’s rays, and sea foam can reflect 25 to 30%.*** As the UV rays are reflected, they can cause sunburns and skin damage, even in cloudy conditions. Whether under clear or cloudy skies, be sure to stay mindful of UV reflection and practice proper sun safety.

Invest in Quality Sunglasses
Your eyes are sensitive to the sun in more ways than you might think.
Prolonged UV exposure can damage your eyes and vision, leading to conditions such as blurred vision, cataracts, and even certain eye cancers. To avoid this, opt for sunglasses labeled with 100% UVA and UVB protection. While many pairs already offer some UV filtering, only those clearly marked ensure the most effective coverage.

Spending time outdoors in warm weather is a great way to lift your mood and get essential Vitamin D. While UV rays can pose risks if you aren’t careful, you can still have plenty of fun in the sun just by incorporating these helpful tips. Join us as we work together to promote proper sun safety and ensure a happy and healthy summer for all!

 

Sources

* https://www.skincancer.org/skin-cancer-information/skin-cancer-facts/
** https://publichealth.jhu.edu/skin-safety-facts
*** * https://www.cancercouncil.com.au/cancer-prevention/sun-protection/understanding-uv-radiation/factors-that-affect-uv-radiation-levels/

With that in mind, we want to dispel some myths around captive insurance while helping you brush up on your captive knowledge.

Captive Insurance 101

To put it in simple terms, a captive is a wholly owned subsidiary that is created to provide insurance or reinsurance to a non-insurance parent company or group of companies.^*** It’s a way to self-insure that allows the insured party to own the insurer, giving them control over the arrangement they would lack otherwise along with significant tax advantages. Group captives have seen significant growth in recent years, but captive insurance companies have been in existence for more than a hundred years now. The term was first coined by a property-protection engineer, Frederic Reiss, who established the first captive insurance company in 1962.^*** Since then, captives have grown exponentially across all industries and many nations, their use stretching across the globe.

Group Captives on the Rise

A group captive is usually created to address the specific risk-management needs of a group of companies and their owners. It can also offer significant tax benefits, which can be crucial for a company’s long-term success. The flexibility provided by a captive arrangement allows for coverage of about any risk a regular insurance or reinsurance company would cover—once a captive is set up, it functions just like any other insurance company, with its own regulatory requirements like reporting and maintaining reserves and capital.

Additionally, captives aren’t restricted to a company’s size. They can be formed by a wide range of organizations of different industries and corporate structures, from big multinational corporations to nonprofit groups. In fact, around 90% of Fortune 500 companies have their own captives.^***

“Captives used to be an enigma, but that’s simply not the case anymore,” according to Nick Hentges, CEO of Captive Resources. “Most people we talk to have heard of a captive, have some understanding of how it works, and are getting more comfortable with the idea of joining one.”^*

Captive insurance and group captives offer businesses a powerful way to take control of their risk management and insurance costs. By stepping outside the traditional insurance market, companies can gain greater financial stability, improved claims management, and potential long-term savings.

While captives aren’t the right fit for every organization, those with the right risk profile and financial strength can benefit from a customized insurance solution that aligns with their unique needs. As the landscape of risk financing continues to evolve, exploring alternative strategies like group captives could be a game-changer for businesses looking to secure their future with greater flexibility and control.

At BRMS, we’re dedicated to staying on top of the industry’s latest, which includes working with stellar captive partners who help our clients manage risk and reduce costs. Interested in learning more? Pay us a visit at https://www.brmsonline.com.

Sources

• * https://www.captive.com/news/2024-a-milestone-year-for-captive-insurance-growth
• ** https://www.captive.com/news/captive-insurance-in-2025-growth-challenges-and-opportunities
• *** https://content.naic.org/insurance-topics/captive-insurance-companies