No broker or employer is expected to know every question in this series, or what every answer means. I have written them out so you can use them. Putting them together, knowing which threads to pull and what one answer means next to another, is the work I do with plans and brokers in Under the RFP.
Why leadership belongs in your vetting
Choosing a TPA is a fiduciary decision. Employer health spending is commonly described as the second-largest expense after payroll, and Aon projects an average employer cost of about $14,400 per employee in 2026. You are also placing members’ health information and the company’s financial data in the TPA’s hands. Selection criteria that cover software and price but skip the people running the operation leave out a big part of the risk.
Reporting structure: what to ask for
- The full org chart, not only the leadership slide in the sales deck.
- Who runs each function: claims, customer service, account management, plan build, integrations, compliance, and technology. Who do they report to?
- Where service sits. Does account management report into operations, into sales, or on its own? Neither is wrong, but it tells you whose incentives shape the service you get.
- Who owns escalations. When a large issue lands, which named person is accountable and what authority do they have to commit resources?
Three common profiles
These are patterns, not verdicts. Each one comes with a question worth asking.
A young or founder-led team. Strong technology and speed are common. Ask how the leadership fills the gaps in claims operations, self-funded plan administration, and industry tenure. Hired operators, advisors who are actually engaged, and a documented escalation path are different answers from “we move fast and figure it out.”
A tech-forward team with a thin bench. The roster may include one or two people with deep self-funded and TPA experience, while the rest of the team is newer. Ask what happens when those two people are out, are promoted, or leave. How is their knowledge captured and passed on?
A long-tenured team. Deep experience is valuable. Ask how those leaders stay current. Do they attend industry events, serve on committees, and talk to peers at other organizations? Or is their experience limited to the way things have always been done at that one TPA, so they have little view of what else is happening in the market?
What the answers mean
No profile is automatically better. A less experienced leadership team that is honest about gaps and has filled them deliberately can outperform a seasoned team that has stopped learning. What you are testing is whether the experience that your plan needs exists somewhere on the roster, and whether it is deep enough to hold up when problems come in.
Ask to speak with the people who run claims, plan build, and integrations, not only the executives who joined the sales calls.
Frequently asked questions
What should I ask for when vetting a TPA’s leadership?
The org chart, reporting lines for each function, and the number of years each leader has spent in self-funded plan administration, separate from years at the company.
Is a young leadership team a red flag?
Not by itself. The question is how they fill gaps in industry knowledge and operational experience.
Why does industry exposure matter for a long-tenured team?
A team that knows only one organization may not recognize better practices, or may not see new risks coming.
Sources: Palomar; Aon, August 2026.