What is the term for an organization that processes claims for self-insurance groups?

Study for the Florida 2-15 Insurance License Test. Use flashcards and multiple-choice questions with helpful hints and explanations. Get ready for your exam!

The term that describes an organization responsible for processing claims for self-insurance groups is "Third-party administrator" (TPA). A TPA acts as an intermediary between the self-insured entity and the claimants, managing the claims process, including both the administration and processing aspects for participants in a self-insured plan.

Self-insurance groups often rely on TPAs to handle claims because these organizations have the expertise and resources to evaluate claims efficiently and ensure compliance with applicable regulations. This frees the self-insured group to focus on its primary operations while the TPA manages the complexities of claims handling.

Other options do not accurately represent the role specified in the question. A Claims Adjuster is typically employed by an insurance company to evaluate claims but does not specialize in managing self-insurance claims specifically. Similarly, a Self-Insured Retention Specialist involves managing high retention levels for specific self-insured risks, which is a function distinct from claims processing. An Insurance Broker primarily facilitates the purchase of insurance and is not involved in claims handling for self-insured groups.

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