During RosettaFest 2026, I heard one word used repeatedly in conversations with brokers: reliable.Brokers are looking for reliable TPAs. They want partners who are honest, responsive, experienced and willing to remain in the room when …
The Broker’s Side of a Reliable Partnership
During RosettaFest 2026, I heard one word used repeatedly in conversations with brokers: reliable.
Brokers are looking for reliable TPAs. They want partners who are honest, responsive, experienced and willing to remain in the room when a problem becomes uncomfortable. That is a perfectly reasonable expectation. There are fair and trustworthy TPAs in this business, and I hope J.P. Farley has earned the right to be considered one of them.
But reliability cannot exist on only one side of a partnership.
A high-value partnership is not created when a broker selects a TPA and hands that TPA a list of expectations. The best TPAs are also evaluating the brokers with whom they work. They are looking for professionals who communicate, prepare their clients, remain involved throughout the year and know how to lead when a situation becomes difficult.
Charlie Munger often made a simple point about finding a good partner: the most practical way to find one is to become one. That principle applies remarkably well to the relationship between a broker and a TPA.
Jim Farley
A Health Plan Is a Human Environment
Consider a relatively small employer with 100 employees. Once dependents are included, the health plan may cover 200 or more people.
What are the chances that every one of those people will understand every benefit, limitation and instruction correctly?
Essentially none.
Some employees will misunderstand something they were told. Some will hear only the part of a sentence that confirms what they already hoped was true. Very few will read the plan document from beginning to end. Many will look at it for the first time only after a claim has been denied or a service has not been handled as expected.
Some people will be dealing with pain, a frightening diagnosis, financial pressure or a family problem. Others will simply be tired, distracted or frustrated before the health plan ever enters the conversation.
This does not make them unreasonable people. It makes them human beings trying to navigate a system that even experienced professionals sometimes find unnecessarily complicated.
That is the actual environment in which brokers and TPAs work. We are not managing a spreadsheet populated by perfectly rational participants. We are managing a plan used by real people, frequently at moments when they are worried, sick or under pressure.
Problems and misunderstandings are therefore not unusual interruptions to plan management. They are part of plan management.
“Approved” Does Not Necessarily Mean “Covered”
During the interview that led to this article, a situation developed in our office that demonstrated the problem almost perfectly.
A self-funded plan rented a provider network. The network was also responsible for precertification. A provider contacted the network regarding a particular medication, and the network authorized it – but advised that authorization was not a guarantee of benefits and that coverage had to be confirmed with the plan.
The plan document excluded the medication.
The treatment was nevertheless provided, claims were submitted, and those claims were denied. From the employee’s perspective, someone had said the medication was approved. From the provider’s perspective, an authorization had been issued. From the plan’s perspective, the drug was clearly excluded. The network’s position was that it had authorized the treatment clinically without guaranteeing that the plan would pay for it.
APPROVED, BUT NOT COVERED.
People inside our industry may understand how those two statements can coexist. To an employee, they sound contradictory – and understandably so. The employee was not part of the calls between the provider, the network and the plan. The doctor prescribed the medication, the network issued an authorization, and the employee proceeded with treatment.
Who will that employee blame when the claim is denied?
Most likely, whichever party is closest and easiest to reach. That may be HR, the broker or the TPA. Emotionally, the distinction between authorization and coverage will seem far less important than the unpaid bill.
This is exactly the kind of situation in which a partnership is tested.
Taking the Client’s Side Is Not the Same as Leading the Client
When a client is angry, a broker may feel compelled to become equally angry. There are usually two forces behind that reaction.
The first is fear. The broker worries that if something has gone wrong, the account may be at risk.
The second is the belief that mirroring the client’s frustration proves loyalty. If the client is angry with the TPA and the broker becomes angry with the TPA too, the broker may appear to be standing firmly on the client’s side.
I understand the instinct, but I question whether it produces the intended result.
If the broker immediately joins the client’s outrage, what has the client actually learned? The client may conclude that the broker has lost control of the situation, selected an unreliable partner or failed to understand how the plan operates. Now there are two frightened or angry people in the conversation instead of one – and still no resolution.
A broker’s responsibility is not to agree with every emotional reaction. It is to take the concern seriously, establish the facts, make sure commitments are honored and guide everyone toward a solution.
That does not mean defending a TPA when the TPA made an error. If the TPA is wrong, it should acknowledge the mistake and correct it. Reliability requires accountability.
But accountability is different from immediately choosing sides before the facts are known.
The strongest broker in a difficult situation is often the calmest person in the room. Calm does not mean passive or indifferent. It means being capable of saying:
Here is what happened. Here is what the plan says. Here is where the communication failed. Here is what can be corrected. And here is what we need to do next.
That response protects the client far more effectively than anger does.
A Good TPA Also Chooses Its Brokers
TPAs do not want unnecessary conflict. They want broker partners who understand that a health plan contains thousands of transactions and countless opportunities for confusion. Claims will be questioned. Employees will misunderstand benefits. Providers will give incomplete information. A vendor may make a mistake. The TPA may make a mistake.
The question is not whether a difficult situation will ever arise. It will.
The question is what the people responsible for the plan do when it happens.
Does the broker collect the facts before reaching a conclusion? Does the broker explain the plan’s structure to the client? Does the broker help reduce confusion, or amplify it? Can the broker distinguish between a legitimate administrative failure and an outcome that someone simply does not like?
A good TPA notices those things.
We also notice whether the broker is present throughout the year. A broker who appears only when an account is in danger is not offering much of a partnership. Neither is a broker who delivers the group, disappears for eleven months and returns with a renewal spreadsheet.
That approach may produce commissions for a period of time, but it does not create a durable block of business; and it does not give the TPA much reason to invest deeply in the relationship.
Retention Is a Continuous Process
Some brokers imagine the ideal client as a company whose plan runs quietly in the background. The client rarely calls, employees present few problems, commissions continue to arrive, and everyone reconvenes at renewal.
That may sound convenient. It is not necessarily a healthy account.
Silence does not always mean satisfaction. Sometimes it means the client is already talking to someone else.
Retention is not a meeting held during renewal or open enrollment. It begins when the client signs the contract and continues throughout the entire year.
Self-funded plans give brokers an extraordinary opportunity to make that process meaningful. The broker has access to monthly and quarterly reporting that can support intelligent conversations with the employer. Those reports can reveal developing claims patterns, utilization issues, opportunities for employee education and areas where the plan may need to evolve.
A quarterly conversation does not need to be ceremonial or excessively long. It should answer practical questions:
What is happening in the plan? What appears to be changing? What concerns does the employer have? What are employees struggling to understand? What decisions may need to be made before the next renewal?
The broker should identify an issue before the client discovers it through a crisis. If several options exist, the broker should explain the advantages, limitations and consequences of each one. That is how the employer gains confidence in the broker’s judgment.
It is also how a genuine five-year plan is built. A five-year strategy cannot be created during one annual renewal meeting. It develops through a series of informed decisions made throughout the life of the plan.
We Share the Same Business Objective
Brokers and TPAs ultimately have the same commercial goal: retain a healthy, satisfied client.
That does not mean keeping the client happy by agreeing to everything the client requests. In healthcare, some requests cannot be granted. Some services are excluded. Some claims must be investigated. Some expectations are based on incomplete information. A promise to eliminate every unpleasant outcome would be dishonest.
Keeping a client means helping that client understand what is happening, correcting genuine errors, anticipating problems and making sound decisions even when the conversation is uncomfortable.
The broker has a particularly important role because the broker owns the broader advisory relationship. A TPA may communicate directly with the employer and handle substantial parts of the plan’s administration, but the broker normally has the relationship that connects the plan to the employer’s larger business strategy.
If the broker does not maintain that relationship, the TPA cannot maintain it on the broker’s behalf.
This matters economically as well. Implementing and learning a new account requires a considerable investment from the TPA. In a transparent arrangement, the first year is not necessarily the most profitable year. The long-term value emerges when the broker, TPA and employer are able to retain the plan and improve it over time.
A broker who cannot retain accounts is therefore not merely creating a problem for the broker’s own business. That broker becomes a less valuable partner for every organization investing resources in those accounts.
The Partnership Standard Runs Both Ways
Brokers should absolutely investigate a TPA before trusting it with a client. They should ask difficult questions about transparency, service, claims administration, communication and accountability. A TPA should be expected to explain its decisions and stand behind its work.
But brokers should be willing to apply a similarly serious standard to themselves.
✔️ Am I available when a problem develops?
✔️ Do I communicate with my client throughout the year?
✔️ Have I taught the client how the plan actually works?
✔️ Do I bring facts into difficult conversations, or simply bring more emotion?
✔️ Do I help my partners resolve problems, or place them on trial whenever someone complains?
✔️ Would a high-quality TPA consider me a high-quality partner?
These are not comfortable questions, but they are commercially important ones.
Reliable TPAs exist. Reliable brokers exist. When the two find each other, they can build something far more valuable than a vendor arrangement. They can create a partnership capable of surviving confusion, correcting mistakes and improving a health plan over many years.
But the standard cannot be imposed in only one direction.
The best partners are choosing, too.
Initiate a Consultation
We invite employers and vendors who are uncompromising about the impact of their healthcare plans to schedule a strategic conversation.
