Glossary
Administrator (insurance)
The entity that administers a policy on behalf of the risk carrier (enrollment, premiums, reimbursements, claims), without necessarily bearing the financial risk itself.
An insurer or mutual can delegate all or part of a policy’s administrative operations — enrolling policyholders, collecting premiums, processing care reimbursements, right through to paying out benefits — to a specialized administrator. This administrator can be a subsidiary of the insurer, an independent provider, or a broker to whom a delegation of management has been granted.
Day to day, the policyholder often deals solely with the administrator: it is their name that appears on the direct-billing card or the reimbursement correspondence. The financial liability for the policy, however, remains with the risk carrier, whose name must appear in the policy’s information notice or general terms.
Example
A policyholder may send their care receipts to a delegated administrator, whose name appears on the direct-billing card, while the risk is in fact borne by a separate insurance company named in the general terms.
Also searched as: delegated administrator · delegated management · benefits administrator
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