What exactly does a third party administrator do and is this a scam?

Hi,

So I have insurance through my father and he gets it from his employer. My father’s employer hired Ameriben as a third party administrator to the plan.

In Network-Blue Cross Blue Shield of NJ-where we live

Out of Network-Blue Cross Blue Shield of Illinois-employer isn’t from there so oddity #1

Pharmacy Benefits- MedImpact

Dental-Delta

So here’s where things get really weird. Even though the medical is through BCBS, they know who i am but none of my claims or coverage shows up only my deductible. The ID shows up in there system with my name but nothing else. The reason for that is that Ameriben is supposed to handle claims and benefits. Thing is, by Ameriben’s admission, the rates and coverage are decided by BCBS. What makes it even weirder is that every Ameriben rep I’ve spoken to doesn’t have any direct communication capability with BCBS. Also even though they handle claims and benefits, it goes to BCBS and then they’re supposed to send it to Ameriben and then they send it to us.

To me it sounds best case scenario it’s a case of a company that basically only exists to waste companies’ money or at worst it’s basically a bunch of companies bundling together under Ameriben and Ameriben takes the insurance, which should be illegal or is.

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