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The Kempton Group –
Third Party Administrators
Welcome to the Future of Healthcare & Employee Benefits
The Free-Market Approach
Fed up with big insurance companies? So are we.
For decades, medical pricing has been hidden from consumers, creating a perfect storm of medical inflation, price gouging and predation on consumers. At the Kempton Group, we’re putting an end to it. We have a passion for revolutionizing the healthcare industry, and are determined to help heal the very system we trust to heal us.
The Kempton Group:
It’s kind of like insurance, but with a conscience.
The Kempton Group is an independent third-party administrator (TPA). That means we process claims and manage benefit plans for self-funded employers – companies that essentially cover healthcare costs for their workforce out of their own revenue, instead of paying expensive premiums to an insurance carrier who pays those costs out of their pool (and who keeps the considerable difference).
There are some important differences between the Kempton Group as a TPA and the insurance carriers you’re probably accustomed to – and likely frustrated with.
Ready to learn more?
The next step is to get together – via phone, Teams, or in-person – to discuss how the Kempton Group can work with you.
What we do
- Empower & Educate our Clients and Their Employees
- Fight for Pricing Transparency and Free-Market Principles
- Adjudicate & Pay Claims
- Maintain Eligibility
- Assist Clients with Real, Human Customer Service
- Arrange for Stop Loss Coverage
- Manage Network Access
- Outreach and Partner with Local Medical Providers
- Much More…
What we Don’t do
- Charge Premiums
- Keep Leftover Dollars
- Accept Commissions or Kickbacks
- Monetize Dysfunction
- Skim Money from Discounts
- Collude with Providers to Hide Actual Costs
- Use Technology to Avoid Customers
- Many More Objectionable “Standard Practices”
All TPAs are Not Created Equal.
Self-funded employers cannot afford to rely on facilitators who have a financial incentive to allow claims costs to increase unchecked. If an insurance carrier is the TPA or owns the PPO Network utilized, the employer will have little to no control over their Plan and it will be difficult to work directly with them.
Three types of TPAs exist:
Independent TPAs (like the Kempton Group)
Independent status is the gold standard for true third-party administrators.
“Administrative Services Only” (ASOs)
These include companies like Blue Cross, United, Cigna, Aetna, etc., which means you are still playing by their very restrictive rules and interests.
Hybrid
These are essentially independent TPAs that use a traditional carrier’s PPO or network, which can severely limit options and nullify efforts at transparent pricing.
Even among Independent TPAs, many consider it standard practice to increase their revenue stream in deceptive ways:
- Commissions on policies, products and other vendor services
- Keeping a percentage of subrogation recovery and negotiated savings
Costs & Payment
We tell our clients every dollar we are paid in relation to their plan. Our total compensation consists only of the up-front, per-employee, per-month fee we charge.
Since we are accountable to one entity, the employer:
- We Accept no Commissions
- We Keep Zero Savings from Subrogation Recovery or PBM Rebates
- We Return All Negotiated Savings to the Employer
- PPO and vendor fees are passed directly to you with no markup
Schedule a Consultation
Interested in what we can do together to empower and educate your team to make the most of every healthcare dollar? Let’s talk. We can meet in-person, over the phone, or on Teams.
Our Philosophy & Principles
The Kempton Group is driven to revolutionize how patients relate to healthcare and their benefit plans. We know the system is broken, and we believe we’ve found a way to fix it that works for patients, employers and healthcare providers alike.
Our philosophy is firmly rooted in our core principles:
Transparency
Around here, transparency is not a buzzword. It is a very real criterion by which every provider relationship and interaction is judged. We believe in transparency and free-market principles in every layer of healthcare, and we play by our own rules, too, giving our clients full accessibility and accountability for every dollar we are paid in relation to their plan.
Evaluating Actual Value
Value does not exist in a vacuum. It is a balance between price and quality – two measurements that have been hidden from consumers for too long. The only way to judge value is by knowing its price, its quality and how it compares to the competition. That’s basic value shopping, and when we enable free-market principles like these in the healthcare domain, it empowers consumer choice and motivates the entire system to provide better care for less money.
Many believe the best healthcare is the most expensive, but the opposite is usually true. A recent study indicated that if everyone in the U.S. received their care from the Mayo clinic, health costs would sharply decline, because Mayo has excellent quality care at relatively low prices.
Empowerment
We believe any TPA is in a position to either work in the best interest of their bottom line or the best interest of their client. We choose the latter. The Kempton Group does much more than process claims. We keep a keen eye on the actual cost of claims, not only to effectively manage costs, but to empower self-funded employers to take control of their plans, offer better benefits and, in turn, empower their employees to make better health choices.
Education
The sad truth is that the insurance industry does not profit by the public understanding its inner workings. Therefore, it strives to keep people confused. The Kempton Group does not stand for that. We believe educating our clients on all of the mechanics – while simplifying unnecessary complexities – empowers better choices.
That’s why we not only keep you apprised of any compliance and regulatory changes that arise through meetings, educational videos, webinars, emails, flyers and conference calls, we also provide numerous routes for effective employee education, personalized assistance, consultative meetings and more.
Kempton Group and KPPFree™ Clients
KPPFree™
KPPFree™ is an elite group of providers who offer up-front, all-inclusive, deeply discounted and completely transparent prices for their services. The participating providers are progressive, free-market thinkers who earn top marks in quality and value. These are not fly-by-night facilities or physicians. Many are physician-owned and highly respected – some at the national level.
Typical Providers
Nearly impossible to learn procedure costs in advance
Each component coded, billed, discounted (etc.) separately, causing confusion
Justify higher prices as “necessary cost shifting”
Pricing not based on free-market forces
No method of verifying quality
KPPFree™ Providers
Disclose prices up front
Pricing is all inclusive
Have chosen to compete for patients based on price and quality in a free market
Prices 80% less than typical providers
Recognized leaders in their fields
These are just a few examples of cost savings – and significant value improvements – resulting from KPPFree™ Provider partnerships.
| Procedure | Amount Billed by Other Providers | KPPFree™ Provider Billed Amount |
|---|---|---|
| Hernia Repair | $19,384.00 | $3,190.00 |
| Carpal Tunnel Release | $11,143.00 | $2,750.00 |
| Arthroscopic Knee Surgery | $14,977.00 | $3,740.00 |
| Bilateral/Multiple Joint Knee Replacement | $205,444.44 | $26,071.31 |
| Spinal Fusion | $192,622.94 | $5,695.72 |
| Laparoscopic Hysterectomy | $51,609.90 | $11,500.00 |
| Adenoidectomy | $14,991.19 | $3,300.00 |
| Major Joint Replacement Lower Extremity | $93,905.99 | $19,400.00 |
KPPFree™ Providers by State
KPPFree™ providers practice in nearly every state in the US.
KPPFree™ Procedures by State
Virtually every procedure and medical service is covered by our KPPFree™ provider network.
Ready to Learn More about KPPFree™?
The next step is to get together – via phone, Teams, or in-person – to discuss how the Kempton Group can work with you.
What’s Included
Our administrative fee includes everything you need to manage a self-funded benefit plan:
- Safeguarding your claims to ensure reimbursement is reasonable and rational
- Administration of consumer-driven options such as the KPPFree™ program
- Complete plan reporting including comprehensive utilization reporting, unaudited financial statements and general ledger detail
- Filing of reinsurance claims, if applicable
- Employee education meetings, flyers, newsletters and educational materials.
- Employee enrollment and initial printing and issuance of ID cards
- Plan design and plan document creation assistance
- Customized plan building and implementation
- HIPAA administration, including ARRA
- COBRA administration, including initial and sample notices included in Summary Plan Description, sample notices provided annually for distribution, COBRA election form provided to the employee upon separation from the employer, and collection and management of COBRA payments directly from the participant
- Compliance assistance with ERISA, IRS laws, DOL regulations and most ACA mandates, requirements and reporting
- Secure Benefit Portal for employees to view accumulator balances, claim details, view/print EOBs, ask questions, and more
- Secure Benefit Portal for employers to view and edit participant eligibility, enrollment details, view claim detail and reports
- Online enrollment
Any additional services will be quoted based on a flat fee.
Client Testimonials
Schedule Consultation
The next step is to get together – via phone, Teams, or in-person – to discuss how the Kempton Group can work with you.
The Kempton Story
We’ve been around since 1969, but it hasn’t always been business as usual.
Find Answers
Healthcare and insurance are a complicated world. We aim to demystify it and put control back in your hands. Check our FAQ for answers to common questions.
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The Kempton Group is a family owned and operated organization, with real people here ready to help you. Get in touch. We’re eager to hear from you.