October 14, 2025

Transparency and empathy can take consumers from skepticism to confidence

Trust in the U.S. health insurance system is at a critical low. According to “The Trust Foundation is Fractured for US Health Insurers, 2025,”  published in BenefitsPRO (October 2025), consumers overwhelmingly report frustration and confusion when navigating their health benefits. Surprise bills, unclear pricing, and poor communication have eroded confidence to the point where only a small fraction of Americans say they trust their health insurer to act in their best interest.

For third-party administrators (TPAs), this environment presents both a challenge and an opportunity; a chance to redefine what health benefits can look like when transparency, empathy, and data-driven insight lead the way.

The Growing Trust Problem in Health Care

Health care is one of the most personal aspects of our lives, yet for many people, it feels impersonal and opaque. The report highlights how distrust stems largely from a lack of transparency: members often don’t understand how prices are determined, why claims are denied, or what their benefits really cover.

This trust gap doesn’t just impact individual members — it affects employers, brokers, and providers, too.

• For employees, low trust often leads to disengagement. They delay care, skip preventive visits, or fail to use valuable programs like Employee Assistance Programs (EAPs).
• For employers, it results in lower satisfaction with benefits and diminished return on investment.
• For the industry, it fuels rising costs as members forgo early intervention and require higher-cost care later.

In short, when people don’t trust their health plan, everyone loses. But TPAs are uniquely positioned to change that story.

How TPAs Can Bridge the Trust Divide

1. Be Transparent About Networks and Costs

Traditional insurance carriers often operate behind closed doors when it comes to network pricing and reimbursement rates. TPAs, on the other hand, can open that door.

Through approaches like reference-based pricing (RBP) or direct provider contracting, TPAs can create clear, fair structures for both employers and members. This transparency not only helps control costs but also builds credibility because when people understand why something costs what it does, they’re far less likely to feel misled.

Education plays a huge role here. Simple, plain-language explanations of how network discounts work or what “usual and customary rates” mean can go a long way toward reducing frustration and confusion.

2. Use Data as a Tool for Trust

Self-funded plans managed by TPAs generate a wealth of data — and with it, powerful insights. Unlike traditional carriers, TPAs can give employers visibility into claims, utilization, and trend analysis.

That transparency helps employers make proactive, informed decisions about their plan designs and cost-control strategies. For instance, if the data reveals high emergency room utilization for non-urgent care, employers can work with their TPA to promote urgent care, telehealth, or nurse line alternatives.

At Nova Healthcare Administrators, we’ve seen first-hand how access to this level of detail builds partnership and confidence. Data doesn’t just tell the story of cost; it tells the story of opportunity.

3. Lead With Humanity in Medical Management

Trust is built through relationships, and that’s where TPAs truly stand apart. Some third-party administrators, including Nova, offer in-house medical management programs that connect members directly with nurses.

These teams provide case management, disease management, and care coordination — ensuring that members feel supported and guided through complex medical situations. The result is not only better outcomes but also genuine trust.

For example, through Nova’s Care Transitions Program, nurses reach out to members after hospital discharge to help them follow treatment plans and prevent readmissions. This program has achieved $3.9 million in averted admission savings by helping members stay on track after care — a clear example of how empathy-driven engagement benefits everyone.

When members hear a real voice on the other end of the line, one that listens, advises, and advocates, the experience of health care changes completely.

4. Simplify Member Experience

The health care system is inherently complex, and members often struggle to understand the difference between an EOB, a bill, and a benefit summary. TPAs can make a huge impact simply by demystifying these processes.

Educational initiatives, such as plain-language guides, short videos, or one-on-one consultations, help employees feel more confident in navigating their care. As we’ve said a few times on Nova’s Under the Coverage podcast, “An EOB is not a bill.” Clarity empowers employees to make informed choices and reduces unnecessary stress or billing confusion.

Simplifying doesn’t have to mean oversimplifying. It’s about meeting people where they are and explaining the system in a way that feels human, not transactional.

5. Partner, Don’t Police

One of the biggest differentiators of a TPA is its partnership mindset. TPAs work with employers, brokers, and providers to align around shared goals, not rigid corporate policies.

Instead of enforcing one-size-fits-all rules, TPAs help clients design benefit plans that match their workforce’s unique needs and priorities. Whether that means integrating telehealth, expanding chronic disease support, or adopting value-based care contracts, TPAs can act as true trusted allies in optimizing both cost and care.

This collaboration fosters accountability and mutual respect, transforming the dynamic from one of oversight to one of partnership.

Turning Trust Into a Strategic Advantage

For employers, choosing a TPA is about more than administrative efficiency — it’s about aligning with a partner who can strengthen employee trust, improve outcomes, and reduce unnecessary costs.

Employers who partner with transparent, data-driven TPAs can:

• Gain real-time insights into cost drivers and utilization trends.
• Offer more flexible, transparent benefit designs.
• Build stronger engagement and satisfaction among employees.

When members feel supported and informed, they make smarter choices. When employers have access to actionable data, they make better decisions. And when all parties trust each other, health care becomes less adversarial and more collaborative.

The Bottom Line

In today’s environment, where skepticism toward insurers runs high, TPAs have the opportunity to redefine what trust in health care looks like. By combining transparency, empathy, and data, they can bridge the divide between payers and patients, turning confusion into clarity and frustration into confidence.

At Nova Healthcare Administrators, we believe trust isn’t earned through marketing; it’s earned through consistent, human-centered service. From data insights to clinical advocacy, we’re proud to help employers and members see health care differently: not as a maze to navigate, but as a partnership built on understanding, transparency, and care.