News and Updates
Category: OhioBWC
2023 MCO Open Enrollment is Around the Corner!
MCO Open Enrollment will take place Monday, May 1st, through Friday, May 26th, 2023. The opportunity for employers to choose their managed care organization (MCO) for Ohio Workers’ Comp comes only every two years, so employers will not have the opportunity again until 2025. Don’t miss out if you want to make a change! We know May is “busy season” for several industries with the weather warming up, but if you’re anything less than pleased with your MCO – it’s worth making time to take a few meetings and consider your options. With all of the mergers and acquisitions in the Ohio MCO marketplace over the last several years, there are now only 10 companies to choose from. Since MCOs aren’t paid directly by employers, there are often low expectations set because no “value” is assigned. It’s true that MCOs are paid by Ohio BWC, but they are paid with a portion of employer premium dollars. If you want to stay with your current MCO, there is nothing you need to do. We suggest being very cautious of what you sign or agree to during this time period, as some sales tactics can be misleading. You can view BWC’s 2023 MCO Report Card here, and learn more about how to interpret the results
Why You Need a TPA (and a Service Contract!) for Ohio Workers' Comp
If an Ohio employer wants to participate in a BWC sponsored discount program, they need to partner with a TPA (third-party administrator). Failure to do so can cost employers thousands, if not tens of thousands, in additional premiums annually. In addition to getting employers discounts on their workers’ comp premiums, TPAs work for the employer – not for BWC. Your TPA should be advocating on your behalf to manage all aspects of your workers’ comp claims and policy, including (but not limited to): Proper program placement Claims investigations Claims management Workplace safety programs Compliance and deadlines Attorney representation at Industrial Commission hearings If you rely on your TPA to manage workers’ comp claims (and you should be – you’ve paid them to!), you need a service agreement in place to protect you and provide terms for your relationship. Have you read your contract with your TPA? Do you even have one? If your TPA doesn’t have a service contract that spells out what services they are providing, ask them why that is. Often, we see that employers just get an invoice from their TPA with the amount due. In the event of a claim, do you know if you’re paying your TPA for anything more than a discount? Due to TPAs holding the key to BWC sponsored discount programs –many Ohio employers don’t realize that their TPA’s main objective should
