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Why You Need a TPA (and a Service Contract!) for Ohio Workers' Comp

Why You Need a TPAIf 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 be claims management, not simply filing paperwork.  


We often talk to employers who have been automatically re-enrolled for the Group Rating program they were in last year, without any discussion of other programs. With changes made recently by Ohio BWC, the Group Rating program has become less valuable and employers may save up to 40% more by participating in a program like Group Retro.  The summer prior to the policy year in question is the best time to talk to your TPA about renewal options, or to look at other TPAs that might offer a more valuable partnership.  For example, in the summer of 2021 – you should be looking ahead at options for the 2022 policy year.  Your current TPA will send your renewal as much as 14 months in advance – so be cautious about signing paperwork and writing checks to them if you’re not sure you want to continue that partnership. 


If you’re waiting until you have a claim to find out the level of service your TPA provides, it may already be too late.   


 

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