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TPA’s 101 – Part II

In my previous post, TPA’s 101 – Part I, I discussed why you should hire a TPA to help you with your worker’s compensation plans.  But that’s only half the battle.  If you hire one or currently have one in place, you need to make sure they are doing their job.  Let me put it this way – if they aren’t doing a good job on your behalf, it’s only costing you money.

An HR Manager that I know called me one day and asked a few questions about worker’s compensation.  In addition to answering them, I said, “What did your TPA say?”  She said, “I don’t know, I never really talk to them.”  Buzz – wrong answer.  If you aren’t calling your TPA, you’re nothing more than a file to them.

Here’s what you need to be asking them:

  • Do we have any claims currently on our experience that would qualify for handicapped reimbursement?
  • Do we have any claims currently on our experience that would be ideal to try and settle?
  • When the last time was the TPA had their actuary review the claims experience to ensure that the BWC reserves were correct?
  • Are they attending hearings on your behalf or do they assign an attorney to attend?
  • If they assign an attorney, which law firm is it and what is the fee schedule they have arranged?
  • If they send someone, who is it?  It should be an attorney.
  • Tell them you will be personally attending all hearings from here on out to get a feel for how they handle the account and to be present as the face of the employer.
  • How much do you pay them per year?

You should know the latter points regardless.  But if you don’t, I would encourage more dialogue between you and your TPA.

In addition, like I previously discussed, a good TPA can strategically discuss a claim as soon as it happens, and ensure you are on the right course when handling it.

Considering the complex maze that is worker’s compensation, this is one investment you need to be considering.  Anyway, I wanted to include all of this in my first post, but it got a little too long when I wrote it…

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