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Workers' Compensation 101: Who are the Players? - Employers, Insurance Brokers / Companies, Third-Party Administrators
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Workers' Compensation 101: Who are the Players? - Employers, Insurance Brokers / Companies, Third-Party Administrators
 

 
Home > Workers' Compensation 101 > Who are the Players?

HOW IT WORKS    ●    WHAT YOU'LL GET    ●    WHY CHOOSE WORKERS' COMP KIT

 

 


 

 

Workers' Comp 101 Topics

  1. What is Worker's Compensation?
  2. Are All Injuries Compensable?
  3. Managing the Process
  4. Who Pays for Insurance?
  5. Who are the Players?
  6. Where Do I Get Help?
  7. Abbreviations


or call 860-553-6604 now!
 

 

 


Who are the Players?

There are many parties involved in the injury management process:

Employer

Your company is the employer. An employer can also be referred to as the "insured."

Insurance Broker

Your insurance broker understands the risks of your company and obtains insurance to cover those risks in the event of a loss.

A broker reconciles problems between an insurance company and an employer. Some insurance brokers provide risk management services. These include:

  • Loss Control
  • Integrated Benefits
  • RMIS (Risk Management Information Services) or Data
  • Consulting and Workers' Compensation Cost Containment Consulting Services.

Insurance Company

Absorbs some of the financial risk of loss. Often referred to as the "carrier," the "underwriter" or the "insurer." All three terms mean the same thing.

Insurance is often referred to as "cover," "coverage," and "paper."

  • In several states, workers' compensation is provided by the state itself through state funds, including:
    • North Dakota
    • Ohio
    • Washington
    • West Virginia
    • Wyoming 
  • In three states, an employer can obtain permission to self-insure or can purchase coverage through the state fund, including:
    • Ohio
    • Washington
    • West Virginia
  • In most states, employers are permitted to self-insure provided they can meet applicable criteria
  • Many large employers have high deductible programs:
    • Although the employer pays the majority of each loss, this type of insurance arrangement is different from self-insurance because an insurance company "holds the paper"
  • There is more control over how their claims are handled if a company self-insures

Third-Party Administrator (TPA) or Claims Handling Company

There are two types of claims handlers: Third -Party Administrators (TPAs) and insurance companies.

An insurance company has adjusters that handle claims. Independent companies also have adjusters to handle claims.

  • A TPA is an independent company that adjusts claims
  • TPA's focus on administering workers' compensation benefits in accordance with state laws
  • "Unbundling" occurs when an insurance company allows the employer to use a TPA

Next Topic: Where Do I Get Help?

For more information about how you can greatly reduce your Workers' Compensation costs, call us at 860-553-6604, or send us an e-mail, or simply submit this short form.