Most states require you to include the names and addresses of your organization's workers' comp insurance carrier and claims administrator on every first report of injury form. Since this information usually changes once a year at most, it is stored in a profile so you don't have to key in the same information for every incident.
It is important to place claim administrator profiles at the proper level in your organizational structure. If you setup a claim administrator at the employer level, the name of the claim administrator will appear on the selection list for every claim administrator within the employer. This would be fine if the employer only has one claim administrator. But it would be a problem if claim administrators are different for different locations.
Profiles are the only way to enter information about carriers and claim administrators in FirstReport Online. They cannot be entered manually on incident reports.
Help Content
- What is a claim administrator?
- What is a carrier?
- Review your setup
- Adding a claim administrator
- Editing a claim administrator
- Hiding a claim administrator
- Unhiding a claim administrator
- Deleting a claim administrator
- Undeleting a claim administrator
- Sample claim administrator form in HTML format
What is a claim administrator?
A claim administrator is the business entity that manages your organization's claims and cuts checks to pay claims.
- If you are fully insured, the carrier will usually also serve as the claim administrator. In this instance, the carrier would be entered as both the carrier and the claim administrator.
- If you are self insured, and you administer your own claims, your organization would be entered as both the carrier and the claim administrator.
- If you are self insured, but hire a third part administrator (TPA) to handle your claims, then the TPA would be entered as the claims administrator. Most insurance companies also provide TPA services for self insured employers, so an insurance company can serve as a claim administrator even if you do not have a workers' comp policy with the insurance company.
The important thing to remember is that a claim administrator is always an organization, not a person. Do not confuse a claim administrator with a claims adjuster.
What is a carrier?
A carrier is the entity that has fiduciary responsibility for paying your organization's workers' comp claims. In this sense, a carrier may be an insurance company, a self insured group, or, if you are self insured, your own organization. If your organization is self insured, your organization should be listed as the carrier even if you contract with an insurance company to cut checks and administer claims.
Review your setup
Like all other profiles in FirstReport Online, the carrier and claim administrator profiles can be created and edited by clicking Manage>>Setup from the navigation menu at the top of each screen.
It is important to consider the levels in the organizational structure whenever you create a new carrier or claim administrator.
- If you setup a carrier or claim administrator at the employer level, that profile will automatically be applied to every location within the employer.
- If you setup a carrier or claim administrator at the location level, that profile will be applied only to the specific location you select.
- If a carrier or claim administrator is setup at the employer level, and another profile is entered at the location level, the profile at the location level will override the profile that was entered at the employer level for that location only.
Add a new carrier:
This claim administrator will be included as a choice on the claim administrator selection “drop-down” lists.
You can only create a claim administrator if you have Administration access when you login.
- Manage
- Setup
- claim administrator - New
- Next
- Select the appropriate Organization Level for the claim administrator then select "Next"
- Enter the required claim administrator Name field noted in red
- Complete any other information about the claim administrator that is available
- Click on the “Save” button
Edit a claim administrator profile:
If you change the "claim administrator name" after incident records have been created they will continue to carry the old claim administrator name on incident reports and summary reports unless updated individually. The "State" cannot be changed.
- Manage
- Setup
- claim administrator - Edit
- Next
- Select the appropriate Organization Level for the claim administrator then select "Next"
- Select the claim administrator to edit from drop-list if more than one exist
- Edit information as needed
- If you need to edit more claim administrators select “Edit Another”
- Click “Save” after you have completed editing claim administrators
Hide a claim administrator:
Hiding a claim administrator only affects this claim administrator.
- Manage
- Setup
- claim administrator - Edit
- Next
- Select the appropriate Organization Level as needed
- Next
- Select claim administrator to hide from drop-list if more than one exists
- Hide
- Review "warning"
- Yes
Unhide a claim administrator:
Unhiding a claim administrator only affects this claim administrator.
- Manage
- Setup
- claim administrator - Edit
- Select "Show Hidden Records" check box
- Next
- Select the appropriate Organization Level as needed
- Next
- Select a claim administrator to unhide (in gray) from drop-list if more than one exists
- Next
- Unhide
- Review "warning"
- Yes
Delete a claim administrator:
Deleting this claim administrator only affects this claim administrator.
- Manage
- Setup
- claim administrator - Edit
- Next
- Select the appropriate Organization Level as needed
- Next
- Select a claim administrator to delete from drop-list if more than one exists
- Delete
- Review "warning"
- Yes
Undelete a claim administrator: (you have until 11:59 PM EST to Undelete)
Undeleting a claim administrator only affects this claim administrator.
- Manage
- Setup
- claim administrator - Edit
- Select "Show Deleted Records" check box
- Next
- Select the appropriate Organization Level as needed
- Next
- Select a claim administrator to undelete (in gray) from drop-list if more than one exists
- Next
- Undelete
- Review "warning"
- Yes
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