Setting up Carriers and Claim Administrators

This article applies to organizations that are using FirstReport Online to generate workers' comp first reports of injury. Skip this article if your organization is using FirstReport Online to generate OSHA forms only.

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. In fact, Profiles are the only way to enter information about carriers and claim administrators in FirstReport Online. They cannot be entered manually on incident reports.

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.

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 insurace 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.

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.