How to Establishing a Winning Team with Your TPA

This panel at the 2015 California Workers’ Compensation & Risk Conference shared a fresh approach for how employers can properly select and establish a winning long-term relationship with their third-party administrator (TPA). Panelists included Kurt Leisure, Vice President, Risk Services at The Cheesecake Factory Incorporated, and Katrina Zitnik, Senior Vice President at Sedgwick.

The historical TPA selection process is not necessarily the best approach for today’s business. In fact, it can be a major waste of time for everyone involved. The arduous task of completing RFPs and sifting through all of the responses drains time and resources and, usually, leaves the employer often making a selection solely based on pricing. It’s time to toss aside this process for a fresh approach that focuses on culture match and outcome base.

Employers can start an early elimination process to vet TPAs by evaluating who has national versus regional capabilities, expertise in coverage lines that pertain to the employer, and by obtaining referrals from other carriers. It takes very little time and resources to gather this information – most of which can be found on websites.

The next step is finding a culture match that aligns with the employer’s goals and objectives, risk management philosophies and claims-handling protocol. Once the employer narrows it down, they should bring these TPAs into their office to discuss by asking questions like:

• Is the TPA comfortable with handling the organization’s type of risks? 
• Is auditing important to the TPA? 
• Does the TPA have a nurse triage program? 
• What does the TPA’s case loads look like? 
• Does the TPA offer designated, dedicated adjustors? 
• What methods of communication with injured employees does the TPA utilize?

Some TPAs may self-decline at this point. Those left will be the TPAs that are truly interested in staying in the process and that the employer is truly interested in pursuing. This is the step to further refine the selection with the intent of finding a TPA that the employer can have a relationship with for years to come. The natural best fit at this point will often be apparent. This collaborative process should help find the TPA that will help give the employer the best claims outcomes.