My group discount is the maximum, so why get other offers for next year?

If your experience modifier (EM) is 47, you are getting the maximum group rating discount.  Why bother getting other offers for the 7/1/16 policy year?  Here are some scenarios:

No claims:  If you haven’t had any claims, your company should still be eligible for the maximum discount.  But other group TPAs might offer a lower fee, or only charge for the 12 months of the policy year instead of 24 months.  Some TPAs charge a yearly fee that covers January through December, even though the policy year is July to June, and then charge another yearly fee for the second 6 months of the policy year.

One big new claim:  The Ohio BWC offers a One Claim program to mitigate the cost of an expensive claim.  Your current TPA may offer group retrospective rating which means you would pay the full premium increase and hope for rebates 3, 4 & 5 years later.

Some claims costs will be added in to your premium calculation:  A different group may offer a better discount.  Another TPA might be better at containing the claims costs or getting the injured worker back to work faster.

Lots of claim costs will be added in to your premium calculation:  The BWC offers an EM Capping program, which will cap the experience modifier (EM) at double this year’s EM.  Your group TPA may only offer you retrospective group rating, wherein you pay the full premium rate and hope for rebates 3, 4 & 5 years later.  You may agree to retro group rating & pay the TPA fee before the BWC notifies you of your eligibility for the EM Capping program.

You can get a free and unbiased assessment by contacting ActuComp Ohio.

Posted in BWC, claims, discounts, EM cap, group rating, group retro, OCP, premiums, TPA.