Andy Kuchar
Vice President, Risk Management
The Wendy's Co.

We're currently in our fourth year with Sedgwick. We look for robust claims systems that are easy to use, flexibility to customize services, responsiveness and competitive pricing.  Sedgwick's systems are good, as is their pricing. Their systems are easy to use, including nice touches like the ability to click on an adjuster's name and have an e-mail automatically generate with the claim number or the ability to see diaries the adjusters have set for themselves.

Sarah Perry
Risk Manager
City of Columbia, MO.

Corporate Claims Management Inc. (CCMI) in Chesterfield, Mo., has been our TPA for 16 years. CCMI's status as a regional TPA means they can be flexible and respond to our needs without needing to follow corporate guidelines or check with “higher-ups.” Their ability to adapt has allowed them to add Medicare/SCHIP Act reporting to the services they provide; new claim information dashboards available online; and generate special loss reports particular to the requests of city administration; and open records requests from the media.

Important characteristics of a good TPA for us are exhibiting knowledge of public-entity claims, responsiveness, flexibility and the ability to adapt to changes in technology, reporting needs and legislative demands. Of course, we want all of this at a reasonable price, especially since as a public entity we must be able to justify our expenses. Given the value we receive for their fee, it is worth the cost.

Karl Zimmel
Manager, Risk Management Services
UNS Energy Corp. Tuscon, Ariz.

I have found that once you select a third-party administrator that has the key capabilities necessary, it is better to work closely with that TPA to fix issues as they arise and develop a relationship, rather than change TPAs.  If a company has a substantial volume of claims, then there will always be issues, it's the nature of the business given all of the individual claims adjusters and volume of work.  Risk managers need to take some ownership in the challenge for high quality TPA work, because as a group for so many years we have beat down TPA fees, which then requires TPAs to increase adjusters caseload for the economics to work. 

When I came to Tuscon Electric Power (TEP) we had two separate TPAs handling our different operating companies, so I did an extensive request for proposals and selected Gallagher Bassett Services.  We are pleased with the services of GBS. I particularly like our current TPA, because they provide us very customized service that makes us feel like one of their largest customers when in fact we are one of their smallest.

Michael J. Tilley
Vice President, Workers' Compensation
Kelly Services Inc.

We have been with ESIS Inc. since 2005 when we moved four self-insured states to them as a “test” of their ability/commitment. In 2007, we moved the rest of the U.S. business to ESIS.

Best-in-class performance is, of course, terribly important when selecting a TPA but, unfortunately sometimes the burden is on the client to measure the TPA in order to make that determination.  

During the selection process, the client ought to have a real good sense as to the “vital few” metrics that are important to their organization. The “significant many” other metrics will probably fall into line if the TPA is among the nationally recognized.  

Our current TPA fits the bill perfectly.  Our working relationship is excellent and we have unfettered access to leadership not only across their organization but also into their parent company (Ace) as well.  

Becky Robinson
Hobby Lobby, Oklahoma City,
Okla.

We use Sedgwick on our national account (we moved our TPA services to them in 2009) but use Providence Risk & Insurance on our Texas non-subscriber program.  

We have a hands-on risk management team in our corporate office.  A TPA managing our account must be flexible and work with our corporate risk management team as we navigate through our own guidelines with respect to prescription protocols, return-to-work programs and in-house claim activity. 

Additionally, we track every claim on a RMIS system; sometimes being so involved creates challenges with TPAs. We need to partner with a TPA that can interface with our system. Sedgwick fits that bill for us on our national program.

Regarding our specialty program in Texas, our partner, Providence, was selected in 2004 as our TPA of choice. We have been extremely happy with that relationship; they have been very responsive to our needs creating an interface with our system and teaming with us on continuing wages through our payroll department.

Gary Urban, MA, ARM
Director of General Services
City of Waco, TEXAS

We have used TRISTAR Risk Management for four years. The characteristics most important to us in selecting a TPA:

1. Timely response to my staff's questions. 
2. Adjusters who contact the injured employee within 24 hours of the claim being filed.  
3. Adjusters who keep their case notes current and keep the employer informed about potential false claims—and addresses these issues early.  
4. Daily discussions between the employer and the TPA adjuster.
5. No hidden costs and no over-billing.
6. A user-friendly Claims database that includes detailed case notes and produces quality reports—the type that an Employer needs.

Jim Recchia, CRM, AIC
Director of Risk Management
Beam Inc.

Sedgwick has been our TPA since 2004. There are several primary characteristics that matter to me:

Flexibility in claim handling. When a claim is reported, I expect our injured employee or third-party claimant to be contacted within 24 hours with no exceptions. What is also extremely crucial is being able to cut through “TPA bureaucracy” and not wasting time on small issues. For example, if an employee is receiving collection notices due to unpaid medical bills relating to a Workers' Compensation claim, I expect the TPA to make payment from the claim office with no questions asked.   

Cost. We are an organization that assertively manages our Workers' Compensation claims. TPAs that can agree to fixed rates on a multiple year deal are much more desirable to do business with. There are way too many fees for TPAs doing what they are supposed to do – recovery of a percentage of subrogation fees by the TPA is one major example.

The Intangibles. Being “there” whenever we need the TPA. Sedgwick has done a solid job in meeting most of my expectations.

Brian Gianfelice
Director, Corporate Claims
Interstate Brands Corporation
Perkasie, Pa.

Due to our size and program complexity, we currently partner with several TPAs. We use Constitutional State Service Company (CSSC), Broadspire and ESIS. We recently selected Gallagher Bassett about a year ago due to a change in carrier program and coverage. Our TPA partners help manage deductible, SIR, self-insured and guaranteed cost programs.

Some of the things I look at when considering a TPA: a strong account-management philosophy, including willingness to produce quarterly metric reports and annual stewardship reports; size (which does matter); price; after hours/ emergency response capabilities; staff turnover; strong, multi-line claim professionals; advanced cost-containment programs; reputation; and can they customize and be flexible and are they willing and able to form a true partnership? A poor choice of TPA can have significant long-term consequences on a company.