Mark Robichaud Email & Phone Number

Currently oversee a claim unit and the many facets involved with the administration of unbundled program business handled by Third-Party Administrators. This includes engagement in the initial set-up of program relationships, negotiation of claim administration fees and contract language, including managed care costs. Perform/facilitate claim audits to ensure appropriate claim handling based on company/industry wide best practices as well as SOX compliance. Work closely with the Compliance team to address various jurisdictional/DOI issues with a focus on Workers Compensation. Support the the Finance department to ensure appropriate escrow funding levels as well as ensuring appropriate reinsurance reporting/billing as warranted. Collaborate with other claim and business areas to share processes/ideas unique to unbundled TPA business.

Manage claim technical and operational support of program claim business including oversight of Third-Party Administrators, in-house claim handling, compliance, contracting and collaboration with underwriting. Ensure timely reinsurance reporting and audit support as needed. Nurture relationships with business partners when necessary, Work toward proactive solutions vs reactive responses.

Us

Oversight duties of Workers Compensation claims for National Accounts with large deductibles or self-insured retentions. Worked closely with accounts and their Third-Party Administrators(TPAs) in managing their large/catastrophic losses to favorable conclusions. Performed on-site and on-line claim audits of the TPAs with subsequent reporting. Established appropriate reserves with timely notification of losses to various reinsurers based on reporting thresholds/criteria.

Hartford, Ct, Us

Oversight of Workers Compensation claims for large self-insureds and captive programs. Perform claim due diligence for program business prospects. Complete claim audits and reports. Present claims above $500,000 for reserving authority.