To determine the level of savings your company may qualify for complete the form below. The evaluation is free and there is no obligation.
Benefit Management Services of Ohio, lnc is a multifaceted, technologically advanced employee benefits service company.
Benefit Management Services of Ohio, !nc. has built a reputation for effective claims administration services by utilizing highly effective technical expertise to assist our clients with controlling workers' compensation and unemployment compensation costs.
BMSO personnel were instrumental in the development of the OBWC UCR fee schedule, the $1k Program and Managed Care Organizations, as well as developing one of the first and largest provider discount networks for utilization exclusively by workers' compensation clients.
BMSO is committed to providing the highest quality cost-effective employee beneft its program through superior service. BMSO personnel are committed to providing aggressive claims management oversight and the most effective hearing representation in the state. At the same time, our expertise and quality cost control and claims management methods allows us the opportunity to form lasting partnerships with our clients.
BMSO has received numerous recognition awards for providing the highest level of quality services to the membership of various organizations that we represent. We are comitted to providing the highest level of service to meet the individual needs of each client.
"Nobody does it better than BMSO. Their service is far above the industry standard and has proven to be an exceptional value to our members"
BMSO can assist your company in the development and implementation of an aggressive and eflective risk management program to provide employers with an excellent opportunity to manage workers' compensation costs.
An effective cost Management program may include:
To: Ohio Bureau of Workers’ Compensation
C/O: Robert CARR INSURANCE AGENCY,
INC
400 Niles-Cortland Rd. SE
Warren, Ohio 44484
Phone: (330) 856-6270
Note: For this to be a valid letter, the self-insured department for self-insured employers, or the employer services department for all other employers, must stamp it. Being temporary in nature, BWC will not record via computer or retain this authorization. Representative must possess a copy when requesting service relative to the authority granted therein.
This is to certify that Robert Carr Insurance Agency. Inc, REP ID #: 222460-80 (46000/02408, 2022/2023, Code 16/26) including its agents or representatives identified to you by them, has been retained to review and perform studies on certain workers' compensation matters on our behalf.
I understand this authorization is limited and temporary in nature and will expire automatically nine months from the date received by the employer services or self-insured departments, which is appropriate. In either case, the length of authorization will not exceed nine months.
Completion of the temporary authorization provides a third-party administrator (TPA) limited authority to view an employer's payroll and loss experience. By signing the AC-3, the employer grants permission to the BWC to release information to the employer's authorized representative(s). The form allows a TPA to view an employer's information regarding payroll, claims and experience modification.
Employers may complete the AC-3 for as many TPAs or group-rating sponsors they feel are necessary to obtain quotes for a group-rating program.
To determine the level of savings your company may qualify for complete the form below. The evaluation is free and there is no obligation.
Benefit Management Services of Ohio, lnc is a multifaceted, technologically advanced employee benefits service company.
Benefit Management Services of Ohio, !nc. has built a reputation for effective claims administration services by utilizing highly effective technical expertise to assist our clients with controlling workers' compensation and unemployment compensation costs.
BMSO personnel were instrumental in the development of the OBWC UCR fee schedule, the $1k Program and Managed Care Organizations, as well as developing one of the first and largest provider discount networks for utilization exclusively by workers' compensation clients.
BMSO is committed to providing the highest quality cost-effective employee beneft its program through superior service. BMSO personnel are committed to providing aggressive claims management oversight and the most effective hearing representation in the state. At the same time, our expertise and quality cost control and claims management methods allows us the opportunity to form lasting partnerships with our clients.
BMSO has received numerous recognition awards for providing the highest level of quality services to the membership of various organizations that we represent. We are comitted to providing the highest level of service to meet the individual needs of each client.
"Nobody does it better than BMSO. Their service is far above the industry standard and has proven to be an exceptional value to our members"
BMSO can assist your company in the development and implementation of an aggressive and eflective risk management program to provide employers with an excellent opportunity to manage workers' compensation costs.
An effective cost Management program may include:
To: Ohio Bureau of Workers’ Compensation
C/O: Robert CARR INSURANCE AGENCY,
INC
400 Niles-Cortland Rd. SE
Warren, Ohio 44484
Phone: (330) 856-6270
Note: For this to be a valid letter, the self-insured department for self-insured employers, or the employer services department for all other employers, must stamp it. Being temporary in nature, BWC will not record via computer or retain this authorization. Representative must possess a copy when requesting service relative to the authority granted therein.
This is to certify that Robert Carr Insurance Agency. Inc, REP ID #: 222460-80 (46000/02408, 2022/2023, Code 16/26) including its agents or representatives identified to you by them, has been retained to review and perform studies on certain workers' compensation matters on our behalf.
I understand this authorization is limited and temporary in nature and will expire automatically nine months from the date received by the employer services or self-insured departments, which is appropriate. In either case, the length of authorization will not exceed nine months.
Completion of the temporary authorization provides a third-party administrator (TPA) limited authority to view an employer's payroll and loss experience. By signing the AC-3, the employer grants permission to the BWC to release information to the employer's authorized representative(s). The form allows a TPA to view an employer's information regarding payroll, claims and experience modification.
Employers may complete the AC-3 for as many TPAs or group-rating sponsors they feel are necessary to obtain quotes for a group-rating program.
To determine the level of savings your company may qualify for complete the form below. The evaluation is free and there is no obligation.
Benefit Management Services of Ohio, lnc is a multifaceted, technologically advanced employee benefits service company.
Benefit Management Services of Ohio, !nc. has built a reputation for effective claims administration services by utilizing highly effective technical expertise to assist our clients with controlling workers' compensation and unemployment compensation costs.
BMSO personnel were instrumental in the development of the OBWC UCR fee schedule, the $1k Program and Managed Care Organizations, as well as developing one of the first and largest provider discount networks for utilization exclusively by workers' compensation clients.
BMSO is committed to providing the highest quality cost-effective employee beneft its program through superior service. BMSO personnel are committed to providing aggressive claims management oversight and the most effective hearing representation in the state. At the same time, our expertise and quality cost control and claims management methods allows us the opportunity to form lasting partnerships with our clients.
BMSO has received numerous recognition awards for providing the highest level of quality services to the membership of various organizations that we represent. We are comitted to providing the highest level of service to meet the individual needs of each client.
"Nobody does it better than BMSO. Their service is far above the industry standard and has proven to be an exceptional value to our members"
BMSO can assist your company in the development and implementation of an aggressive and eflective risk management program to provide employers with an excellent opportunity to manage workers' compensation costs.
An effective cost Management program may include:
To: Ohio Bureau of Workers’ Compensation
C/O: Robert CARR INSURANCE AGENCY,
INC
400 Niles-Cortland Rd. SE
Warren, Ohio 44484
Phone: (330) 856-6270
Note: For this to be a valid letter, the self-insured department for self-insured employers, or the employer services department for all other employers, must stamp it. Being temporary in nature, BWC will not record via computer or retain this authorization. Representative must possess a copy when requesting service relative to the authority granted therein.
This is to certify that Robert Carr Insurance Agency. Inc, REP ID #: 222460-80 (46000/02408, 2022/2023, Code 16/26) including its agents or representatives identified to you by them, has been retained to review and perform studies on certain workers' compensation matters on our behalf.
I understand this authorization is limited and temporary in nature and will expire automatically nine months from the date received by the employer services or self-insured departments, which is appropriate. In either case, the length of authorization will not exceed nine months.
Completion of the temporary authorization provides a third-party administrator (TPA) limited authority to view an employer's payroll and loss experience. By signing the AC-3, the employer grants permission to the BWC to release information to the employer's authorized representative(s). The form allows a TPA to view an employer's information regarding payroll, claims and experience modification.
Employers may complete the AC-3 for as many TPAs or group-rating sponsors they feel are necessary to obtain quotes for a group-rating program.
To determine the level of savings your company may qualify for complete the form below. The evaluation is free and there is no obligation.
Benefit Management Services of Ohio, lnc is a multifaceted, technologically advanced employee benefits service company.
Benefit Management Services of Ohio, !nc. has built a reputation for effective claims administration services by utilizing highly effective technical expertise to assist our clients with controlling workers' compensation and unemployment compensation costs.
BMSO personnel were instrumental in the development of the OBWC UCR fee schedule, the $1k Program and Managed Care Organizations, as well as developing one of the first and largest provider discount networks for utilization exclusively by workers' compensation clients.
BMSO is committed to providing the highest quality cost-effective employee beneft its program through superior service. BMSO personnel are committed to providing aggressive claims management oversight and the most effective hearing representation in the state. At the same time, our expertise and quality cost control and claims management methods allows us the opportunity to form lasting partnerships with our clients.
BMSO has received numerous recognition awards for providing the highest level of quality services to the membership of various organizations that we represent. We are comitted to providing the highest level of service to meet the individual needs of each client.
"Nobody does it better than BMSO. Their service is far above the industry standard and has proven to be an exceptional value to our members"
BMSO can assist your company in the development and implementation of an aggressive and eflective risk management program to provide employers with an excellent opportunity to manage workers' compensation costs.
An effective cost Management program may include:
To: Ohio Bureau of Workers’ Compensation
C/O: Robert CARR INSURANCE AGENCY,
INC
400 Niles-Cortland Rd. SE
Warren, Ohio 44484
Phone: (330) 856-6270
Note: For this to be a valid letter, the self-insured department for self-insured employers, or the employer services department for all other employers, must stamp it. Being temporary in nature, BWC will not record via computer or retain this authorization. Representative must possess a copy when requesting service relative to the authority granted therein.
This is to certify that Robert Carr Insurance Agency. Inc, REP ID #: 222460-80 (46000/02408, 2022/2023, Code 16/26) including its agents or representatives identified to you by them, has been retained to review and perform studies on certain workers' compensation matters on our behalf.
I understand this authorization is limited and temporary in nature and will expire automatically nine months from the date received by the employer services or self-insured departments, which is appropriate. In either case, the length of authorization will not exceed nine months.
Completion of the temporary authorization provides a third-party administrator (TPA) limited authority to view an employer's payroll and loss experience. By signing the AC-3, the employer grants permission to the BWC to release information to the employer's authorized representative(s). The form allows a TPA to view an employer's information regarding payroll, claims and experience modification.
Employers may complete the AC-3 for as many TPAs or group-rating sponsors they feel are necessary to obtain quotes for a group-rating program.
To determine the level of savings your company may qualify for complete the form below. The evaluation is free and there is no obligation.
Benefit Management Services of Ohio, lnc is a multifaceted, technologically advanced employee benefits service company.
Benefit Management Services of Ohio, !nc. has built a reputation for effective claims administration services by utilizing highly effective technical expertise to assist our clients with controlling workers' compensation and unemployment compensation costs.
BMSO personnel were instrumental in the development of the OBWC UCR fee schedule, the $1k Program and Managed Care Organizations, as well as developing one of the first and largest provider discount networks for utilization exclusively by workers' compensation clients.
BMSO is committed to providing the highest quality cost-effective employee beneft its program through superior service. BMSO personnel are committed to providing aggressive claims management oversight and the most effective hearing representation in the state. At the same time, our expertise and quality cost control and claims management methods allows us the opportunity to form lasting partnerships with our clients.
BMSO has received numerous recognition awards for providing the highest level of quality services to the membership of various organizations that we represent. We are comitted to providing the highest level of service to meet the individual needs of each client.
"Nobody does it better than BMSO. Their service is far above the industry standard and has proven to be an exceptional value to our members"
BMSO can assist your company in the development and implementation of an aggressive and eflective risk management program to provide employers with an excellent opportunity to manage workers' compensation costs.
An effective cost Management program may include:
To: Ohio Bureau of Workers’ Compensation
C/O: Robert CARR INSURANCE AGENCY,
INC
400 Niles-Cortland Rd. SE
Warren, Ohio 44484
Phone: (330) 856-6270
Note: For this to be a valid letter, the self-insured department for self-insured employers, or the employer services department for all other employers, must stamp it. Being temporary in nature, BWC will not record via computer or retain this authorization. Representative must possess a copy when requesting service relative to the authority granted therein.
This is to certify that Robert Carr Insurance Agency. Inc, REP ID #: 222460-80 (46000/02408, 2022/2023, Code 16/26) including its agents or representatives identified to you by them, has been retained to review and perform studies on certain workers' compensation matters on our behalf.
I understand this authorization is limited and temporary in nature and will expire automatically nine months from the date received by the employer services or self-insured departments, which is appropriate. In either case, the length of authorization will not exceed nine months.
Completion of the temporary authorization provides a third-party administrator (TPA) limited authority to view an employer's payroll and loss experience. By signing the AC-3, the employer grants permission to the BWC to release information to the employer's authorized representative(s). The form allows a TPA to view an employer's information regarding payroll, claims and experience modification.
Employers may complete the AC-3 for as many TPAs or group-rating sponsors they feel are necessary to obtain quotes for a group-rating program.
To determine the level of savings your company may qualify for complete the form below. The evaluation is free and there is no obligation.
Benefit Management Services of Ohio, lnc is a multifaceted, technologically advanced employee benefits service company.
Benefit Management Services of Ohio, !nc. has built a reputation for effective claims administration services by utilizing highly effective technical expertise to assist our clients with controlling workers' compensation and unemployment compensation costs.
BMSO personnel were instrumental in the development of the OBWC UCR fee schedule, the $1k Program and Managed Care Organizations, as well as developing one of the first and largest provider discount networks for utilization exclusively by workers' compensation clients.
BMSO is committed to providing the highest quality cost-effective employee beneft its program through superior service. BMSO personnel are committed to providing aggressive claims management oversight and the most effective hearing representation in the state. At the same time, our expertise and quality cost control and claims management methods allows us the opportunity to form lasting partnerships with our clients.
BMSO has received numerous recognition awards for providing the highest level of quality services to the membership of various organizations that we represent. We are comitted to providing the highest level of service to meet the individual needs of each client.
"Nobody does it better than BMSO. Their service is far above the industry standard and has proven to be an exceptional value to our members"
BMSO can assist your company in the development and implementation of an aggressive and eflective risk management program to provide employers with an excellent opportunity to manage workers' compensation costs.
An effective cost Management program may include:
To: Ohio Bureau of Workers’ Compensation
C/O: Robert CARR INSURANCE AGENCY,
INC
400 Niles-Cortland Rd. SE
Warren, Ohio 44484
Phone: (330) 856-6270
Note: For this to be a valid letter, the self-insured department for self-insured employers, or the employer services department for all other employers, must stamp it. Being temporary in nature, BWC will not record via computer or retain this authorization. Representative must possess a copy when requesting service relative to the authority granted therein.
This is to certify that Robert Carr Insurance Agency. Inc, REP ID #: 222460-80 (46000/02408, 2022/2023, Code 16/26) including its agents or representatives identified to you by them, has been retained to review and perform studies on certain workers' compensation matters on our behalf.
I understand this authorization is limited and temporary in nature and will expire automatically nine months from the date received by the employer services or self-insured departments, which is appropriate. In either case, the length of authorization will not exceed nine months.
Completion of the temporary authorization provides a third-party administrator (TPA) limited authority to view an employer's payroll and loss experience. By signing the AC-3, the employer grants permission to the BWC to release information to the employer's authorized representative(s). The form allows a TPA to view an employer's information regarding payroll, claims and experience modification.
Employers may complete the AC-3 for as many TPAs or group-rating sponsors they feel are necessary to obtain quotes for a group-rating program.
To determine the level of savings your company may qualify for complete the form below. The evaluation is free and there is no obligation.
Benefit Management Services of Ohio, lnc is a multifaceted, technologically advanced employee benefits service company.
Benefit Management Services of Ohio, !nc. has built a reputation for effective claims administration services by utilizing highly effective technical expertise to assist our clients with controlling workers' compensation and unemployment compensation costs.
BMSO personnel were instrumental in the development of the OBWC UCR fee schedule, the $1k Program and Managed Care Organizations, as well as developing one of the first and largest provider discount networks for utilization exclusively by workers' compensation clients.
BMSO is committed to providing the highest quality cost-effective employee beneft its program through superior service. BMSO personnel are committed to providing aggressive claims management oversight and the most effective hearing representation in the state. At the same time, our expertise and quality cost control and claims management methods allows us the opportunity to form lasting partnerships with our clients.
BMSO has received numerous recognition awards for providing the highest level of quality services to the membership of various organizations that we represent. We are comitted to providing the highest level of service to meet the individual needs of each client.
"Nobody does it better than BMSO. Their service is far above the industry standard and has proven to be an exceptional value to our members"
BMSO can assist your company in the development and implementation of an aggressive and eflective risk management program to provide employers with an excellent opportunity to manage workers' compensation costs.
An effective cost Management program may include:
To: Ohio Bureau of Workers’ Compensation
C/O: Robert CARR INSURANCE AGENCY,
INC
400 Niles-Cortland Rd. SE
Warren, Ohio 44484
Phone: (330) 856-6270
Note: For this to be a valid letter, the self-insured department for self-insured employers, or the employer services department for all other employers, must stamp it. Being temporary in nature, BWC will not record via computer or retain this authorization. Representative must possess a copy when requesting service relative to the authority granted therein.
This is to certify that Robert Carr Insurance Agency. Inc, REP ID #: 222460-80 (46000/02408, 2022/2023, Code 16/26) including its agents or representatives identified to you by them, has been retained to review and perform studies on certain workers' compensation matters on our behalf.
I understand this authorization is limited and temporary in nature and will expire automatically nine months from the date received by the employer services or self-insured departments, which is appropriate. In either case, the length of authorization will not exceed nine months.
Completion of the temporary authorization provides a third-party administrator (TPA) limited authority to view an employer's payroll and loss experience. By signing the AC-3, the employer grants permission to the BWC to release information to the employer's authorized representative(s). The form allows a TPA to view an employer's information regarding payroll, claims and experience modification.
Employers may complete the AC-3 for as many TPAs or group-rating sponsors they feel are necessary to obtain quotes for a group-rating program.
To determine the level of savings your company may qualify for complete the form below. The evaluation is free and there is no obligation.
Benefit Management Services of Ohio, lnc is a multifaceted, technologically advanced employee benefits service company.
Benefit Management Services of Ohio, !nc. has built a reputation for effective claims administration services by utilizing highly effective technical expertise to assist our clients with controlling workers' compensation and unemployment compensation costs.
BMSO personnel were instrumental in the development of the OBWC UCR fee schedule, the $1k Program and Managed Care Organizations, as well as developing one of the first and largest provider discount networks for utilization exclusively by workers' compensation clients.
BMSO is committed to providing the highest quality cost-effective employee beneft its program through superior service. BMSO personnel are committed to providing aggressive claims management oversight and the most effective hearing representation in the state. At the same time, our expertise and quality cost control and claims management methods allows us the opportunity to form lasting partnerships with our clients.
BMSO has received numerous recognition awards for providing the highest level of quality services to the membership of various organizations that we represent. We are comitted to providing the highest level of service to meet the individual needs of each client.
"Nobody does it better than BMSO. Their service is far above the industry standard and has proven to be an exceptional value to our members"
BMSO can assist your company in the development and implementation of an aggressive and eflective risk management program to provide employers with an excellent opportunity to manage workers' compensation costs.
An effective cost Management program may include:
To: Ohio Bureau of Workers’ Compensation
C/O: Robert CARR INSURANCE AGENCY,
INC
400 Niles-Cortland Rd. SE
Warren, Ohio 44484
Phone: (330) 856-6270
Note: For this to be a valid letter, the self-insured department for self-insured employers, or the employer services department for all other employers, must stamp it. Being temporary in nature, BWC will not record via computer or retain this authorization. Representative must possess a copy when requesting service relative to the authority granted therein.
This is to certify that Robert Carr Insurance Agency. Inc, REP ID #: 222460-80 (46000/02408, 2022/2023, Code 16/26) including its agents or representatives identified to you by them, has been retained to review and perform studies on certain workers' compensation matters on our behalf.
I understand this authorization is limited and temporary in nature and will expire automatically nine months from the date received by the employer services or self-insured departments, which is appropriate. In either case, the length of authorization will not exceed nine months.
Completion of the temporary authorization provides a third-party administrator (TPA) limited authority to view an employer's payroll and loss experience. By signing the AC-3, the employer grants permission to the BWC to release information to the employer's authorized representative(s). The form allows a TPA to view an employer's information regarding payroll, claims and experience modification.
Employers may complete the AC-3 for as many TPAs or group-rating sponsors they feel are necessary to obtain quotes for a group-rating program.
To determine the level of savings your company may qualify for complete the form below. The evaluation is free and there is no obligation.
Benefit Management Services of Ohio, lnc is a multifaceted, technologically advanced employee benefits service company.
Benefit Management Services of Ohio, !nc. has built a reputation for effective claims administration services by utilizing highly effective technical expertise to assist our clients with controlling workers' compensation and unemployment compensation costs.
BMSO personnel were instrumental in the development of the OBWC UCR fee schedule, the $1k Program and Managed Care Organizations, as well as developing one of the first and largest provider discount networks for utilization exclusively by workers' compensation clients.
BMSO is committed to providing the highest quality cost-effective employee beneft its program through superior service. BMSO personnel are committed to providing aggressive claims management oversight and the most effective hearing representation in the state. At the same time, our expertise and quality cost control and claims management methods allows us the opportunity to form lasting partnerships with our clients.
BMSO has received numerous recognition awards for providing the highest level of quality services to the membership of various organizations that we represent. We are comitted to providing the highest level of service to meet the individual needs of each client.
"Nobody does it better than BMSO. Their service is far above the industry standard and has proven to be an exceptional value to our members"
BMSO can assist your company in the development and implementation of an aggressive and eflective risk management program to provide employers with an excellent opportunity to manage workers' compensation costs.
An effective cost Management program may include:
To: Ohio Bureau of Workers’ Compensation
C/O: Robert CARR INSURANCE AGENCY,
INC
400 Niles-Cortland Rd. SE
Warren, Ohio 44484
Phone: (330) 856-6270
Note: For this to be a valid letter, the self-insured department for self-insured employers, or the employer services department for all other employers, must stamp it. Being temporary in nature, BWC will not record via computer or retain this authorization. Representative must possess a copy when requesting service relative to the authority granted therein.
This is to certify that Robert Carr Insurance Agency. Inc, REP ID #: 222460-80 (46000/02408, 2022/2023, Code 16/26) including its agents or representatives identified to you by them, has been retained to review and perform studies on certain workers' compensation matters on our behalf.
I understand this authorization is limited and temporary in nature and will expire automatically nine months from the date received by the employer services or self-insured departments, which is appropriate. In either case, the length of authorization will not exceed nine months.
Completion of the temporary authorization provides a third-party administrator (TPA) limited authority to view an employer's payroll and loss experience. By signing the AC-3, the employer grants permission to the BWC to release information to the employer's authorized representative(s). The form allows a TPA to view an employer's information regarding payroll, claims and experience modification.
Employers may complete the AC-3 for as many TPAs or group-rating sponsors they feel are necessary to obtain quotes for a group-rating program.
To determine the level of savings your company may qualify for complete the form below. The evaluation is free and there is no obligation.
Benefit Management Services of Ohio, lnc is a multifaceted, technologically advanced employee benefits service company.
Benefit Management Services of Ohio, !nc. has built a reputation for effective claims administration services by utilizing highly effective technical expertise to assist our clients with controlling workers' compensation and unemployment compensation costs.
BMSO personnel were instrumental in the development of the OBWC UCR fee schedule, the $1k Program and Managed Care Organizations, as well as developing one of the first and largest provider discount networks for utilization exclusively by workers' compensation clients.
BMSO is committed to providing the highest quality cost-effective employee beneft its program through superior service. BMSO personnel are committed to providing aggressive claims management oversight and the most effective hearing representation in the state. At the same time, our expertise and quality cost control and claims management methods allows us the opportunity to form lasting partnerships with our clients.
BMSO has received numerous recognition awards for providing the highest level of quality services to the membership of various organizations that we represent. We are comitted to providing the highest level of service to meet the individual needs of each client.
"Nobody does it better than BMSO. Their service is far above the industry standard and has proven to be an exceptional value to our members"
BMSO can assist your company in the development and implementation of an aggressive and eflective risk management program to provide employers with an excellent opportunity to manage workers' compensation costs.
An effective cost Management program may include:
To: Ohio Bureau of Workers’ Compensation
C/O: Robert CARR INSURANCE AGENCY,
INC
400 Niles-Cortland Rd. SE
Warren, Ohio 44484
Phone: (330) 856-6270
Note: For this to be a valid letter, the self-insured department for self-insured employers, or the employer services department for all other employers, must stamp it. Being temporary in nature, BWC will not record via computer or retain this authorization. Representative must possess a copy when requesting service relative to the authority granted therein.
This is to certify that Robert Carr Insurance Agency. Inc, REP ID #: 222460-80 (46000/02408, 2022/2023, Code 16/26) including its agents or representatives identified to you by them, has been retained to review and perform studies on certain workers' compensation matters on our behalf.
I understand this authorization is limited and temporary in nature and will expire automatically nine months from the date received by the employer services or self-insured departments, which is appropriate. In either case, the length of authorization will not exceed nine months.
Completion of the temporary authorization provides a third-party administrator (TPA) limited authority to view an employer's payroll and loss experience. By signing the AC-3, the employer grants permission to the BWC to release information to the employer's authorized representative(s). The form allows a TPA to view an employer's information regarding payroll, claims and experience modification.
Employers may complete the AC-3 for as many TPAs or group-rating sponsors they feel are necessary to obtain quotes for a group-rating program.
