Carrier Service Agreements: What Should Be in Your Glass TPA Contract
The Carrier Service Agreement (CSA) is the foundation of every glass TPA relationship. A well-written CSA protects both parties, sets clear expectations, and provides the framework for measuring performance. Here are the essential elements every CSA should include.
Scope of services. Define exactly what the TPA will handle — call center operations, coverage verification, shop dispatch, invoice review, payment processing, reporting, and fraud monitoring. Ambiguity in scope leads to disputes later.
Service level agreements. Specific, measurable SLAs for call answer time, dispatch speed, invoice review turnaround, and payment processing give both parties objective benchmarks for performance evaluation.
Pricing and fee structure. Whether per-claim, monthly retainer, or volume-tiered, the fee structure should be explicit. Include provisions for how pricing adjusts with volume changes and when rate reviews occur.
Data ownership and security. State clearly that all data belongs to the carrier, define GLBA compliance requirements, specify breach notification timelines, and establish audit rights.
Reporting requirements. Define the frequency, format, and content of standard reports. At minimum, carriers should receive data on claim volumes, costs, cycle times, shop performance, and fraud indicators.
Term and termination. Specify the initial term, renewal provisions, and termination conditions. Include transition provisions that ensure continuity of service and complete data transfer when the relationship ends.
Insurance requirements. The TPA should maintain adequate professional liability, errors and omissions, and cyber liability coverage. Minimum coverage amounts should be specified in the CSA.
A thorough CSA takes time to negotiate but prevents far more problems than it creates. Both parties should engage legal counsel familiar with TPA relationships and insurance regulation.