When an employer becomes a client of a PEO and the employer has a different managed care organization (MCO) than the PEO, which MCO will medically manage the claims?
18A. An employer who becomes a client of a PEO with all payroll and claims for that client reported under the PEO’s policy, the MCO of the client will be changed to the MCO of the PEO. An employer who becomes a client of a PEO but continues to report payroll and claims under its own policy will continue to use the MCO assigned to its policy. In a partial relationship where the PEO only takes on a portion of the client’s employees, the client will continue to use the MCO assigned to its policy for the employees it retains, and the PEOs MCO will manage the claims for the employees reported to the PEOs policy.
Related Questions
- When an employer becomes a client of a PEO and the employer has a different managed care organization (MCO) than the PEO, which MCO will medically manage the claims?
- Does the PEO have the right to approve (sign off) on the settlement of a claim that is associated with a client employer?
- How does Employee Leasing or a PEO (Professional Employer Organization) work?
