California

1. It is necessary for the employer to fill out the required form 5020 and notify us immediately via coverage@trean.com. Form DWC-1 must be signed by the injured worker and then returned to us but don’t let this delay reporting of the accident. Please also forward any medical reports and notices from the doctor (work/disability slips).
2. Contact a preferred urgent care facility by telephone prior to sending the injured worker.
3. Initial medical can be done by a local urgent care or industrial medical clinic. If possible, notify the urgent care that you have an injured worker coming and that Benchmark Administrators is the claims administrator. A list of providers in the Medical Provider Network (MPN) can be found through the link on this page.
4. If a worker is seriously injured and needs immediate care or is transported by ambulance, the employer should have a co-worker or supervisor go with the injured worker to assist the injured worker with any insurance related information that the medical provider may require.
   • If possible, the injured worker must return to your office or job site after seeing the doctor and give you the doctor’s signed return to work slip or disability slip.

Networks By Design: Medical Provider Network

A Medical Provider Network (MPN) is a group of health care providers designated by an employer to treat the work-related injuries of its employees. It is an important part of an effective workers’ compensation program. Use of an MPN can greatly reduce claims costs and promote early return to work. The MPN established for Benchmark Administrators is Networks By Design, which can be accessed at www.netbyd.com/NbdMpn.

Networks By Design: MPN Notification Distribution Instructions

Provide the injured employee with a copy of the Employee MPN Notification document. The notice must be provided in English and in Spanish for Spanish-speaking employees. Download the English or Spanish version of the MPN Notice.

Networks By Design: MPN Physician Locator

To locate a physician or facility in the insurance carrier’s MPN, visit the Networks By Design website at www.netbyd.com/NbdMpn and select “NBD Plus MPN” from the Network dropdown to begin your search. You can also call our MPN Customer Service Coordinator for assistance. If you have any questions concerning a claim, physician, clinic, or have problems with the website, please call Benchmark Administrators at (800) 362-5198.

SB-1159 Mandatory Covid-19 Reporting

• 2020-2022 COVID-19 Reporting Requirement
• NON COVID Report Form