Work Comp Claims Management

This is the second installment of The Seltzer Group’s Workplace Injury Best Practices Series! This is part one of three for the month of February. Check back next week for part 3!

Accurately understanding the financial impact of workplace injuries is a critical first step to managing your overall insurance costs.  In the last Workplace Injuries Best Practices Series article, Exposing the Cost of Workplace Injuries, it was explained how Work Comp injuries cost employers as much as 3X the amount of a claim in the form of direct premium surcharges.  Once an employer or management team grasps the basis of why this happens they want to know how they can improve outcomes for their companies.

One of the best ways to accomplish this is through claims management.  Effectively managing your Workers Compensation claims isn’t easy, but it is a realistic and achievable goal. In fact, it’s almost impossible to do on your own without the specialized training and education.   Most employers realize this, so they go to the most logical place for answers- their insurance company and broker- for support.  Unfortunately, most claim adjusters maintain a case load of 150 to 200 claims, hindering their ability to provide the level of care and attention that your claims deserve.

Not all brokers are qualified to effectively manage claims because they do not have the required training, expertise or knowledge. Some brokerage firms may have ability to assign an employee to oversee claims and track information, but they are usually not able to proactively manage and navigate your claim. This is vital necessary to drive down your costs and prevent expensive mistakes.

The Seltzer Group along with East Coast Risk Management, built a staff of knowledgeable and experienced Work Comp Claims Adjusters who work on behalf of you, our employer clients, not the insurance company.  Once engaged, our dedicated claims team becomes an extension of your company.  Here is a sample of what they do:

• Manage all claims from start to finish to control costs, prevent fraud and abuse and eliminate expensive mistakes that commonly go undetected during the claim process

• Design, implement, train and oversee a Return to Work program that is suitable for your business

• Guide injured employees through the complex work comp system by explaining the rules, assisting with scheduling of doctor appointments and notifying them of their expectations throughout the claim process

• Communicate with attending physician to get up-to-date diagnosis allowing us to proactively manage your claims while eliminating wasteful and costly delays

• Mitigate unnecessary and costly (time and money) litigation and maintain powerful documentation for a strong defendable position in the event a case does go to court

• Coordinate and work with your HR department and safety personnel

• Continually communicate with injured employees, your supervisors, treating physician(s), and insurance company

• Substantiate and confirm that you insurance company is setting fair and reasonable reserves

• Verify proper and timely claim closures

• Preserve your rights to claim recovery and file appropriate forms to obtain premium refunds for your company

If your company is experiencing even just a few Workers Compensation claims a year and if you are relying on your insurance company or broker to manage them, there is a good chance you are being charged thousands of dollars a year in additional premium.  As an employer you have the power to take control and reduce or eliminate these excessive charges.

For more information about Claims Management or to receive your free Workers Compensation Financial Report, contact us at 888-366-1000.

NLRB postpones effective date of posting rule from Jan. 31 to April 30, 2012

At the request of the federal court in Washington, D.C., which is hearing a legal challenge on the rule, the National Labor Relations Board (NALB) has postponed the effective date for posting a notice advising employees of their rights under the National Labor Relations Act (NLRA). As a practical matter, the Board’s jurisdiction is very broad and covers the great majority of non-government employers with a workplace in the United States, including non-profits, employee-owned businesses, labor organizations, non-union businesses, and businesses in states with “Right to Work” laws.

The notice will have to be posted in a conspicuous place, where other notifications of workplace rights and employer rules and policies are posted. Employers also will be asked to publish a link to the notice on an internal or external website if other personnel policies or workplace notices are posted there. You can get the poster, read a FAQ and learn more by going to https://www.nlrb.gov/poster.

The notice advises employees of their rights, including the right to organize and form unions. While the requirement has been the subject of several legal challenges, employers should obtain the official notice and prepare to comply with the requirement. Supervisors should be trained so that they understand the meaning of the posting and how to respond to questions. The best defense for employers is robust personnel policies that encourage employee engagement and commitment.

The Seltzer Group, located in Eastern Pennsylvania, specializes in developing safety, workers compensation, human resources, claims, and risk financing programs. They are a proud member of the Keystone Insurers Group and are nationally recognized for their expertise in workers compensation solutions. The Seltzer Group serves businesses and individuals locally, regionally, and on the national level.

Exposing the Cost of Workplace Injuries

Welcome to the first installment of The Seltzer Group’s Workplace Injury Best Practices Series! This is part one of three for the month of February. Check back next week for part 2!

Exposing the Cost of Workplace Injuries

 If your business was responsible for paying 100% of your Work Comp claims, would you look at workplace injuries differently? 

Most employers have been led to believe that by purchasing a Workers Compensation insurance policy they are transferring the cost of claims to their insurance company. That is not the case.  Yes, insurance companies initially pay claims but how they impact your future premiums may alarm you!

The Work Comp rating system has been designed so that when a business has a claim they actually end up paying back every claim dollar in the form of direct premium surcharges over the course of three years1.  Many times the amount paid back by the employer exceeds what the insurance company originally paid by as much as 3 times.  In other words, employers are financing their Work Comp claims at ridiculously high “interest rates”.

The good news is employers are recognizing that they have more control over what they pay for Workers Compensation than any other insurance policy… if they invest the time to learn how.

The Seltzer Group’s team of Work Comp specialists is helping employers accomplish just that.  To start we review your company’s past claim and premium data to generate custom reports to clearly define the financial impact of workplace injuries at your company.  These reports are helpful to business leaders because they provide valuable information, such as:

  • Claim Surcharge (Interest) Rate – a detailed summary calculating how each claim increased or will increase your premium over a three year period.
  • Controllable Premium –the portion of your premium that your company is currently paying as a result of your prior claim history.
  • Minimum Premium –your achievable minimal cost based upon your company size and classification

This comprehensive review not only provides valuable financial data it, but it also exposes hidden rating and carrier mistakes, procedural mishaps, and other costly, yet avoidable overcharges.  With this information our team of area experts (claims, safety, HR, insurance) will meet with your management team to develop an action plan that

  • Minimizes the potential threat of future claims
  • Implements proven claim management procedures to control claims that do occur
  • Eliminates costly overcharges caused by hidden, yet frequently undetected, mistakes
  • Identifies and obtains premium refunds for past claims on behalf of your company and
  • Improves your risk profile and insurability, which reduces your overall insurance costs and dependency

1 In Pennsylvania, for purposes of premium surcharge calculations, claims are capped at $42,500.  If a claim exceeds this limit the premium surcharge typically will not exceed $127,500 (42,500 x 3).

The Seltzer Group, located in Eastern Pennsylvania, specializes in developing safety, workers compensation, human resources, claims, and risk financing programs. They are a proud member of the Keystone Insurers Group and are nationally recognized for their expertise in workers compensation solutions. The Seltzer Group serves businesses and individuals locally, regionally, and on the national level.

For more information about your free Workers Compensation Financial Report please contact us at info@seltzergrp.com or 1-888-366-1000 Ext. 126.

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OSHA Form 300A posting- deadline tomorrow!

The time of the year that OSHA 300A forms must be posted is fast approaching. While there are exemptions, most employers with ten or more employees must maintain an OSHA 300 Log throughout the year and record a summary on the 300A, also called the Annual Summary form, and post no later than February 1, 2012.

A company executive must certify the summary. In so doing, executive certifies they have reviewed the related records and that the posted summary is accurate, true and complete. OSHA describes this requirement as imposing “senior management accountability” for the integrity and accuracy of the data.

All establishments covered by Part 1904 must complete this summary page, even if no work-related injuries or illnesses occurred during the year. If there are no recordable injuries or illnesses, zeros are recorded in all spaces provided on the 300A form.

This information must then be posted for three months in a common area of the workplace, from February 1 to April 30. Employers must keep the records for five years following the calendar year covered by them, and if the employer sells the business, he or she must transfer the records to the new owner. Copy of the form visit

It’s always a good idea to review the OSHA recordable requirements with managers and supervisors. The recordable tree on the OSHA website is a helpful guide.

There are exemptions. If you had 10 or fewer employees during all of calendar year 2010 or your business is classified in a specific low-hazard retail, service, finance, insurance, or real estate industry as spelled out on the webpage, you do not have to keep injury and illness records unless the Bureau of Labor Statistics or OSHA informs you in writing that you must do so. However, all employers covered by the Occupational Safety and Health Act of 1970 (P.L. 91-596) must report to OSHA any workplace incident resulting in a fatality or the in-patient hospitalization of three or more employees within eight hours of the incident, regardless of the number of workers a business employs.

The Institute of WorkComp Professionals January 2012 Newsletter

info@seltzergrp.com

The Seltzer Group, located in Eastern Pennsylvania, specializes in developing safety, workers compensation, human resources, claims, and risk financing programs. They are a proud member of the Keystone Insurers Group and are nationally recognized for their expertise in workers compensation solutions. The Seltzer Group serves businesses and individuals locally, regionally, and on the national level.

Don’t find fault. Find a remedy. – Henry Ford

 

 

Don’t find fault.  Find a remedy.  

 

-          Henry Ford (1862-1947)

Find a remedy!

 

Calculating Experience Mods

The time is NOW for employers to understand rule changes on Experience Mods

One of the noteworthy events of 2011 for Workers’ Compensation, The National Council on Compensation Insurance’s (NCCI) proposal to change the Experience Rating formula, seems to be under most employers’ radar screen. While the new implementation schedule does not begin until January 2013 and many of the details are unknown, employers who understand the implications will be able to better manage their costs.

Currently in NCCI states, the first $5,000 of a loss is considered primary and the portion of the loss higher than $5,000 is considered excess. This is called the split point and is important because the primary losses are weighted at 100% in the experience rating formula driving it up quickly, whereas the excess loss only receives partial weight.

It has been over two decades since this $5,000 benchmark was established and during this time the average cost of claims has more than tripled. As a result, the plan gives less weight to each employer’s actual experience and according to NCCI, mods “have gravitated toward the all-risk average.”

NCCI’s proposal is to increase the split point over a three-year transition period, based on the state’s filing date

■In 2013 increase the split point to $10,000

■In 2014, increase the split point to $13,500

■In 2015 and thereafter, increase the split point to the indexed value of $15,000 based on the average of cost of claim

The impact on an individual employer could be significant. Experience Mods are essentially a comparison of the employer’s losses compared with those of other employers in the same industry. Primary losses are the major cost driver in experience ratings. Under the current system, employers with several small claims under $5,000 will have a higher Mod than a company with one large loss. While frequency still trumps severity, the threshold for frequency is changing significantly. Employers with many claims exceeding $5,000 will feel the bite. If you were to plot Experience Mods today, the result would be a bell curve with a concentration around the 1.0 rating. The result of this change will be to stretch and flatten that curve.

While many of the details are yet to be flushed out, it is generally agreed that employers with higher than expected losses will pay more than under the current system. It is also possible that employers with lower than expected losses may see their Mods and premiums drop. The situation is compounded for employers with multi-state Mods. The change is being phased in, based on the state’s filing date; therefore, it is quite possible that split points will differ.

While controlling the Experience Mod has always meant reduced premiums over the long-term, it takes on even more importance now. This change in the system is dynamic, unlike the long-standing static split point of $5,000, the new split point will rise as losses rise.

Employers should assess their primary losses and costs of claims and take steps to reduce losses and improve hiring practices. Many employers must have a 1.0 Mod to bid on jobs; it’s critical they begin to look at the composition of their losses to ensure that they do not lose their bidding eligibility.

Info from: The Institute of Work Comp Professionals December newsletter

info@seltzergrp.com

The Seltzer Group, located in Eastern Pennsylvania, specializes in developing safety, workers compensation, human resources, claims, and risk financing programs. They are a proud member of the Keystone Insurers Group and are nationally recognized for their expertise in workers compensation solutions. The Seltzer Group serves businesses and individuals locally, regionally, and on the national level

Studies on Shift Workers

Shift Workers, risk of MS

Shift workers at a young age is linked to an increased risk of multiple sclerosis, suggests a new study from the Karolinska Institutet in Sweden. Researchers analyzed data from two previous studies and found that people younger than 20 who had worked shifts between 9pm and 7am for at least three years had a twofold increased risk of MS, compared with those who never worked such shifts.

The study, published in Annals of Neurology concluded that the increased risk of developing the central nervous system disease stems from off-shifts disrupting the younger workers’ circadian rhythms and sleep patterns.

Shift Workers , risk of heart disease

Female shift workers may be at a greater risk for heart disease, find research from Queen’s University in Kingston, Ontario. Researchers examined 227 female hospital workers ages 22 to 9=66 for metabolic syndrome, which is a combination of factors- including abdominal obesity and high blood pressuer- that increase the risk of heart disease.

Researchers found a connection between age, length if employment and risk. Almost 75% of women working shifts for more than 15 years had metabolic syndrome, compared with 8% of women with less than six years of shift work. The condition may be linked to the disruption of biological rhythms and rest patterns associated with shift work, researchers suggested.

Info from: The Institute of Work Comp Professionals December 2011 newsletter

info@seltzergrp.com

The Seltzer Group, located in Eastern Pennsylvania, specializes in developing safety, workers compensation, human resources, claims, and risk financing programs. They are a proud member of the Keystone Insurers Group and are nationally recognized for their expertise in workers compensation solutions. The Seltzer Group serves businesses and individuals locally, regionally, and on the national level

Obesity and the Employer

It seems the obesity epidemic is making national news almost daily. According to the Center for Disease Control, 33.8% or one third of U.S. adults are obese. The facts are scary and it’s no secret that obesity increases the risk of other health conditions such as heart disease, diabetes, high blood pressure, stroke, cancer, respiratory problems and more! In 2008 medical care costs relating to obesity in the U.S. were a staggering $147 billion and with the percentage of obese individuals increasing every year, that number is not getting any smaller.

How is this a concern of the employer and what can they do about it? Consider that most working adults obtain health insurance through their employers. This means that health insurance premiums, paid by the employer, will fluctuate and increase in relation the health care needs of their employees.  If it is safe to assume that one in three employees are obese, the chances of a serious health issue or the need for care will also increase. The same goes for Workers Compensation. According to a study published in the American Medical Association that was taken from 1997-2004, there is a direct correlation between body mass index and workplace injuries. In this study obese employees had 50% more claims during this time than those of recommended weight. There were also higher medical claim costs, indemnity costs and more lost work days.

One great way to help fight obesity is to encourage your employees to be healthy. Try organizing a wellness fair or an exercise program for your employees.  Help your employees find a local gym or see if you can work with the gym to offer your employees a discounted memberships. Another idea is to start a company sponsored wellness program.  There is evidence that having wellness program available to your employees can significantly improve health and productivity and decrease injury and health care costs overall.

For more information about Wellness Programs and how starting one can affect your bottom line, click here!

The Seltzer Group, located in Eastern Pennsylvania, specializes in developing safety, workers compensation, human resources, claims, and risk financing programs. They are a proud member of the Keystone Insurers Group and are nationally recognized for their expertise in workers compensation solutions. The Seltzer Group serves businesses and individuals locally, regionally, and on the national level.

Exercise at the Office

The Center for Disease Control and Prevention recommends that the average adult get at least 150 minutes of moderate physical activity per week. This may seem like an unreachable goal for most working adults. Our time is filled up with work and household duties, leaving little time to work out. One way to try to make exercising part of your day is to schedule it as you would any other appointment or task you wouldn’t break- or you could try getting a work out in over your lunch break. If your company has a wellness or exercise program, take advantage of it.

According to the CDC, even if you don’t have the time for a full 30 minute workout, three short 10 minute bursts of activity will have the same cumulative effect overall. Here are a few ideas for ways to squeeze in some exercise at work:

-          Try some stretching moves at your desk for your legs, back, neck and arms

-          Stand up and do jumping jacks or lunges while you’re waiting for something to print

-          Try getting a 10 minute walk in during break times

Obviously this will not replace a full home or gym workout, but it’s definitely better than nothing. Your health is worth it!

For more ideas about office workouts click here!

It is always a good idea to check with your doctor before starting any exercise program.

The Seltzer Group, located in Eastern Pennsylvania, specializes in developing safety, workers compensation, human resources, claims, and risk financing programs. They are a proud member of the Keystone Insurers Group and are nationally recognized for their expertise in workers compensation solutions. The Seltzer Group serves businesses and individuals locally, regionally, and on the national level

“There are risks and costs to a program of action…”

“There are risks and costs to a program of action. But they are far less than the long-range risks and costs of comfortable inaction.”

-          John F. Kennedy (1917-1693)

Take action!

info@seltzergrp.com

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