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How To Reduce Your Workers
Comp Costs
Kathryn
Carlson
Peter
Zaidel
Moderator
Becky Ross
Marketing Manager
Office: (303) 228-8753
bross@kpaonline.com
PRESENTED BY
Peter Zaidel
KPA Product Manager
Office: (303) 228-2397
pzaidel@kpaonline.com
Presenter
Kathryn Carlson, SPHR
Director HR Management
Products
303.228.8765
kcarlson@kpaonline.com
If you have questions during
the presentation, please
submit them using the
“Questions” feature
QUESTIONSQuestions
History
Employee must prove:
• The employer was negligent
• The employee was not negligent
• The employer’s negligence was the cause of the employee’s
damages
Employer defenses:
• Contributory negligence
• Assumption of risk
• Fellow servant rule
Current Structure
The Great Trade Off
• No Fault System
• In the course of employment
• Scheduled Benefits
• Exclusive Remedy Sources
• Monopolistic
• NV, ND, OH, WA, WV, WY
• Competitive State Fund
• Private Insurance
• Self Insurance
Premium Calculation
Premium Factors
• Payroll
• Employee Class Codes
• Loss Experience
– Scheduled Ratings
– Discounts
} Manual Premium
• Rates are pre-determined
• Common set of class codes
• Ensure accuracy with job descriptions
8380
8748
8810 9410
7380
Manual Premium
Manual Premium Example
• 6 Point Dealer Group
• 100 Employees at each location
• Annual Payroll of $5 million per dealership
600 Total Employees with $30 million in payroll
Payroll For Aacme Motors
Class
code
Employee Type % of
Payroll $ Payroll
Premium
$100 payroll
8380 Technicians/
Detailers/ Drivers 30% $9 mil $5
8748 Sales 30% $9 mil $2
8810 Administrative 40% $12 mil $1
Payroll For Aacme Motors
Manual Premium Example
• 8330 (Tech) $9,000,000 = $90,000 x $5.00 = $450,000
$100
• 8748 (Sales) $9,000,000 = $90,000 x $2.00 = $180,000
$100
• 8810 (Admin) $12,000,000 = $120,000 x $1.00 = $120,000
$100
Total manual premium: $750,000
Payroll For Aacme Motors
Manual Premium Calculation
Experience Modification
“E-mod”
“X-mod”
“Mod Factor”
“Experience Rating”
“Merit Rating”
Experience Modification
• Calculated by the National Council on Compensation Insurance
(NCCI) or a state agency
• 3 consecutive years are used to calculate a rating
• Excludes current and prior year
2004 2005 2006 2008
2005 2006 2007 2009
2006 2007 2008 2010
2007 2008 2009 2011
2008 2009 2010 2012
Experience Modification
• Calculated by the National Council on Compensation Insurance
(NCCI) or a state agency
• 3 consecutive years are used to calculate a rating
• Excludes current and prior year
• Frequency of claims is weighted higher than severity
• Used to compare businesses in the same industry
• Industry Average is set to “1”
$750,000 Manual Premium
Aacme Motors ABC Motors
Experience Mod .80 (-20%) 1.2 (+20%)
$600,0000 $900,000
A difference of $300,000!
Ratings are based on business characteristics the insurance company
thinks can make a difference in reducing future losses.
• Regular safety committee meetings
• Positive incentive programs
• Written safety programs
• Hazard inspections
• Ongoing safety training
• Timely reporting
• Claims Management
Scheduled Ratings, Credits and Discounts
– KPA CONFIDENTIAL –
Aacme Motors ABC Motors
Tier Rating 1.17 (preferred plus) 1.67 (residual)
Experience Mod -20% (.80 mod) +20% (1.2 mod)
Deductible -3.9% ($500 ded.) 0%
Provider Discount -2.5% 0%
Association Disc. -4% 0%
Cost Containment Cert. -5% 0%
Schedule Rating -10% +10%
Premium Disc. -8.6% -8.6%
$390,795 $1,189,804
A Difference of: $799,008!!!
$750,000 Manual Premium
Scheduled Ratings, Credits and Discounts
Reducing Your WC Premium
• Eliminating sources of past losses
• Insurer’s understanding of the business
• Longevity with the insurer
• Competition
• Deductibles
• Loss Control Inspections
• Safety Program
• Return to Work Program
From the Employee’s Perspective
• Medical care: Paid for by the employer to help employees recover from an injury or
illness caused by work
• Temporary disability benefits: Payments to the employee if there are lost wages because
the injury prevents you from doing the usual job while recovering
• Permanent disability benefits: Payments if the employee doesn't recover completely
• Supplemental job displacement benefits (if your date of injury is in 2004 or later in many
states including CA): Vouchers to help pay for retraining or skill enhancement if the
employee does not recover completely and don't return to work for your employer
• Vocational rehabilitation (in some states in including CA): Job placement counseling and
possibly retraining for the employee if they are unable to return the old job and the
employer doesn't offer other work
• Death benefits: Payments to the family if the employee dies from a job injury or illness.
– KPA CONFIDENTIAL –
Checklist for Reporting a Claim
• Post “How to Report a Claim” poster
in the workplace
• Provide instructions and claim forms
to employees during orientation
• Complete the “First Report of Injury”
form and send to Carrier/TPA
without delay
• Follow up with your carrier/TPA-be
proactive!
– KPA CONFIDENTIAL –
Claim Suppression
Never say to your employee who has reported
an injury or illness
• You didn’t really hurt yourself on the job.
• If we keep our work place accidents down, employees
will receive an incentive bonus. If you file a claim you
will cause all your co-workers to lose their bonus.
• If you hurt yourself at work, you won’t be called out for
another job with this company.
• You’ll be fired if you file a claim.
• You don’t need to file a claim. We’ll take care of it…
• Why don’t you put this on your health insurance?
– KPA CONFIDENTIAL –
Restricted Duty (Light Duty)
• Follow the doctor’s orders
• Employers do not have “create work” to fulfill
restricted duty requests
• Employees may not refuse restricted duty if
restricted duty is reasonable (don’t make it
punitive)
• Studies show that employees offered light duty
return to work faster than employee who are
not offered light duty
– KPA CONFIDENTIAL –
HIPAA and Workers’ Comp
• Always keep employee medical records
separate from other personnel files
• Do no share any information that is not directly
related to the claim without the employees
written permission
• Employees may not restrict protected health
information in regards to a workers’ comp
claim
• Employees are entitled to copies of their file
23– KPA CONFIDENTIAL –
How To Reduce Your Workers Comp Costs
Contact Information
25– KPA CONFIDENTIAL –
The recorded webinar and presentation slides will be emailed to you
today including your local representative’s contact information.
www.kpaonline.com
bross@kpaonline.com
866-356-1735

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How To Reduce Your Workers Comp Costs

  • 1. How To Reduce Your Workers Comp Costs Kathryn Carlson Peter Zaidel
  • 2. Moderator Becky Ross Marketing Manager Office: (303) 228-8753 bross@kpaonline.com
  • 3. PRESENTED BY Peter Zaidel KPA Product Manager Office: (303) 228-2397 pzaidel@kpaonline.com
  • 4. Presenter Kathryn Carlson, SPHR Director HR Management Products 303.228.8765 kcarlson@kpaonline.com
  • 5. If you have questions during the presentation, please submit them using the “Questions” feature QUESTIONSQuestions
  • 6. History Employee must prove: • The employer was negligent • The employee was not negligent • The employer’s negligence was the cause of the employee’s damages Employer defenses: • Contributory negligence • Assumption of risk • Fellow servant rule
  • 7. Current Structure The Great Trade Off • No Fault System • In the course of employment • Scheduled Benefits • Exclusive Remedy Sources • Monopolistic • NV, ND, OH, WA, WV, WY • Competitive State Fund • Private Insurance • Self Insurance
  • 8. Premium Calculation Premium Factors • Payroll • Employee Class Codes • Loss Experience – Scheduled Ratings – Discounts } Manual Premium
  • 9. • Rates are pre-determined • Common set of class codes • Ensure accuracy with job descriptions 8380 8748 8810 9410 7380 Manual Premium
  • 10. Manual Premium Example • 6 Point Dealer Group • 100 Employees at each location • Annual Payroll of $5 million per dealership 600 Total Employees with $30 million in payroll Payroll For Aacme Motors
  • 11. Class code Employee Type % of Payroll $ Payroll Premium $100 payroll 8380 Technicians/ Detailers/ Drivers 30% $9 mil $5 8748 Sales 30% $9 mil $2 8810 Administrative 40% $12 mil $1 Payroll For Aacme Motors Manual Premium Example
  • 12. • 8330 (Tech) $9,000,000 = $90,000 x $5.00 = $450,000 $100 • 8748 (Sales) $9,000,000 = $90,000 x $2.00 = $180,000 $100 • 8810 (Admin) $12,000,000 = $120,000 x $1.00 = $120,000 $100 Total manual premium: $750,000 Payroll For Aacme Motors Manual Premium Calculation
  • 14. Experience Modification • Calculated by the National Council on Compensation Insurance (NCCI) or a state agency • 3 consecutive years are used to calculate a rating • Excludes current and prior year 2004 2005 2006 2008 2005 2006 2007 2009 2006 2007 2008 2010 2007 2008 2009 2011 2008 2009 2010 2012
  • 15. Experience Modification • Calculated by the National Council on Compensation Insurance (NCCI) or a state agency • 3 consecutive years are used to calculate a rating • Excludes current and prior year • Frequency of claims is weighted higher than severity • Used to compare businesses in the same industry • Industry Average is set to “1” $750,000 Manual Premium Aacme Motors ABC Motors Experience Mod .80 (-20%) 1.2 (+20%) $600,0000 $900,000 A difference of $300,000!
  • 16. Ratings are based on business characteristics the insurance company thinks can make a difference in reducing future losses. • Regular safety committee meetings • Positive incentive programs • Written safety programs • Hazard inspections • Ongoing safety training • Timely reporting • Claims Management Scheduled Ratings, Credits and Discounts
  • 17. – KPA CONFIDENTIAL – Aacme Motors ABC Motors Tier Rating 1.17 (preferred plus) 1.67 (residual) Experience Mod -20% (.80 mod) +20% (1.2 mod) Deductible -3.9% ($500 ded.) 0% Provider Discount -2.5% 0% Association Disc. -4% 0% Cost Containment Cert. -5% 0% Schedule Rating -10% +10% Premium Disc. -8.6% -8.6% $390,795 $1,189,804 A Difference of: $799,008!!! $750,000 Manual Premium Scheduled Ratings, Credits and Discounts
  • 18. Reducing Your WC Premium • Eliminating sources of past losses • Insurer’s understanding of the business • Longevity with the insurer • Competition • Deductibles • Loss Control Inspections • Safety Program • Return to Work Program
  • 19. From the Employee’s Perspective • Medical care: Paid for by the employer to help employees recover from an injury or illness caused by work • Temporary disability benefits: Payments to the employee if there are lost wages because the injury prevents you from doing the usual job while recovering • Permanent disability benefits: Payments if the employee doesn't recover completely • Supplemental job displacement benefits (if your date of injury is in 2004 or later in many states including CA): Vouchers to help pay for retraining or skill enhancement if the employee does not recover completely and don't return to work for your employer • Vocational rehabilitation (in some states in including CA): Job placement counseling and possibly retraining for the employee if they are unable to return the old job and the employer doesn't offer other work • Death benefits: Payments to the family if the employee dies from a job injury or illness. – KPA CONFIDENTIAL –
  • 20. Checklist for Reporting a Claim • Post “How to Report a Claim” poster in the workplace • Provide instructions and claim forms to employees during orientation • Complete the “First Report of Injury” form and send to Carrier/TPA without delay • Follow up with your carrier/TPA-be proactive! – KPA CONFIDENTIAL –
  • 21. Claim Suppression Never say to your employee who has reported an injury or illness • You didn’t really hurt yourself on the job. • If we keep our work place accidents down, employees will receive an incentive bonus. If you file a claim you will cause all your co-workers to lose their bonus. • If you hurt yourself at work, you won’t be called out for another job with this company. • You’ll be fired if you file a claim. • You don’t need to file a claim. We’ll take care of it… • Why don’t you put this on your health insurance? – KPA CONFIDENTIAL –
  • 22. Restricted Duty (Light Duty) • Follow the doctor’s orders • Employers do not have “create work” to fulfill restricted duty requests • Employees may not refuse restricted duty if restricted duty is reasonable (don’t make it punitive) • Studies show that employees offered light duty return to work faster than employee who are not offered light duty – KPA CONFIDENTIAL –
  • 23. HIPAA and Workers’ Comp • Always keep employee medical records separate from other personnel files • Do no share any information that is not directly related to the claim without the employees written permission • Employees may not restrict protected health information in regards to a workers’ comp claim • Employees are entitled to copies of their file 23– KPA CONFIDENTIAL –
  • 25. Contact Information 25– KPA CONFIDENTIAL – The recorded webinar and presentation slides will be emailed to you today including your local representative’s contact information. www.kpaonline.com bross@kpaonline.com 866-356-1735