WORKERS COMPENSATION BEST PRACTICES

Transcription

1 Restaurant Loss Prevention & Security Association s 36 th Annual Conference WORKERS COMPENSATION BEST PRACTICES AUGUST 2015 Presented By: Marsh Risk Consulting & Marsh Restaurant Industry Practice Lynn R. MacGill, SVP Risk Innovation & Quantification

2 CONTENTS Evolution of your Role and Responsibility Restaurant Industry Benchmarks (Claims) Best Practice Survey Results Impact to your RATES Average Costs Lost Time: RTW, Durations and Cost Components Slip/Falls Panel Discussion - Marsh Risk Consulting RiskIQ: R. Duane Pifer, SVP Workforce Strategies: Rose Roth, SVP Claims Consulting: Randi Urkov, Managing Director MARSH RISK CONSULTING 2

3 MARSH INDUSTRY BENCHMARK REPORT Sneak Peak (to date) Data Collected Claims Exposure Survey Participants Report Available: Q Marsh Restaurant Industry Group [ ] Advisory Panel John Logan Marsh Restaurant Industry Mark Jeffares Chick-fil-A Mike Keeler Bloomin Brands Debbie Nichols BJ s Restaurants Keri Rhoades Arby s Britt Roarx Texas Roadhouse David Williams California Pizza Kitchen Champions Jim Forlenza RLPSA (Executive Director) PARTICIPANT DEMOGRAPHICS Delivery Service Some Locs 26% All Locs 13% No 61% Alcohol Served All Locs 30% Some Locs 17% No 52% Ownership Franchs 17% Corp 83% Drive Thru Locations Some Locs 43% All Locs 17% No 39% Additional Baselines for Rpt Sales # Locations Payroll Carrier/TPA Jurisdictions MARSH RISK CONSULTING 3

4 FREQUENCY & SEVERITY: Average Cost per Claim Average Cost per Claim $4,538 (5yrs Quick Service: $4,623 (770 meal sales to cover 1 claim - $6) Casual Dining: $4,473 (300 meal sales to cover 1 claim) - $15) Control Claim Growth 64% (From 1yrs to 5yrs) Cost Increase over time: $3,284 to $5,455 Quick Service: (74%) $3,114 to $5,972 Casual Dining: (56%) $3,099 to $5,006 INDIRECT COSTS = 3-5 X DIRECT COSTS $13K - $26K 1 claim = 3,000 quick service meals sold 1 claim = 1,300 casual dining meals sold STAFFING (replacement / training costs) OPERATIONS (production) WC PREMIUMS (losses drive premium costs) WC ADMIN FEES (Carrier / TPA) MARSH RISK CONSULTING 4

5 FREQUENCY & SEVERITY: Severe Losses TOP 10 STATES OF LARGE LOSSES Accident State California Florida Pennsylvania Georgia Illinois New York New Jersey Virginia North Carolina Louisiana % Frequency % Severity Average Incurred 31% 28% $157,165 7% 7% $180,396 6% 6% $182,647 5% 5% $181,360 5% 6% $234,234 4% 6% $239,257 3% 4% $235,339 3% 3% $139,032 3% 3% $156,031 3% 2% $159,350 MARSH RISK CONSULTING 5

6 FREQUENCY & SEVERITY: Lost Time Claims Avg Cost LOST TIME Claim $23,927 (5yrs Percentage of Lost Time Claims 16% (5 Yr. 12/31/2014) Quick Service: $24,316 (4,000 meal sales to cover 1 claim - $6) Casual Dining: $23,626 (1,600 meal sales to cover 1 claim) - $15) WC LOSS PROFILE OF LOST TIME CLAIMS - MOST COMMON TRENDS 5YRS The following criteria outlines the profile of the your 5yr combined. The highest frequency criteria is provided for each category. Avg Incurred Claims Avg PROFILE DESCRIPTION Incurred % % Days CAUSE: Fall / Slip / Trip $28,072 35% Fall / Slip / Trip 31% 418 NATURE: Strain / Sprain / Dislocation / Tear $30,188 44% Strain / Sprain / Dislocation / Tear 39% 473 BODY PART: Upper, Lower, or Middle Back $34,700 21% Hand / Wrist 26% 321 STATE: CA $34,758 22% CA 15% 481 AGE: $39,459 15% % 339 SERVICE: 0-1 Yrs $21,380 31% 0-1 Yrs 40% 407 By Severity By Frequency MARSH RISK CONSULTING 6

7 FREQUENCY & SEVERITY: In Concert Scenario 1: Low Frequency High Cost Focus Pre Loss Scenario 2: High Frequency Low Cost Focus Post Loss BEST PRACTICE Scenario 3: Low Frequency Low Cost Focus Pre & Post Loss in concert Greatest Impact on cost reduction MARSH RISK CONSULTING 7

8 FREQUENCY & SEVERITY: Cause of Injury TOP 5 CAUSES OF LOSS (FREQUENCY) - ALL CLAIMS Average Incurred $8,000 $7,000 $6,000 $5,000 $4,000 $3,000 $2, Contact with / Exposure To / Inhalation Lifting / Pushing / Pulling / Reaching 4. Struck or Injured By 3. Cut / Puncture / Scrape 3. $1,000 5% 10% 15% 20% 25% Percent Claims TOP 5 CAUSES OF LOSS (FREQUENCY) - ALL CLAIMS Average Incurred $9, Lifting / Pushing / Pulling / Reaching QUICK SERVICE DINING Peer Most Frequent (5yr) Cause of Injury 1. Fall / Slip / 1. Fall / Slip / Trip Trip 22% of Total Clms $6,511 Avg Inc Current Year Only % of Total Clms $4,651 Avg Inc Quick Service 5yrs. WORKERS COMPENSATION BEST PRACTICES % ClaimsAvg Incurred 1. Fall / Slip / Trip 22% $6, Lifting / Pushing / Pulling 14% / Reaching$7, Cut / Puncture / Scrape 13% $2, Struck or Injured By 12% $3, Contact with / Exposure 11% To / Inhalation $3,168 CASUAL DINING $8, Fall / Slip / Peer Most Frequent (5yr) Cause of Injury Trip 1. Cut / Puncture / Scrape $7,000 27% of Total Clms $6,000 $1,477 Avg Inc Current Year Only $5,000 29% of Total Clms $1,439 Avg Inc $4, Struck or 5. Electrical / Injured By Casual Dining 5yrs. $3,000 Fire / Hot 4. element 1. Cut / Puncture $2,000 / Scrape $1,000 5% 10% 15% 20% 25% 30% Percent Claims % ClaimsAvg Incurred 1. Cut / Puncture / Scrape 27% $1, Fall / Slip / Trip 19% $7, Lifting / Pushing / Pulling 15% / Reaching$8, Struck or Injured By 12% $2, Electrical / Fire / Hot element 7% $1,899 MARSH RISK CONSULTING 8

9 SAFETY BEST PRACTICES: Fall / Slip / Trip Avg Cost LOST TIME Claim Fall/Slip (5yrs Quick Service: 30% / $28,143 Avg Inc Casual Dining: 33% / $28,023 Avg Inc All Claims Slip Resistance Avg Incurred Stratification Avg Duration Location Rpt Lag % Lost Time LT Avg Inc >$25,000 >$100,000 LT Duration MO Duation Fall / Slip / Trip 10 22% $28,072 30% 6% All Peer Fall / Slip / Trip 11 20% $28,134 28% 7% Quick Service Fall / Slip / Trip 8 24% $28,023 31% 6% Casual Dining Formal, mandatory slip resistant footwear program 91% The footwear program is company funded 14% Enforced by: audits, payroll deducted at orientation, allocation, uniform policy Non Slip Mats used in the following areas. (check all that apply) Entrance-ways 65% Front of House 57% Back of House 57% Only during inclement weather 22% Varies by Location 30% Non Slip Mats not used 9% MARSH RISK CONSULTING 9

10 LOST TIME CLAIMS: Driving Factors LOST TIME CLAIMS: COST COMPONENTS - AT 12MOS Average Incurred % of Total Incurred Trend % Chg Period Indemnity Medical Expense Indemnity Medical Expense Indemnity 2010 $4,341 $9,487 $2,353 27% 59% 15% 8% 2011 $4,193 $9,491 $2,526 26% 59% 16% Medical 2012 $3,721 $9,102 $2,554 24% 59% 17% -1% 2013 $4,286 $9,323 $2,534 27% 58% 16% Expense 2014 $4,670 $9,381 $2,681 28% 56% 16% 14% IMPACT Managed Care Investigations Surveillance Return to Work Nurse Triage Preferred Provider Networks Litigation Management Pharmacy Bill Review MARSH RISK CONSULTING 10

11 WC BEST PRACTICES: Return to Work Return to Work "Formal" company-wide Return-to-Work (RTW) Program in place Yes 78% No 17% No Corporate Policy, Varies by Location 4% Job bank of written Transitional or Light Duty work assignments Yes, Standard for All Locations 61% Yes, Varies by Location 11% No 28% Benchmark the duration of disabilities by type of injury (multi) Yes, internal company only trends 22% Yes, TPA provides comparison 44% Yes, with other external sources 28% No, I do not benchmark disability durations 33% Successful Program Components Build accountability o Sr Mgmnt / Champions Written policy Defined roles o Employee o Employer o Nurses o Medical Provider Defined procedures and escalation process Identified tasks Metrics Measure success Sustainable RTW: Transitional Duty Bank Improved sustainable RTW program with existing list of transitional duty tasks categorized by physical demands (i.e. no lifting, over shoulder height, no kneeling, carry up to 15 pounds 4x daily) Larger employers create databases of tasks employee with restrictions matched with appropriate tasks are identified. Leverage safety professional or others with ergonomic backgrounds to help identify transitional duty tasks physical demands, task analysis. MARSH RISK CONSULTING 11

12 WC BEST PRACTICES: Nurse Triage 24/7 Nurse Triage 24/7 Nurse Triage is used Yes, on all cases 35% Yes, on selected cases/shifts only 17% No/unknown 43% Varies by Location 4% If "selected" cases, they are determined by: Pre-determined criteria 14% Manager/Employee own judgment 14% Other (all reported, intake specialist, corp decision) 71% The majority of Nurse Triage calls are reported to Claim Intake: (multi) Nurse Triage reports directly to Claim Intake 50% Claim Intake (tele /elect) sends referral to Nurse 25% Nurse Triage contacts Clm Adj for treatment approval, triggering Claim Intake 0% Varies by Location and by claim 8% Other 33% Unknown 0% Employee Benefits: Speak to nurse at time of injury Obtain clinical direction Identified emergency Educates caller Follow-up call for those who initially are self-care Nurses use nationally recognized guidelines/treatment decision protocol Results 30-40% self-care 25% of MD visits annually are unnecessary Office visits approx. 50% Emergency dept visits 9-15% Benefits to employer: Fewer Emergency Room visits (55% visits are unnecessary) Improved provider network penetration Fewer claims increase in self-care On-site supervisors don t have to make treatment decisions Coordinate or initiate health ticket /first fill cards Decrease time off ability to reinforce RTW approach with preferred providers Reports: by unit, time of day, day of week, disposition MARSH RISK CONSULTING 12

13 SAFETY BEST PRACTICES Training Safety training method for employees/managers (multi) Safety video (Commercial or in house) 43% Webinars/computer-based training 52% In person seminars/meetings 74% Other (handbook, newsltr, orientation, posters, ) 39% Focus Training programs based on metric based outcomes. Safety training is provided to employees: Monthly 18% Annually 9% During orientation to new employees only 36% Varies by location 27% Other 9% 45% 35% Lost Time: Length of Service Quick Service Casual Dining 25% 15% 5% -5% 0-1 Yrs 1-2 Yrs 2-3 Yrs 3-4 Yrs 4-5 Yrs 5-10 Yrs Yrs Yrs Yrs Yrs Yrs % of Claims and Average Lost Time Costs QSD 36% 15% 8% 7% 5% 14% 7% 5% 2% 1% 0% QSD $21,432 $26,729 $32,237 $25,813 $29,168 $0 $46,863 $45,451 $58,179 $66,867 $26,266 CAS 42% 14% 9% 6% 4% 13% 7% 2% 1% 1% 1% CAS $21,353 $24,836 $33,388 $27,801 $32,519 $28,280 $33,663 $34,491 $49,299 $50,283 $57,832 MARSH RISK CONSULTING 13

14 APPENDICES MARSH RISK CONSULTING TEAM BIOGRAPHIES

15 X WORKERS COMPENSATION BEST PRACTICES MARSH RISK CONSULTING 15

16 X WORKERS COMPENSATION BEST PRACTICES MARSH RISK CONSULTING 16

17 X WORKERS COMPENSATION BEST PRACTICES MARSH RISK CONSULTING 17

18 X WORKERS COMPENSATION BEST PRACTICES MARSH RISK CONSULTING 18

19 This document and any recommendations, analysis, or advice provided by Marsh (collectively, the Marsh Analysis ) are intended solely for the entity identified as the recipient herein ( you ). This document contains proprietary, confidential information of Marsh and may not be shared with any third party, including other insurance producers, without Marsh s prior written consent. Any statements concerning actuarial, tax, accounting, or legal matters are based solely on our experience as insurance brokers and risk consultants and are not to be relied upon as actuarial, accounting, tax, or legal advice, for which you should consult your own professional advisors. Any modeling, analytics, or projections are subject to inherent uncertainty, and the Marsh Analysis could be materially affected if any underlying assumptions, conditions, information, or factors are inaccurate or incomplete or should change. The information contained herein is based on sources we believe reliable, but we make no representation or warranty as to its accuracy. Marsh shall have no obligation to update the Marsh Analysis and shall have no liability to you or any other party with regard to the Marsh Analysis or to any services provided by a third party to you or Marsh. Marsh makes no representation or warranty concerning the application of policy wordings or the financial condition or solvency of insurers or reinsurers. Marsh makes no assurances regarding the availability, cost, or terms of insurance coverage. All decisions regarding the amount, type or terms of coverage shall be your ultimate responsibility. While Marsh may provide advice and recommendations, you must decide on the specific coverage that is appropriate for your particular circumstances and financial position. By accepting this report, you acknowledge and agree to the terms, conditions, and disclaimers set forth above. Copyright 2015 Marsh LLC. All rights reserved.