Arizona Workers Compensation At A Glance

Transcription

1 Arizona Workers Compensation At A Glance

2 Worker s Compensation Premium Rankings

3 $3.20 $3.00 Arizona s Ranking Range of Premium Rates $2.80 $2.60 $2.40 $2.20 $2.00 $1.80 $1.60 $1.40 $1.77 $1.49 $1.73 $1.71 $ Ranking: 36 (15 th lowest in country) Premium Rate Index per $100 of Payroll: $1.61 Percent of National Median ($1.88): 86% $1.20 $ Source: Oregon Workers Compensation Premium Rate Ranking Summary Reports, Oregon Department of Consumer & Business

4 Workers Compensation Rates

5 Rate Changes in Arizona Jan 2008 Oct

6 WC Premiums

7 Taxable Premium In Millions

8 2012 Taxable Premium Allocation by Payer In Millions Self-Insured $276.4 All Insurance Carriers $647.6

9 Claims Frequency

10 Arizona WC Claims Frequency 184,600 All Self-Insured 155, , ,535 97,415 94,772 96,003 99,497 24,615 27,865 26,847 23,561 22,772 22,469 23,

11 Claim Frequency of Lost Time Claims Per 100,000 Workers Arizona Colorado Nevada New Mexico Utah Regional CW Source: 2012 NCCI Arizona State Advisory Forum

12 Direct Losses & Costs

13 Total Direct Losses In Millions

14 1999 to 2011 Allocation of Losses by Payer In Millions Insurance Carrier Self-Insured SCF

15 2012 Loss Allocation by Payer In Millions Self-Insured: $126.2 (23%) All Insurance Carriers: $432.5 (77%)

16 CY Snapshot of Losses and Frequency $416.2 $362.3 $404.2 $431.7 $467.2 $481.4 $524.6 $558.7 $562.6 $519.4 $544.7 $568.2 $ Losses in Millions Frequency in Thousands

17 AZ Average Indemnity Cost Per Case Adjusted to Current Wage Level Actual 24.8 In Thousands $ Source: 2012 NCCI Arizona State Advisory Forum

18 Comparison to CW Average Indemnity Cost Per Case Actual In Thousands $ Arizona CW Source: 2012 NCCI Arizona State Advisory Forum

19 Average Medical Cost Per Case Adjusted to Current Wage Level Actual 46,911 In Thousands $ 40,879 42,100 42,483 42,100 32, Source: 2012 NCCI Arizona State Advisory Forum

20 Comparison to CW Average Medical Cost Per Case Actual In Thousands $ Arizona CW Source: 2012 NCCI Arizona State Advisory Forum

21 Distribution of Benefit Costs Carrier Claims Ten Years Ago Medical Indemnity Medical Today Indemnity 50% 50% 29% 71% Source: 2012 NCCI Arizona State Advisory Forum

22 Distribution of Benefit Costs Self-Insured Claims Ten Years Ago Today Medical Indemnity Medical Indemnity 28% 24% 72% 76%

23 Newsworthy Notes!

24 Revenue Is On The Rise!

25 Calendar Year Admin Fund Revenue Admin Fund Rate Admin Fund Revenue in Millions % Change from Prior Year % $ % % $ % % $ % % $ % % $ %

26 Calendar Year Special Fund Revenue Special Fund Rate Total Special Fund Revenue in Millions % Change from Prior Year % $ % % $ % % $ % % $ % % $ %

27 Special Fund Actuarial Picture Actuarial deficit estimated as of : $46.9 million

28 Tax/Assessment History Calendar Admin SF General SF Insolvents SF Apportionment Total % 1.5% % % 1.5% % % 1.5% % % 1.5% % % 1.25% % % 1% % % 1% % %.75% % % % % % % % % % % % % % % % % % % % % % % % % 1.5% % % 1.5%.5%.5% 5.5% % 1.5%.5%.5% 5.5% % 1.5%.5%.5% 5.5% % 1.5% % % 1.5% % % 1.5%.5%.5% 5.15% % 1.5%.5%.5% 5.5% % 1.5%.5%.5% 5.5% % 1.25%.5%.5% 5%

29 SB 1310 Special Fund Report

30 Legislation 1. The Commission shall publish a report showing the amount of cash and assets held by the Special Fund that are attributable or allocated to the payment of claims of insolvent insurers as of June 30, The report shall include all insurance carriers that have had claims assigned to the Special Fund.

31 Legislation 3. The report shall be accompanied by an actuarial opinion confirming the adequacy of the reserves reported and shall also include an opinion from an independent CPA that the methodology used fairly presents the attributable cash and assets. 4. The amount of attributed cash and assets shall include the total amount of monies that are held by the Special Fund from any assessments, recoveries, and released deposits.

32 Legislation 5. The Commission must publish the report by the last Commission meeting in 2013.

33 SB 1148 Workers Compensation Reciprocity

34 A.R.S Effect of injury without the state; right to compensation of out-ofstate employee injured within state The old A.R.S is repealed and replaced with a new A.R.S Subsection (A) is the same as it was and preserves the entitlement to AZ benefits for the worker who is hired or regularly employed in AZ but injured in another state Everything else is new effective September 13, 2013!

35 Extraterritorial Provisions Insurance coverage from State A follows ER s workers performing temporary work in State B. Benefits are provided as if the worker were injured in State A.

36 Reciprocity A state will honor the extraterritorial provisions of another state as long as the other state honors its extraterritorial provisions.

37 What Claims are Subject to Reciprocity? Any claim made after September 13, 2013, regardless of the date of injury. Any claim that has not been accepted as compensable or adjudicated as compensable as of September 13, 2013.

38 If Reciprocity Criteria Apply, Then: An employer and worker from another reciprocity state are exempt from the Arizona Workers Compensation Act while the worker is temporarily in Arizona doing work for the employer. An Arizona employer and worker are exempt from the application of the workers' compensation insurance laws of another reciprocity state while the Arizona worker is temporarily working in the other state doing work for the employer.

39 If Reciprocity Criteria Apply, Then: An Arizona worker who is injured in another reciprocity state while temporarily working in that state is entitled to receive Arizona benefits as their exclusive remedy. A worker from another reciprocity state who is injured while temporarily working in Arizona may not file a claim in Arizona. Their exclusive remedy is under the WC laws of the other reciprocity state.

40 If Reciprocity Criteria Apply, Then: An employer is exempt from requirement to obtain WC insurance in reciprocity state where worker is temporarily working because employers insurance policy in home state covers out-of-state temporary employment (extraterritorial coverage).

41 Reciprocity Criteria Employer has WC coverage in home state that covers a worker's temporary employment while in Arizona (e.g. policy with extraterritorial coverage) Employer s home state recognizes extraterritorial provisions of Arizona and exempts employers and workers from application of the home state s workers compensation laws. The workers compensation benefits of the home state are the exclusive remedy against the employer for injuries sustained by a worker who is injured while temporarily working in Arizona Employee has worked less than 90 continuous days in Arizona during the 365 days immediately before the date of injury

42 But Wait, There is More Talk to your Legal Counsel!!

43 Commission Process If the Claims Division receives a claim for a worker injured while temporarily in this state, and no Arizona coverage is found, the Special Fund No Insurance Section will be notified. If it appears extraterritorial reciprocity coverage exists, the Special Fund will deny the claim and check box 11 with this explanation. The injured worker can then file in his/her state of usual employment or can protest the denial.

44 Evidence Based Medical Treatment Guidelines

45 Legislation A.R.S , requires the Industrial Commission of Arizona to develop and implement a process for the use of evidence-based treatment guidelines, where appropriate, to treat injured workers no later than December 31, 2014.

46 Advisory Committee Established to Represent Stakeholders Dir. Laura McGrory, Chair Melinda Poppe, ICA Staff Donald Dearth, D.C. Marjorie Eskay-Auerbach, M.D., J.D. Dennis Kurth, Attorney Sydney Standifird, State of Arizona Risk Management Patricia Treharne, M.D. Cathy Vines, SCF Arizona Chris Labban, D.O. Steve Weiss, Attorney Bill Lewis, M.D Joe Tracey, York Risk Todd Lundmark, Attorney Services Group

47 Recommendations for the Development and Implementation of Treatment Guidelines Advisory Committee has agreed to the following: It is appropriate to use treatment guidelines in the management of chronic pain. Existing guidelines will be considered for adoption (as opposed to drafting Arizona specific guidelines). A multidisciplinary panel of respected specialists will be established to evaluate case scenarios under the following guidelines: ACOEM, Colorado State, ODG, and Washington State.

48 2014 Statutory Maximum AMW Beginning January 1, 2014, for injuries that occur during calendar year 2014, the maximum average monthly wage is $4,

49 Change of Physician Requests Under A.R.S Off-Label prescription of controlled substances; Prescription of schedule II controlled substances; Reports; Treatment Plans; Definition

50 Change of Physician Requests Under A.R.S An employer, carrier, or the Commission may request a change of physicians if the treating physician does not comply with the provisions of the statute File Request to Change Physician with the Claims Division specifically stating that it is made pursuant to A.R.S (C)(2) The Claims Division will refer the request to the Administrative Law Judge Division for investigation and resolution. If necessary, the matter will be set for hearing on an expedited basis

51 Deductible Policies Is it time to level the paying field? You decide.

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