PERMA is New York s premier provider of workers compensation for public entities.

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1 PERMA is New York s premier provider of workers compensation for public entities.

2 PERMA s Promise Since 1982, PERMA has been devoted to providing workers compensation protection and risk management services to public employers throughout New York State. In the past 22 years, PERMA has grown to become the largest self-funded municipal workers compensation pool in New York and one of the largest in the country. Our annual contributions exceed $35 million and total assets are Brent Wilkes, about $100 million. President and CEO There are three keys to our success: 1. Superior coverage appropriately priced. 2. As a non-profit association, we specialize in local units of government. 3. We focus on, and emphasize, excellent service and personal attention. Our coverage is simply the most comprehensive available. We provide: Unlimited Employer B Coverage for each accident and Terrorism coverage. We cover all municipal employees under the general workers compensation statute. Volunteer firefighters and volunteer ambulance workers are covered under their own special laws. The cost of coverage reflects the expected losses plus the cost to administer the program. Anything left over goes to reduce future costs. PERMA has no profit margin, no stockholders, and we do not have to pay any premium taxes. We are a non-profit association created by local officials and governed today by local officials. Our board of directors is comprised of members, paying their share like every other member. It makes for a leaner operation. Finally, we focus on service and personal attention. It starts with comprehensive loss control services to ensure a safe workplace, maintain PESH and OSHA standards, and prevent work-related injuries, illnesses and accidents. It continues with our claims department, which promptly manages each claim, providing the best care to the injured employee while controlling costs. And what you see throughout PERMA is personal attention. We care about the employer. We care about the employee. We know you by name. We follow up. We call you back. Because taking care of you and keeping the workplace safe and productive is what PERMA is all about. For more information about PERMA, visit our website at or call PERMA-NY. 1

3 PERMA Is Governed by Public Officials Elected from among the Membership Joseph Braun PERMA Board Chairman and Administrator for the City of Beacon PERMA s workers compensation program is non-assessable. This means PERMA members don t have to worry about joint and several liability because they are not assessed for other members losses. Stephen Altieri PERMA Board Member and Administrator for the Town of Mamaroneck Local governments are beginning to realize we can t afford not to invest in loss control programs. PERMA s expert loss control consultants custom-design health and safety programs that can save money and save lives! Thomas Augostini PERMA Board Member and Clerk/Treasurer of the Village of Johnson City PERMA members have a variety of coverage and service options, including First Dollar, Large Deductible or Budget Protection Plan coverage. Each member is individually underwritten to meet specific needs. At the same time, PERMA strives to deliver stable and competitive pricing, reflecting industry standards. Don McIntyre (Retired) PERMA Board Vice Chairman from the Town of Westport With $100 million in assets, PERMA s financial stability is strong. In addition, we re backed by reinsurance providers who are rated A- and A+ by A.M. Best. John T. Pierpont PERMA Board Secretary and Manager of the Village of Pelham Manor PERMA provides unlimited coverage for both workers compensation and employer liability claims. Your annual contribution is all you will ever pay to PERMA, no matter how high your workers comp or employer liability claim may be. Cathryn Thomas PERMA Board Member and Supervisor of the Town of Webster PERMA s claims service is unsurpassed in the industry. Our claimant satisfaction scores are superb and our PERMACARE program helps employers control costs. Thomas Whittaker PERMA Board Member and Clerk of the Board of Supervisors for Chenango County There s no doubt, PERMA is the gold standard for workers compensation and risk management services. But the costs are competitive and the rewards immeasurable. 2

4 Did you know? The American Society of Safety Engineers (ASSE) advises employers to invest in workplace safety as an integral part of their operations strategy. Studies have shown that the indirect cost of an accident can be up to ten times the direct cost. Work-related low back pain accounts for 25% of all workers compensation costs. PERMA s Membership Retention Rate Is 97% Over 20 Years PERMA protects public employers and employees throughout New York State, including: Cities, Towns, Villages, Fire Districts, Water and Sewer Districts, Housing Authorities, Schools, Bridge Authorities, Libraries virtually any municipal entity and its employees. What PERMA Members Say: When you can save a life, you can t put a price on that for certain! Sandy LaBarre, Highway Superintendent for the Town of Ellenburg Without a safe workforce, you don t have a workforce. Gregory Santry, Director of Personnel for the Mohawk Valley Water Authority PERMA is always there. A couple of years ago when we needed special care for one of our employees, which included a hospital bed, PERMA took care of everything in just a couple of hours. That means a lot for a small municipality. Greg Maxwell, Comptroller for the Town of Geddes The number one reason we stay with PERMA is because of the nurses [Patient Advocates]. They are always so responsive. We get approvals really fast. We have gotten approvals overnight! Lisa Geoghegan, District Treasurer of the Greenville Fire District PERMA-NY 3

5 1-888-PERMA-NY What Do Employees Say About PERMA? A career firefighter from Westchester County said, I could not have asked for a smoother or more organized process. PERMA has things so well in hand. All I did was heal. Thank you so much. A volunteer firefighter from Monroe County said, Special thanks to my Case Analyst. She was terrific! And thanks to my Patient Advocate. They demonstrated knowledge and caring throughout. A sanitation worker from Nassau County said, Very pleased with your service. It is obvious that you take pride in your work. That s something that we don t see too often anymore. A building inspector from Suffolk County said, I have bragged to other town employees about how good the service is. Thank you again. Did you know? 67% of our members have been with PERMA for six years or more! According to annual surveys, the top three reasons municipal entities choose PERMA: 1. Superior claims handling. 2. Reasonable cost. 3. Friendly, helpful service. According to data compiled by OSHA (Occupational Safety and Health Administration), Effective health and safety programs return $4 to $6 for every $1 invested. 4

6 1-888-PERMA-NY Where Should You Focus Your Workplace Safety Efforts? Accident frequency, not severity, is what drives up the cost of workers compensation. The New York State Workers Compensation Board advises employers to evaluate every accident, especially the smaller, more frequent incidents, to determine how to avoid future problems. Does your workplace deserve special safety attention? PERMA s exclusive research and analysis reveal that because firefighters and volunteer firefighters put their lives on the line to protect our communities, they are more likely to encounter serious accidents. PERMA recommends that if you are concerned about your firefighters or volunteer firefighters, ask us for an individual consultation to find out how to help to keep them safe and healthy. How Much Do Workplace Injuries and Illnesses Actually Cost PERMA Members? According to a recent analysis of calendar year 2004 claims, accidents involving overexertion and slips and falls on the same level and to a lower level accounted for more than $7.5 million in direct costs to PERMA s members. Indirect costs totaled an additional $21 million. Direct costs include indemnity and medical payments. Indirect costs include lost productivity, overtime costs, training costs and other uninsured costs. According to insurance experts the indirect costs incurred by a worker s injury average from $4 to $10 for every claim dollar spent. CAUSE OF INJURY TOTAL INCURRED COST Exertion $4,422,633 Slip, trip, fall on a level surface 1,913,761 Struck by or against an object 1,377,080 Slip, trip, fall from a height 1,350,767 Power equipment 599,799 Motor vehicle 535,479 Caught in, on, or between objects 472,380 Contact with heat or cold 220,348 Fight or physical violence 54,292 Animal or insect bite 50,167 Inhalation of vapors 18,734 Contact with chemical liquids 3,288 Electricity 696 TOTAL $11,019,424 More that 69% of the total cost of workers compensation claims for calendar year 2004 were due to overexertion and slip and fall accidents. 5

7 Among PERMA Members: Average Cost Per Claim Over $50,000 OCCUPATION AVE. COST PER CLAIM OVER $50K Volunteer Firefighter $207,121 Police & all other non-admin. workers $142,240 Police Patrol Officer $135,691 Heavy Equipment Operator $117,698 Waste Water Treatment Worker $113,407 DPW & all others $101,027 Equipment Operator $100,466 Laborer $96,767 Refuse Collector $85,336 Together We Can Control Workers Compensation Costs PERMA Loss Control consultants help you identify where your workers compensation costs are coming from and how to get control of your losses. Employees that lose time from work after suffering a workplace injury and/or illness will receive professional assistance from trained registered nurses within 24 hours of notifying PERMA. PERMA s immediate attention to claims helps employees to heal faster and safely return to work sooner while reducing possible fraud and abuse. PERMA s expert loss Control staff provide individual safety and health programs from ergonomic consultations and safety training to specialized assistance with PESH and OSHA compliance. Easy on-line reporting of injuries at saves time and administrative costs. PERMA s timely management reports provide members with important data for effective workplace risk management programs. What s the Most Dangerous Day? Day of % of Total Occupations reporting most the week Accidents injuries on that day SUNDAY: 1.3% Volunteer Firefighter, Police Patrol Officer MONDAY: 20% Laborer TUESDAY: 20% Laborer and Equipment Operator WEDNESDAY: 20% Equipment Operator THURSDAY: 20% No specific job FRIDAY: 18% No specific job SATURDAY: 0.6% Volunteer Firefighter, Police Patrol Officer 6

8 We Work with the Broker of Your Choice PERMA s Member Services staff are pleased to work with any broker a member may choose. We are proud of the strong and productive relationships we have developed over the years with many leading brokers from across New York State. Our shared commitment to service and value is a strong advantage for PERMA members. It has been and will continue to be a privilege for me, as a broker, to continue to represent PERMA. Every aspect of broker/client relations has been handled professionally and expediently. Linda Taylor, Broker for Niagara Risk Association PERMA s Superior Financial Stability PERMA is the largest self-funded municipal workers compensation pool in New York and one of the largest in the country. Our annual contributions are over $35 million and total assets are about $100 million. PERMA voluntarily adheres to the Government Accounting Standards Board (GASB) accounting standards and is independently audited each year by a leading national accounting firm. PERMA s actuary accounts for Incurred But Not Reported (IBNR) claims costs. PERMA s claims, including reserve practices, are audited annually. PERMA has set aside a fund to cover all future New York State Workers Did you know? Highway accidents are the leading cause of occupational deaths. (OSHA) Nearly 25% of on-thejob fatalities involve motor vehicles. (OSHA) Wearing a seatbelt reduces the risk of dying in a traffic accident by 45% and by 60% in a truck or SUV. (OSHA) Compensation Board Assessments that will come due per the latest GASB rule. Ask PERMA Member Services for a copy of our latest audited financial statements. For more information about becoming a PERMA member, call PERMA-NY. Did you know? Ergonomic work stations and training led to 47% fewer workers suffering from work-related musculoskeletal discomfort. (Liberty Mutual Research Institute for Safety). Nationwide, the top three causes of workplace injuries: Overexertion, Same-level falls and Bodily reaction accounted for $23 billion dollars in costs, more than half the total for all injuries. 7

9 How to Speak Workers Comp A Glossary of Terms Accident (Work-Related): An event arising out of and in the course of employment that results in personal injury to a worker. Accident Date: Refers to either (a) the date the accident occurred or (b) the date of onset of an occupational disease. The accident date is officially established by a Law Judge. Cause of Accident: Object, substance or condition that directly contributed to the occurrence of an accident. Claim: A request, on a prescribed Form C-3, for workers compensation for work-connected injury, occupational disease, disablement, or death (Form C-62). A claimant must file a claim within a two-year period from the occurrence of the accidental injury, knowledge of occupational disablement, or death. Failure to file a claim may bar an award for compensation unless the employer has made advance benefit payment or fails to raise the issue, in which event the claim filing requirement is deemed waived. Classification Code: A system of insurance risk classification based on industrial or occupational categories, supported by the National Council on Compensation Insurance and in use in about 40 states where private insurance is available. More than 700 classifications are used in New York to establish basic pricing for workers compensation insurance. Conciliation: A Workers Compensation (WC) Board process established to resolve, in an expeditious and informal manner (e.g. through meetings or telephone conferences), issues involving non-controverted claims in which the expected duration of benefits is fifty-two weeks or fewer. Failure to reach an agreement through the conciliation process results in the case being scheduled for a hearing. Controverted Claim: A claim challenged by the insurer on stated grounds. C-2: WC Board form titled Employer s Report of Work-Related Accident or Occupational Disease filed by employers within ten days after an accident occurs, as required by WCL.110. Failure to make timely C-2 filings subjects employers to potential administrative and criminal penalties. C-3: WC Board form titled Employee s Claim for Compensation, that should be completed by the injured worker and submitted to the Board within two years of the accident or onset date. C-4: WC Board form titled Attending Doctor s Report to be filed by the doctor within two days of initial treatment. C-7: WC Board form titled Notice that Right to Compensation is Controverted, that a carrier (as appropriate) must file within (1) 18 days of the date disability begins or (2) ten days from the date the employer first had knowledge of the alleged injury, whichever is later. (Within 25 days from the Board s mailing of a notice of indexing in volunteer firefighter or volunteer ambulance worker cases.) C-8: WC Board form titled Notice that Payment of Compensation for Disability has been Stopped or Modified, that carriers are required to file within 16 days of the date on which benefit payments are stopped or modified PERMA-NY 8

10 1-888-PERMA-NY Exclusive Remedy: The premise on which the Workers Compensation system is based: workers give up the right to sue the employer in exchange for medical care or payment for their injuries. Experience Rating: A method for determining an employer s workers compensation premiums that reflects a comparison of the employer s recent loss experience with the amount the employer would have been expected to pay if it had been an average employer in the same industry with the same payroll. Hearing: No case may be closed without notice to all interested parties, with all such parties having an opportunity to be heard. Board hearings are held before Workers Compensation Law Judges. Indemnity Benefits: Compensation paid to the workers compensation claimants for non-medical loss resulting from an injury or illness. Lost Time: The period of total wage loss and loss of earning capacity beyond the statutory waiting period, caused by the claimant s work-connected disability. In workers compensation cases only, if the disability period exceeds 14 days, compensation will be paid from the first day of disability. There is no waiting period for volunteer ambulance worker or volunteer firefighter cases. Manual Rates: The listed cost for workers compensation coverage, stated as dollars per $100 of weekly earnings for each employee. New York manual rates are linked to the Classification Code system. (Rates are stated for each work classification code used in the state.) Medical Benefits: Medical treatment provided, under the Workers Compensation Law, to injured workers as a result of injuries arising out of and in the course of employment. Medical Fee Schedule: A schedule, established by the Chair of the Workers Compensation Board, of charges and fees for medical treatment and care furnished to workers compensation claimants. Medical Treatment: Care (other than first-aid) administered by a physician, chiropractor or podiatrist or on a physician s referral, by a psychologist, or physical or occupational therapist. National Institute for Occupational Safety and Health (NIOSH): An agency within the U.S. Department of Health and Human Services established in It is part of the Center for Disease Control and Prevention and is generally responsible for conducting research and making recommendations for the prevention of work-related illnesses and injuries. NIOSH s responsibilities include: investigating potentially hazardous working conditions (as requested by employer or employees), evaluating workplace hazards, creating and disseminating methods for preventing disease/injury/disability, conducting scientifically valid research on safety issues, and providing education and training in the field of occupational safety and health. New York Compensation Insurance Rating Board: A private, non-profit association of licensed insurance companies that provide workers compensation insurance in New York, responsible for collecting and reviewing compensation loss experience from carriers, developing policy forms and rating plans, conducting actuarial analyses and preparing rate filings with the New York State Insurance Department. 9

11 Notice: Written notification from an employee to his/her employer, indicating that a work-connected injury or injury has occurred. For accidental injuries, notice must be given no later than 30 days after the accident. The Board must excuse a failure to give notice on the grounds that a) for some reason, notice could not have been given; b) the employer had knowledge of the accident; or c) the employer s case has not been prejudiced. In cases involving occupational diseases, the time period for notice is two years from the date of disablement or from the date when the employee knew, or should have known, that the disease was due to the nature of employment. Occupational Disease (OD): A disease arising from employment conditions for a class of workers, with the disease occurring as a natural incident for particular occupations, distinct from and exceeding the ordinary hazards and risks of employment. Occupational Illness: Any abnormal condition or disorder, other than one resulting from an occupational injury, caused by exposure to environmental factors associated with employment; it includes acute and chronic illnesses or diseases which may be caused by inhalation, absorption, ingestion or direct contact. Occupational Injury: Any injury, such as a fracture, sprain, amputation, etc. which results from a work accident or other exposure involving a single accident in the work environment. PESH: The Public Employee Safety and Health (PESH) bureau oversees workplace protection of public employees at the state and local level, issues compliance orders, assesses civil penalties for non-compliance and provides safety and health consultation services to public employers. Protection guidelines are determined by standards set by the federal Occupational Safety and Health Administration (OSHA). Reimbursement, Request for: A request by an employer for reimbursement for wages paid to an employee for a period during which the employee was eligible to receive workers compensation or disability benefits. Second Injury Fund: A special fund, technically known in New York as the Special Disability Fund, which assumes, in certain cases, part of the permanent disability liability resulting from injuries to previously handicapped workers. Total Disability: Lack of ability to follow continuously some substantially gainful occupation without serious discomfort or pain and without material injury to health or danger to life. Waiting Period: Period covering the first seven days of disability resulting from a work-connected injury or illness. Workers compensation indemnity benefits are not allowable for the first seven days of disability, except (a) in cases where the disability period exceeds 14 days, indemnity awards are allowed from the date of disability, and (b) there is no waiting period for VAWBL/VFBL cases. Workers Compensation Board, New York State (WCB): The agency charged with administering the Workers Compensation Law, the Volunteer Ambulance Workers Benefit Law and the Volunteer Firefighters Benefit Law and the Disability Benefits Law. Workers Compensation Law (WCL): Chapter 67 of the Consolidated Laws, governing the workers compensation system. Separate laws cover compensation benefits for volunteer firefighters and volunteer ambulance workers PERMA-NY 10

12 WORKERS COMP CHECKLIST How Well Protected Are Your Employees? IMPORTANT QUESTIONS PERMA Other Provider 1. What type of Carrier Trust Carrier organization State Fund x Pool State Fund is the provider? 2. Are your provider s financial statements independently audited and made available to you? 3. Does your provider have reinsurance coverage and if so, what is the coverage limit? UNLIMITED 4. Do you assume the financial burdens of Joint & Several Liability by joining this program? In other words, are you liable for the losses of others? NO 5. Are you offered a robust Loss Control and Injury Prevention Program? 6. Do you have regular opportunities to attend safety and loss control meetings with other local municipalities? 7. Can you report employee injuries by fax or over the Internet? 8. Do you receive the individual attention of an assigned claims team for employee injuries? 9. Does the provider assign registered nurses as Patient Advocates to assist your injured employees to return to work? 10. Do you have the opportunity to attend and network with your peers at an informative annual meeting sponsored by the provider? 11. Do you have the opportunity to benefit from annual Experience Modification Factor calculations? 12. Does the provider perform a payroll audit to ensure that your contribution is accurate? 13. How many public entities does the More than 500 provider serve? Public Entities 14. How many years of experience does the provider have protecting Over 20 Years public entities? of Experience 15. What are the provider's PERMA's total total assets? assets are over $100 million. Trust Pool Public Employer Risk Management Association, Inc. P.O. Box 12250, Albany, NY For more information about becoming a PERMA member, call PERMA-NY or visit or our web site: