Heffernan Insurance Presents: A Workers Compensation Update A review and what s on the horizon?

Transcription

1 Heffernan Insurance Presents: A Workers Compensation Update A review and what s on the horizon? April 28, 2015 Debra Parker, COSS Risk and Safety Consultant Director of Marketing Aspen Risk Management Group

2 Agenda & Objectives CA Workers Compensation is it broken? The problems and the problems with the numbers What does Workers Comp have in common with the Healthcare system? What are the cost drivers? What does this mean for you? How can you keep your costs down?

3 Polling Question #1 I have experience with workers compensation in CA: a) n/a new to workers compensation in CA b) 1-3 years c) Over 3 years

4 Polling Question #2 What industry/business type are you in? 1-Restaurant and/or Retail 2-Construction 3-Manufacturing and/or Industrial 4-Non-Profit and/or Social Services 5-Other

5 Industry Type Rates

6 Polling Question #3 Do you feel the workers comp system is broken? a) Yes b) No c) I m not sure

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8 Terminology Temporary Disability Permanent Disability ADA Indemnity Medical LAE ALAE ULAE

9 State Compensation Insurance Fund 2014 Results (source: SCIF Annual Report) ,669 1,094 1, Loss adjustment expenses incurred Underwriting and administrative expenses (681) (302) Net investment gain (loss) Other income (loss) (17) (22) Income before dividends Dividends to policyholders 4 (85) Loss ratio 82.2% 75.0% LAE ratio 36.1% 27.0% Underwriting expense ratio 24.8% 25.5% 143.2% 127.5% (In millions) Net premiums earned $ Losses incurred Net underwriting loss Net income Combined ratio $

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12 What is driving these higher costs?

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14 The common denominators between Health and Workers Comp Insurance: Prescription Medications Age related illnesses Obesity Medical Marijuana Benefits to undocumented workers of uninsured employers

15 Polling Question #4 In the past year, how many workers compensation cases have you helped manage? or more

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17 Prescription Drugs: Adoption of Formularies

18 Prescription Drugs (pain meds): Training Medical Providers The use of pain meds to treat pain, especially in workers compensation cases, has been shown to delay an injured worker s return to work. Evidence-based research supports effort to set guidelines for the medical provider community to prescribe the lowest dose and the shortest duration that is effective.

19 Possible Solution: Wellness Programs Treating the whole person not just an injury Encouraging wellness behaviors in the workplace and as a whole life choice. Alternative treatments for pain (alternative to prescription drugs) could include physical activity, physical and occupational therapy, cognitive behavioral therapy and alternative treatments such as acupuncture or yoga

20 Polling Question#5: Over the last few years have you seen your workers comp insurance rates: Decrease Increase Stay the same Not sure

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22 2015 Workers Comp Rates

23 Polling Question#6: How involved are you in choosing your WC insurance program? Very Somewhat Not at all Other

24 Risk Characteristics Location of risk Past Frequency of claims Past Severity of claims Light or heavy exposure for the base classification rate assigned A debit experience modification

25 Risk Controls Safety Program not just collecting dust on the shelf but you and your supervisors and employees are actively engaged and it is regularly documented and updated Safety Participation Drug Screening Shoes for Crews or any similar program applicable to your business Return to Work Employee Wellness Health Insurance participation Utilization of an MPN (in California) Hoist devices or other mechanized manner for healthy back protection (if lifting is an applicable exposure to your employees) Fleet maintenance program and DMV screening (pre and post hire) with a distracted driving policy

26 The Underwriter Quote Worksheet Restaurant Example: $500,000 annual payroll $3.50 Pure Premium rate $5.00 manual base rate $500,000 /100 x 5.00 = $25,000 premium Experience modification factor x $25,000 = $21,250 Underwriter discretionary scheduled credits is a 15% credit $21,250 x.85 = $18, 062

27 2015- WCIRB Changes (Highlights) Having a physical premium audit by the insurance company auditors changed from $10,000 to $13,000 annual premium Construction industry- NO changes to the dual wage thresholds Covered Executive Officers: minimum payroll $44,200 (from $42,900) and Max $111,800 (from $109,200) Amendments to over 120 classifications to clarify intent and descriptions (A 3 year project by the WCIRB) Experience Rating: Limit experience modifications for employers with only a single claim in the experience period to be no more than 25 percentage Experience rating qualification: is $31,700

28 SUMMARY Rate reductions may not apply in all cases You control the information the insurance company has to make decisions on the price of your program Direct involvement in safety for preventing losses is the best course of action to reduce costs Good communication with the injured employee, medical facility and your program partners Keep wellness programs in mind for overall productivity and health and wellbeing for all

29 Polling Question#7: If a Workers Compensation designation (via online training) were available for HR professionals, supervisors or others, would this be something for you to consider? Yes No Not sure

30 Department of Workers Compensation CA Department of Insurance CalOsha FedOSHA Proposed Rate Filing July 1, 2015 sent to CDI

31 Discussion and Questions Thank You! Debra Parker, COSS Risk and Safety Consultant Director of Marketing Aspen Risk Management Group

32 Content Disclaimer The information presented is general in nature and is intended to present an overview of workers compensation in California. The written and verbal contents of the presentation are not intended to constitute consulting and/or advice and no client relationship is established between the presenter and attendees.