Arizona Workers Compensation At A Glance
Worker s Compensation Premium Rankings
$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 $1.61 2012 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 $1.00 2000 2004 2006 2010 2012 Source: Oregon Workers Compensation Premium Rate Ranking Summary Reports, Oregon Department of Consumer & Business
Workers Compensation Rates
Rate Changes in Arizona 10 8 8.4 7.9 6 4 2 0-2 0.6 2.4 4.5 4.5 4.1 2002 2003 2004 2005 2006 2006 2007 Jan 2008 Oct 2008 5.2 4 2010 2011 2012 2013-4 -6-4.3-3.1-4.2-2.8
WC Premiums
Taxable Premium In Millions 1059.3 1015.5 672.9 724.1 820.6 946.9 864.4 773 806 924 463.2 541.9 571.5 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
2012 Taxable Premium Allocation by Payer In Millions Self-Insured $276.4 All Insurance Carriers $647.6
Claims Frequency
Arizona WC Claims Frequency 184,600 All Self-Insured 155,687 136,985 120,535 97,415 94,772 96,003 99,497 24,615 27,865 26,847 23,561 22,772 22,469 23,613 1994 2000 2007 2008 2009 2010 2011 2012
Claim Frequency of Lost Time Claims Per 100,000 Workers 1173 660 991 912 739 944 879 Arizona Colorado Nevada New Mexico Utah Regional CW Source: 2012 NCCI Arizona State Advisory Forum
Direct Losses & Costs
Total Direct Losses In Millions 523.8 524.6 558.7 562.6 519.4 544.7 568.2 558.7 416.2 404.2 431.7 467.2 481.4 362.3 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
1999 to 2011 Allocation of Losses by Payer In Millions 296.2 294.9 315.7 285.7 187.8 166.4 158.1 168.9 116.1 232 211.1 182.6 146.3 136.0 135.2 243.2 126.6 129.7 137.4 251.6 165.5 161.9 243 187.6 219 212.2 137 61.2 70.3 77.2 75.3 84.6 100 111.6 100 105.5 111.3 105.9 114 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Insurance Carrier Self-Insured SCF
2012 Loss Allocation by Payer In Millions Self-Insured: $126.2 (23%) All Insurance Carriers: $432.5 (77%)
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 $558.7 155.7 147.3 137.8 128.8 136.1 138.7 142.4 134 121 97.4 94.8 96 99.5 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Losses in Millions Frequency in Thousands
AZ Average Indemnity Cost Per Case Adjusted to Current Wage Level Actual 24.8 In Thousands $ 19.9 18.7 2002 2003 2004 2005 2006 2007 2008 2009 2010 Source: 2012 NCCI Arizona State Advisory Forum
Comparison to CW Average Indemnity Cost Per Case Actual In Thousands $ 20.7 20.5 22.3 Arizona CW 18.7 2007 2008 2009 2010 2011 Source: 2012 NCCI Arizona State Advisory Forum
Average Medical Cost Per Case Adjusted to Current Wage Level Actual 46,911 In Thousands $ 40,879 42,100 42,483 42,100 32,779 2002 2003 2004 2005 2006 2007 2008 2009 2010 Source: 2012 NCCI Arizona State Advisory Forum
Comparison to CW Average Medical Cost Per Case Actual 39.1 42.1 In Thousands $ 24 28 Arizona CW 2007 2008 2009 2010 2011 Source: 2012 NCCI Arizona State Advisory Forum
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
Distribution of Benefit Costs Self-Insured Claims Ten Years Ago Today Medical Indemnity Medical Indemnity 28% 24% 72% 76%
Newsworthy Notes!
Revenue Is On The Rise!
Calendar Year Admin Fund Revenue Admin Fund Rate Admin Fund Revenue in Millions % Change from Prior Year 2012 3.0% $27.7 +14.7% 2011 3.0% $24.2 +18% 2010 2.65% $20.5-21.% 2009 3.0% $26-14.8% 2008 3.0% $30.5-4.1%
Calendar Year Special Fund Revenue Special Fund Rate Total Special Fund Revenue in Millions % Change from Prior Year 2012 2.5% $23.1 +14.9% 2011 2.5% $20.1 +4.1% 2010 2.5% $19.3 +48.5% 2009 1.5% $13-14.5% 2008 1.5% $15.2-42.6%
Special Fund Actuarial Picture Actuarial deficit estimated as of 6-30-12: $46.9 million
Tax/Assessment History Calendar Admin SF General SF Insolvents SF Apportionment Total 1985 3% 1.5% 0 0 4.5% 1986 3% 1.5% 0 0 4.5% 1987 3% 1.5% 0 0 4.5% 1988 3% 1.5% 0 0 4.5% 1989 3.% 1.25% 0 0 4.25% 1990 3% 1% 0 0 4.% 1991 3% 1% 0 0 4.% 1992 3%.75% 0 0 3.75% 1993 3% 0 0 0 3.% 1994 1.25% 0 0 0 1.25% 1995 1.45% 0 0 0 1.45% 1996 1.25% 0 0 0 1.25% 1997 2.15% 0 0 0 2.15% 1998 3% 0 0 0 3.% 1999 3% 0 0 0 3.% 2000 3% 0 0 0 3.% 2001 3% 0 0 0 3.% 2002 2.75% 0 0 0 2.75% 2003 3% 0 0 0 3% 2004 3% 1.5% 0 0 4.5% 2005 3% 1.5%.5%.5% 5.5% 2006 3% 1.5%.5%.5% 5.5% 2007 3% 1.5%.5%.5% 5.5% 2008 3% 1.5% 0 0 4.5% 2009 3% 1.5% 0 0 4.5% 2010 2.65% 1.5%.5%.5% 5.15% 2011 3% 1.5%.5%.5% 5.5% 2012 3% 1.5%.5%.5% 5.5% 2013 2.75% 1.25%.5%.5% 5%
SB 1310 Special Fund Report
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, 2013. 2. The report shall include all insurance carriers that have had claims assigned to the Special Fund.
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.
Legislation 5. The Commission must publish the report by the last Commission meeting in 2013.
SB 1148 Workers Compensation Reciprocity
A.R.S. 23-904. Effect of injury without the state; right to compensation of out-ofstate employee injured within state The old A.R.S. 23-904 is repealed and replaced with a new A.R.S. 23-904. 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!
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.
Reciprocity A state will honor the extraterritorial provisions of another state as long as the other state honors its extraterritorial provisions.
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.
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.
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.
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).
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
But Wait, There is More Talk to your Legal Counsel!!
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.
Evidence Based Medical Treatment Guidelines
Legislation A.R.S. 23-1062.03, 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.
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
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.
2014 Statutory Maximum AMW Beginning January 1, 2014, for injuries that occur during calendar year 2014, the maximum average monthly wage is $4,256.94.
Change of Physician Requests Under A.R.S. 23-1062.02 Off-Label prescription of controlled substances; Prescription of schedule II controlled substances; Reports; Treatment Plans; Definition
Change of Physician Requests Under A.R.S. 23-1062.02 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. 23-1062.02(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
Deductible Policies Is it time to level the paying field? You decide.