BWC Updates and Overview of Prospective Billing

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1 BWC Updates and Overview of Prospective Billing Ohio Health Care Association Timothy McDermott, ARM, CPM, CWCC BWC Regional Business Consultant ((513) Cincinnati (740) Portsmouth (614) fax 1 Private Employer Rate Cuts o BWC has approved rate cuts in three of the past four years. o Another rate cut of 10.8% will take effect July 1, o At that time, rates will be down 21.4% from just five years ago. 2 DRAFT 1

2 BWC claims paid out by decade Decade Claims Payments in s 20 $207, s 374 4,685, s 2,553 36,041, s 8, ,749, s 16, ,376, s 24, ,586, s 79, ,224, s 129, ,862,715 Totals 260,314 $1,824,734,897 BWC claims paid out by decade Decade Claims Payments in 's 16 $132, 's 318 4,044, 's 2,319 32,540, 's 7,548 99,128, 's 15, ,315, 's 23, ,992, 's 67, ,068, 's 147, ,790,986 Totals 263,550 $1,830,014,894 DRAFT 2

3 BWC claims paid out by decade Decade Claims Payments in 's 11 $119, 's 268 3,702, 's 2,036 29,768, 's 6,821 89,591, 's 14, ,679, 's 20, ,041, 's 53, ,204, 's 146, ,957,477 Totals 243,547 $1,739,064,393 BWC claims paid out by decade Decade Claims Payments in 's 10 $107, 's 231 3,021, 's 1,810 26,927, 's 6,266 86,239, 's 13, ,707, 's 18, ,260, 's 42, ,426, 's 147, ,786,125 Totals 230,897 $1,707,475,282 DRAFT 3

4 Recent Rebates to Employers o In 2013 and 2014, BWC returned $2 billion in rebates to Ohio employers. o BWC to provide $1.2 billion transition credit to Ohio employers to ease the transition to a prospective billing system. 7 Increased Commitment to Safety o Last year, BWC awarded $15 million in safety grants to 535 employers. o BWC approved another $15 million for this year. o $15 million will be available to employers in fiscal years 2016 and DRAFT 4

5 Increased Commitment to Safety o Expansion of Safety Council Program to include health and wellness o Advanced workplace safety and health research-to-practice program o Partnership with State Fire Marshall to fund additional training for firefighters o Development of safety curricula and funding for skilled labor training program. 9 Safety Grants o Grants to assist employers in purchasing equipment that will substantially reduce or eliminate injuries o 3-to-1 matching funds (up to $40,000) o Last year, BWC awarded $15 million in grants to 535 employers o Have you applied for your safety grant? If not what are you waiting for? 10 DRAFT 5

6 Prospective Billing for Private Employers 11 Why Transition to Prospective Billing? o Industry standard o More flexible payment options o Decrease in base rates by 2% for private employers o Increased ability for us to detect non-compliance and fraud 12 DRAFT 6

7 Private Employer (PA) Transition Overview o Implement PA prospective payment effective July 1, 2015 o Will move to policy period o To avoid employers needing to make a double payment, BWC will provide an eight-month transition credit. This credit covers the August 2015 payroll report (for January-June) and the first two months of the 2015 policy year. o With the eight-month transition credit, employers will make their first prospective payment at the time they normally make their retrospective payment, by Aug PA Ending Retrospective Billing ( ) o BWC will apply the transition credit to cover the Jan. 1, 2015 June 30, 2015, premium due, when the employer files its payroll report in August Actual payroll is critical data in our rate calculations. 14 DRAFT 7

8 Implementing PA Prospective Billing o BWC will always use the most recently reported policy year to estimate an individual employer s premium obligation. For example, BWC will use the July 1, June 30, 2014, payroll for policy year o In May of each year: Employers will receive a premium along with their certificate of coverage. 15 Notice of Estimated Annual Premium Sample: Notice of Estimated Annual Premium 16 DRAFT 8

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July 15, 2015. The first (covering July and August) will be paid with transition credit.

11 Implementing PA Prospective Billing o In the first year, every employer except minimum payers will be on a bi-monthly plan, with the option of selecting a different plan by July 15, The first (covering July and August) will be paid with transition credit. BWC recommends staying with the bi-monthly default, at least in the first year. 22 DRAFT 11

12 Installment Options Annual (1); Semi- (2); Quarterly (4); Bi-monthly (6); Monthly (12). o Minimum payers will not receive options. o Minimum premium increasing to $120 due by June 30 each year. 23 Implementing PA Prospective Billing (First Year Only) o Employers will receive an for the second in early August. o This will be due by Aug. 31. o Premium security deposits (PSD) will post as credits to the account in this time frame. o BWC will mail s 30 days prior to the due date of each. 24 DRAFT 12

13 Payroll True-up Report o Prospective requires an payroll report trueup. BWC will send a reminder in July of each year. o The employer must report actual payroll for the previous policy year. Online or over the phone only If additional premium is calculated, it is also due by Aug. 15. If credit calculated, it will be released in normal process. Employers must pay online to be eligible for the Gogreen discount. 25 Payroll True-up Report o Actual payroll information is critical for rate setting. For that reason, an outstanding payroll true-up report will result in immediate disqualification from rating plans and programs for that current policy year. o Also, employers must complete* all true-ups to be eligible for programs going forward. *Complete = reporting and paying (if necessary). DRAFT 13

14 Rating Plan and Program Deadline o Group-experience rating Monday prior to Thanksgiving o Group retro, One Claim Program, Deductible, Individual retro Last business day in January o programs Last business day in May 27 PA Timeline First Prospective Year Jan. 1, 2015 to Jan. 31, 2016 May 29, 2015 May 31, 2015 premium for policy year 2015 mailed June 1, 2015 BWC pays 1 st ; no Aug. 1, 2015 mailed for 2 nd Aug. 31, 2015 due, payroll report due for previous six months (no $ due for payroll report) Nov. 23, 2015 Group for to June 30, 2017 Transition credit July 1,2015 July 15, 2015 LSS Filing Deadline to Impact EM for Sept. 30, 2015 EM Snapshot for Notice of premium mailed last week in May. Policy year begins July 1, with BWC paying first two months. Employer will receive first at the beginning of August with due August 31. Payroll report due/no money due by August DRAFT 14

15 PA Timeline First Prospective Year Jan. 1, 2015 to Jan. 31, 2016 May 29, 2015 May 31, 2015 premium for policy year 2015 mailed June 1, 2015 BWC pays 1 st ; no Aug. 1, 2015 mailed for 2 nd Aug. 31, 2015 due, payroll report due for previous six months (no $ due for payroll report) Nov. 23, 2015 Group for to June 30, 2017 Transition credit July 1,2015 July 15, 2015 LSS Filing Deadline to Impact EM for Sept. 30, 2015 EM Snapshot for Notice of premium mailed last week in May. Policy year begins July 1, with BWC paying first two months. Employer will receive first at the beginning of August with due August 31. Payroll report due/no money due by August PA Timeline First Prospective Year Jan. 1, 2015 to Jan. 31, 2016 May 29, 2015 May 31, 2015 premium for policy year 2015 mailed June 1, 2015 BWC pays 1 st ; no Aug. 1, 2015 mailed for 2 nd Aug. 31, 2015 due, payroll report due for previous six months (no $ due for payroll report) Nov. 23, 2015 Group for to June 30, 2017 Transition credit July 1,2015 July 15, 2015 LSS Filing Deadline to Impact EM for Sept. 30, 2015 EM Snapshot for Notice of premium mailed last week in May. Policy year begins July 1, with BWC paying first two months. Employer will receive first at the beginning of August with due August 31. Payroll report due/no money due by August DRAFT 15

16 PA Timeline First Prospective Year Jan. 1, 2015 to Jan. 31, 2016 May 29, 2015 May 31, 2015 premium for policy year 2015 mailed June 1, 2015 BWC pays 1 st ; no Aug. 1, 2015 mailed for 2 nd Aug. 31, 2015 due, payroll report due for previous six months (no $ due for payroll report) Nov. 23, 2015 Group for to June 30, 2017 Transition credit July 1,2015 July 15, 2015 LSS Filing Deadline to Impact EM for Sept. 30, 2015 EM Snapshot for Notice of premium mailed last week in May. Policy year begins July 1, with BWC paying first two months. Employer will receive first at the beginning of August with due August 31. Payroll report due/no money due by August PA Timeline First Prospective Year Jan. 1, 2015 to Jan. 31, 2016 May 29, 2015 May 31, 2015 premium for policy year 2015 mailed June 1, 2015 BWC pays 1 st ; no Aug. 1, 2015 mailed for 2 nd Aug. 31, 2015 due, payroll report due for previous six months (no $ due for payroll report) Nov. 23, 2015 Group for to June 30, 2017 Transition credit July 1,2015 July 15, 2015 LSS Filing Deadline to Impact EM for Sept. 30, 2015 EM Snapshot for Notice of premium mailed last week in May. Policy year begins July 1, with BWC paying first two months. Employer will receive first at the beginning of August with due August 31. Payroll report due/no money due by August DRAFT 16

17 PA Timeline First Prospective Year Jan. 1, 2015 to Jan. 31, 2016 May 29, 2015 May 31, 2015 premium for policy year 2015 mailed June 1, 2015 BWC pays 1 st ; no Aug. 1, 2015 mailed for 2 nd Aug. 31, 2015 due, payroll report due for previous six months (no $ due for payroll report) Nov. 23, 2015 Group for to June 30, 2017 Transition credit July 1,2015 July 15, 2015 LSS Filing Deadline to Impact EM for Sept. 30, 2015 EM Snapshot for Notice of premium mailed last week in May. Policy year begins July 1, with BWC paying first two months. Employer will receive first at the beginning of August with due August 31. Payroll report due/no money due by August PA Timeline First Prospective Year Jan. 1, 2015 to Jan. 31, 2016 May 29, 2015 May 31, 2015 premium for policy year 2015 mailed June 1, 2015 BWC pays 1 st ; no Aug. 1, 2015 mailed for 2 nd Aug. 31, 2015 due, payroll report due for previous six months (no $ due for payroll report) Nov. 23, 2015 Group for to June 30, 2017 Transition credit July 1,2015 July 15, 2015 LSS Filing Deadline to Impact EM for Sept. 30, 2015 EM Snapshot for Notice of premium mailed last week in May. Policy year begins July 1, with BWC paying first two months. Employer will receive first at the beginning of August with due August 31. Payroll report due/no money due by August DRAFT 17

18 PA Timeline First Prospective Year Jan. 1, 2015 to Jan. 31, 2016 May 29, 2015 May 31, 2015 premium for policy year 2015 mailed June 1, 2015 BWC pays 1 st ; no Aug. 1, 2015 mailed for 2 nd Aug. 31, 2015 due, payroll report due for previous six months (no $ due for payroll report) Nov. 23, 2015 Group for to June 30, 2017 Transition credit July 1,2015 July 15, 2015 LSS Filing Deadline to Impact EM for Sept. 30, 2015 EM Snapshot for Notice of premium mailed last week in May. Policy year begins July 1, with BWC paying first two months. Employer will receive first at the beginning of August with due August 31. Payroll report due/no money due by August PA Policy Year May 1, 2016 and Beyond Jan. 29, 2016 Group retro, One Claim Program, Individual retro, and Deductible May 1, 2016 premium sent May 31, 2016 June 1, 2016 mailed for to June 30, 2017 period June 30, st due Payroll trueup report notice sent Aug. 15, 2016 Payroll true-up report due MCO open July 15, 2016 LSS Filing Deadline To Impact EM for July 1, 2017 Invoice mailed June 1 first due June 30 Payroll true-up report notice sent July 1; due August DRAFT 18

19 PA Policy Year May 1, 2016 and Beyond Jan. 29, 2016 Group retro, One Claim Program, Individual retro, and Deductible May 1, 2016 premium sent May 31, 2016 June 1, 2016 mailed for to June 30, 2017 period June 30, st due Payroll trueup report notice sent Aug. 15, 2016 Payroll true-up report due MCO open July 15, 2016 LSS Filing Deadline To Impact EM for July 1, 2017 Invoice mailed June 1 first due June 30 Payroll true-up report notice sent July 1; due August PA Policy Year May 1, 2016 and Beyond Jan. 29, 2016 Group retro, One Claim Program, Individual retro, and Deductible May 1, 2016 premium sent May 31, 2016 June 1, 2016 mailed for to June 30, 2017 period June 30, st due Payroll trueup report notice sent Aug. 15, 2016 Payroll true-up report due MCO open July 15, 2016 LSS Filing Deadline To Impact EM for July 1, 2017 Invoice mailed June 1 first due June 30 Payroll true-up report notice sent July 1; due August DRAFT 19

20 PA Policy Year May 1, 2016 and Beyond Jan. 29, 2016 Group retro, One Claim Program, Individual retro, and Deductible May 1, 2016 premium sent May 31, 2016 June 1, 2016 mailed for to June 30, 2017 period June 30, st due Payroll trueup report notice sent Aug. 15, 2016 Payroll true-up report due MCO open July 15, 2016 LSS Filing Deadline To Impact EM for July 1, 2017 Invoice mailed June 1 first due June 30 Payroll true-up report notice sent July 1; due August PA Policy Year May 1, 2016 and Beyond Jan. 29, 2016 Group retro, One Claim Program, Individual retro, and Deductible May 1, 2016 premium sent May 31, 2016 June 1, 2016 mailed for to June 30, 2017 period June 30, st due Payroll trueup report notice sent Aug. 15, 2016 Payroll true-up report due MCO open July 15, 2016 LSS Filing Deadline To Impact EM for July 1, 2017 Invoice mailed June 1 first due June 30 Payroll true-up report notice sent July 1; due August DRAFT 20

21 PA Policy Year May 1, 2016 and Beyond Jan. 29, 2016 Group retro, One Claim Program, Individual retro, and Deductible May 1, 2016 premium sent May 31, 2016 June 1, 2016 mailed for to June 30, 2017 period June 30, st due Payroll trueup report notice sent Aug. 15, 2016 Payroll true-up report due MCO open July 15, 2016 LSS Filing Deadline To Impact EM for July 1, 2017 Invoice mailed June 1 first due June 30 Payroll true-up report notice sent July 1; due August PA Policy Year May 1, 2016 and Beyond Jan. 29, 2016 Group retro, One Claim Program, Individual retro, and Deductible May 1, 2016 premium sent May 31, 2016 June 1, 2016 mailed for to June 30, 2017 period June 30, st due Payroll trueup report notice sent Aug. 15, 2016 Payroll true-up report due MCO open July 15, 2016 LSS Filing Deadline To Impact EM for July 1, 2017 Invoice mailed June 1 first due June 30 Payroll true-up report notice sent July 1; due August DRAFT 21

22 PA Policy Year May 1, 2016 and Beyond Jan. 29, 2016 Group retro, One Claim Program, Individual retro, and Deductible May 1, 2016 premium sent May 31, 2016 June 1, 2016 mailed for to June 30, 2017 period June 30, st due Payroll trueup report notice sent Aug. 15, 2016 Payroll true-up report due MCO open July 15, 2016 LSS Filing Deadline To Impact EM for July 1, 2017 Invoice mailed June 1 first due June 30 Payroll true-up report notice sent July 1; due August PA Policy Year May 1, 2016 and Beyond Jan. 29, 2016 Group retro, One Claim Program, Individual retro, and Deductible May 1, 2016 premium sent May 31, 2016 June 1, 2016 mailed for to June 30, 2017 period June 30, st due Payroll trueup report notice sent Aug. 15, 2016 Payroll true-up report due MCO open July 15, 2016 LSS Filing Deadline To Impact EM for July 1, 2017 Invoice mailed June 1 first due June 30 Payroll true-up report notice sent July 1; due August DRAFT 22

23 Lapsing Coverage o BWC will lapse any employer who does not pay their on time. o BWC will not lapse an employer who does not true-up. BWC will estimate the true-up by adding an additional 10% to the premium due and bill the employer. If the employer still does not report their true-up, then BWC will certify it to the Ohio Attorney General s office for collections. 45 Web Resources For more information, visit o Overview document (with key dates) o Frequently asked questions document o Webinars 46 DRAFT 23

24 47 Questions? 48 DRAFT 24

BWC Updates and Overview of Prospective Billing

BWC Updates and Overview of Prospective Billing 1 Recent Rebates to Employers In 2013 and 2014, BWC returned $2 billion in rebates to Ohio employers. $1 billion in rebates to employers in summer 2013 Another