Workers Compensation Update

Transcription

1 Workers Compensation Update Andrew P. Frank Assistant Vice President Frank Gates Service Company 5000 Bradenton Avenue Dublin, Ohio Phone:

2 History of The Frank Gates Service Company Family Owned Third Party Administrator (TPA) Started in 1946, oldest TPA in Ohio Acquired by York Risk Services Group (York) December 2011, with focus on customer service York Acquired CareWorks Family of Companies January 2014, creating largest TPA in Ohio

3 Partner With Ohio Township Association Workers Compensation Group Rating Program Started with 260 participants in participants for 2015 rate Year Townships have saved over $160 million in premiums to date

4 Partner With Ohio Township Association Workers Compensation Group Retrospective Rating Program Started with 12 participants in participants for 2015 rate year Townships have saved over $1.3 million to date

5 BWC Payroll Reporting Township Employee Payroll Reporting 1/1/ /31/2014 minimum 45% due by May 15 Early payment discount for paying entire amount Remaining balance 55% due by September 1 Report full-time, part-time, elected officials, zoning

6 BWC Payroll Reporting Volunteers Performing Emergency Services Required Coverage Report payroll under separate manual 9439 BWC will allow segregation of payroll if also paid at station Minimum $300 per volunteer, minimum 15 volunteers per policy

7 BWC Payroll Reporting Volunteers Performing Non-Emergency Duties Elective coverage U-69 Form, Contract for Coverage of Political Subdivisions Resolution stating intent and details of coverage Minimum 20 hour per week multiplied by Ohio Minimum Wage

8 BWC Public Employer Base Rates Changes in Public Employer Base Rates Public Employers are divided into 10 industry groups 14 separate base rates for public employers Public employers can expect an average 9.1% rate reduction Nearly 20% average base rate reduction since 2011

9 BWC Public Employer Base Rates Changes in Township Rates Township base rate reduced by 6% for 2015 First township base rate reduction since 2011 Changes in Volunteer Rates Volunteer/EMS base rate reduced by 22.4% for 2015 Fourth straight year for volunteer base rate reduction

10 BWC Premium Discounts and Rebates Late 1990s / Early 2000s Discounts 20% to 75% discounts applied to payroll reports Billion Back Rebate Summer rebate checks amounting to 56% of 2011 premium Another Billion Back Rebate Fall rebate check amounting to 60% of 2012 premium

11 BWC Prospective Billing 1/1/ /31/2015 Actual payroll reported and premium paid due May 15 Premium discounted 50% 1/1/ /31/2016 Estimated invoiced payroll and premium paid due May 15 Premium discounted 50%

12 BWC Prospective Billing November 1, 2016 BWC mails 2017 rate year estimated premium notice December 1, 2016 BWC mails 2017 rate year first monthly premium notice December 31, 2016 Rate year 2017 first prospective payment due

13 BWC Prospective Billing Annual True-Up of Actual Payroll BWC mails true-up notice in January Township notifies BWC of actual payroll by February 15 Failure to report results in disqualification from future discount programs

14 Alternative Rating Programs Group Rating Program Up front discount on premium paid Employers must be substantially homogeneous Eligibility based on 4-year experience claim cost Group Rating filing deadline moved up to last business day in May

15 Alternative Rating Programs Group Retrospective Rating Program Pay individual premium up front Adjustments to premium 12, 24, 36 months after rate year Refunds/billings based on group s performance Group retro filing deadline moved up to last business day in July

16 Alternative Rating Programs 100% EM Cap Program Cap experience modifier (EM) due to becoming penalty rated Discount equal to 100% of previous year published EM BWC automatically enrolls employer if eligible, no application Complete a one-half day industry-specific BWC safety class

17 Alternative Rating Programs One Claim Program Removed from Group Rating due to significant claim No more than 3 medical only claims in experience First year must attend a half-day BWC safety class Receive annual discount off your base rate 20%, 15%, 10%, 5%

18 BWC Destination: Excellence Go-Green Discount 1% discount on full premium payment, $2,000 maximum File payroll report and pay full premium electronically Lapse Free Discount 1% discount on full premium payment, $2,000 maximum Employers with no lapse in coverage for 60 months

19 BWC Destination: Excellence Safety Council Rebate Program Join local safety council by July 31 each year Attend 10 monthly safety council meetings in the year Group-experience-rating program employers 2% performance standard premium rebate only Group-retrospective-rating program employers 2% participation standard premium rebate only

20 BWC Destination: Excellence Industry-Specific Safety Discount (ISSP) 3% standard premium rebate Participation in loss-prevention activities based on payroll One full-day or two half-day BWC safety-specific training classes On-site safety consulting by BWC Division Safety & Hygiene experts BWC s Ohio Safety Congress & Expo multiple sessions Required annual enrollment last business day in November

21 BWC Destination: Excellence Drug-Free Safety Program (DFSP) Written policy - describe program elements and requirements Employee education - one hour annually, one hour refresher Supervisor training - two hour initially, one hour refresher annually Employee assistance program commitment to health and wellbeing Drug/alcohol testing new hire, reasonable suspicion, post-accident

22 BWC Destination: Excellence Drug-Free Safety Program Basic level 4% standard premium rebate Advanced level 7% standard premium rebate Requires 15% random testing safety-sensitive positions Enrollment last business day in November Re-enrollment DFSP-4 Annual Report last business day in September

23 BWC Destination: Excellence Transitional Work Bonus (TWB) 10% standard premium rebate Have a transitional work plan that meets BWC requirements Bring injured worker back to light duty before full duty release Complete Transitional Work Offer and Acceptance Form (TWB-2) Required annual enrollment last business day in November

24 Claim Cost Containment Strategies Communication Keep all parties updated in claim process Helps prevent attorney involvement Promotes goodwill with employees Reduce claim cost

25 Cost Containment Strategies Salary Continuation Paying wages in lieu of BWC compensation Requires completion of C-55 Agreement Eliminates indemnity payment and partial reserve Helps maintain group rating eligibility

26 Cost Containment Strategies Transitional Work Bring injured worker back to modified position, transition to full duty Increase employee satisfaction and job retention Must be approved by attending physician Potential premium rebates, premium reduction

27 Cost Containment Strategies Handicap Reimbursement 25 pre-existing handicap conditions Condition has to aggravate or delay recovery Claim cost relief in experience calculation Possible premium reduction

28 Cost Containment Strategies Lump Sum Settlements BWC pays future benefits in one lump sum payment Fixes claim cost and removes reserve cost Prevents potential re-activation of claim Can be used to increase group retrospective rating rebates

29 Cost Containment Strategies BWC Examinations and Reviews 90-Day BWC Examination - required by statute when injured worker receives 90 consecutive days of compensation Independent Medical Exams (IME) - objective medical evaluation conducted by independent medical specialist Functional Capacity Exams (FCE) - examination to determine physical abilities as they relate to the job BWC Physicians Review/Exam file reviews and examinations performed by BWC physicians

30 Thank you for your attention Please let us know if you have any questions