Florida Workers Compensation Market 2012

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Florida Workers Compensation Market 2012 October 4, 2012 Lori_Lovgren@ncci.com 561-893-3337

Florida Workers Compensation Rates 1-1-13 10-1-03 to 1-1-13* Manufacturing + 4.8% -51.8% Contracting + 7.4% -58.6 % Office & Clerical + 4.3% -58.1% Goods & Services + 6.7% -54.4% Miscellaneous + 5.6% -54.0% Overall Average +6.1% -56.0% * Assuming 1/1/2013 is approved as filed 2

Florida Historical Rate Changes Percent (%) 25.0 Cumulative 1/1999 4/2003 15.0 +20.6% 12.9 Emma Murray- Related No Filing 6.4 7.8 8.9 6.1 5.0 1.5 2.5 0.0 2.7 0.0-5.0-5.1-6.0-6.8-4.2-15.0-14.0-13.5-15.7-18.4-18.6-25.0-35.0 Cumulative 10/2003 1/2013-56.0% Calendar Year * Pending 3

Why a Third Increase After So Many Years of Decreases? Florida has reached its new post reform baseline; 2006 was likely last year to include additional beneficial impacts of reform; this filing 1/1/13 and the last two (1/1/11 and 1/1/12) are based on years unimpacted by additional impacts of SB 50A Current rates assumed continued improvements in loss experience but for this filing 1/1/13 and the last two (1/1/11 and 1/1/12), the experience changes were positive After 9 years of claim frequency declines, claim frequency started becoming increasingly less negative in policy years 2007 and 2008 and turned positive in the two most recent two policy years - 2009 and 2010 These 3 increases reflect an attempt to find the new normal for Florida post-reform and in face of economic disruption/cost pressures 4

Pure Loss Cost All Classes Current Average Voluntary Pure Loss Costs Using Florida s Payroll Distribution 3 2.62 2 1.69 1 1.07 1.14 1.41 1.08 1.301.22 1.22 1.18 1.17 1.16 1.13 1.10 1.13 0.99 0 FL AL GA NC SC TN State 2003 2012 2013 Based on the latest NCCI approved rates and loss costs in the various states 5

Market Indicators 6

Florida s Workers Compensation Premium Volume $ Billions 5.0 4.495 Direct Written Premium 4.0 1.178 3.405 3.0 2.0 1.0 0.186 3.131 0.955 0.137 2.313 2.681 2.368 2.486 0.873 0.649 0.765 0.106 0.043 0.034 1.702 1.569 1.794 0.0 2007 2008 2009 2010 2011p Calendar Year Carriers Group Self-Insureds Individual Self-Insureds p = Preliminary 7

Combined Ratio Florida Policy Year Combined Ratios 140% 120% 100% 114% 107% 121% 118% 112% 104% 98% 103% 120% 119% 80% 86% 81% 79% 77% 87% 60% 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Policy Year 8

Florida WCJUA Written Premium $ Millions 80 77.5 60 64.5 62.0 40 20 0 42.1 25.6 14.2 18.0 6.4 6.1 9.6 1.2 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012* Calendar Year Data provided by the Florida Workers Compensation Joint Underwriting Association (FWCJUA) *Projected 9

Cost Drivers 10

Percent Change 8.0 6.0 4.0 2.0 0.0-2.0-4.0-6.0-8.0-10.0 Florida Workers Compensation Lost-Time Claim Frequency 1.3 Lost-Time Claims -3.0-3.4-3.0-4.0-5.0-6.9-6.9-6.6-6.1-7.6-8.9 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Policy Year Cumulative Change of 41.1% (1996 2010) 6.1 3.2 Based on data through 12/31/2011, developed to ultimate 11

Medical Benefits Constitute the Majority of Total Benefit Costs in Florida Florida Countrywide Indemnity 32% Medical 68% Indemnity 41% Medical 59% 12

Total Average Claim Severity ($ '000s) Average Total Severity Lost-Time Claims, Excluding On-Levels, No Wage Adjustment 54 51 SB 50A Effective 10/1/2003 50.3 48 47.1 45 42 41.4 39 36 33 32.1 30 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011* Accident Year Florida Countrywide *Countrywide based on preliminary results. Based on NCCI s financial data for lost-time claims developed to ultimate and NOT adjusted to current benefit level. Copyright 2012 National Council on Compensation Insurance, Inc. All Rights Reserved.

Indemnity Average Claim Severity ($ '000s) Average Indemnity Severity Lost-Time Claims, Excluding On-Levels, No Wage Adjustment 24 22 20 18 17.8 SB 50A Effective 10/1/2003 22.3 16 14 16.2 15.0 12 10 8 6 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011* Accident Year Florida Countrywide *Countrywide based on preliminary results. 14 Based on NCCI s financial data for lost-time claims developed to ultimate and NOT adjusted to current benefit level. Copyright 2012 National Council on Compensation Insurance, Inc. All Rights Reserved.

Medical Average Claim Severity ($ '000s) Average Medical Severity Lost-Time Claims, Excluding On-Levels, No Wage Adjustment 34 32 30 28 26 24 22 20 18 16 14 32.1 SB 50A Effective 10/1/2003 28.0 23.6 15.9 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011* Accident Year Florida Countrywide *Countrywide based on preliminary results. 15 Based on NCCI s financial data for lost-time claims developed to ultimate and NOT adjusted to current benefit level. Copyright 2012 National Council on Compensation Insurance, Inc. All Rights Reserved.

2011 Medical Cost Distributions Florida vs. Florida 1 Countrywide 2 Difference PHYSICIANS DRUGS SUPPLIES OTHER HOSPITAL INPATIENT HOSPITAL OUTPATIENT ASC TOTAL 33.7% 41.1% -7.4% 15.1% 10.5% +4.6% 4.2% 7.0% -2.8% 1.9% 4.4% -2.5% 17.8% 14.5% +3.3% 18.8% 17.5% +1.3% 8.5% 5.0% +3.5% 100% 100% 0% 1 Source: Derived from data provided by Florida Division of Workers Compensation for service year 2011. 2 Source: Derived from NCCI Medical Data Call, for Service Year 2011. 16

Potential Areas for Savings Drugs Cap on repackaged drugs 1.1% savings (2011 FL DWC data) or $27.3M If cap were to be implemented, FL would still be 3.5% higher than countrywide average (currently 4.6% above countrywide average) Other options: Florida pays 100% AWP plus a dispensing fee; many other states have lower fee schedules such as 80% or 90% of AWP plus a dispensing fee Other benchmarks such as Wholesale Acquisition Cost which are lower than AWP 17

Comparison of Drug Repackaging Pricings HB 5603 (2008 data) SB 1068 (2009 data) Current Analysis (2011 data) (1) Impact of Limiting AWP on Repackaged or Relabeled Prescription Drugs -52.8% -57.0% -45.1% (2) Share of Repackaged or Relabeled Drug Costs to WC Drug Costs 23.5% 39.8% 24.3% (3) Share of WC Drug Costs to WC Medical Costs 12.8% 16.0% 15.1% (4) Impact on Medical Costs = (1) x (2) x (3) -1.6% -3.6% -1.6% (5) Medical Costs as a percentage of Overall WC System Costs 68.9% 68.3% 68.4% (6) Impact on Overall WC System Costs = (4) x (5) -1.1% -2.5% -1.1% 18

Why Has Markup Decreased? Possibly repackagers have changed behavior after attention issue has received starting with 2010 bill Possibly due to the actions of carriers who may have addressed the markup in different ways such as: Strengthening contracts Using current 440.13(12)(c) language to limit reimbursements Where the employer or carrier has contracted for such services and the employee elects to obtain them through a provider not a party to the contract, the carrier shall reimburse at the schedule negotiated, or contract price, whichever is lower. No such contract shall rely on a provider that is not reasonably accessible to the employee. 19

Potential Areas for Savings Facilities Hospital Inpatient Hospital Outpatient Ambulatory Surgical Centers If Florida facility reimbursements were reduced to countrywide average, savings would be 5.5% 20

Florida Workers Compensation Market In Summary: Mixed Results Statewide premium indicates Florida payroll is up in 2011 - first year since the end of the recession in 2009 Florida combined ratios are high 119% PY 2010 WC JUA premium creeping up in 2011 and 2012; projected to increase further in 2013 21

Despite Mixed Results, Stability Still Possible Even including 6.1% increase, Florida rates would still be down 56% from the peak in 2003 and are still relatively low Most of the post-reform cost reductions have been maintained (reached 64.7% in 2010 and now would be 56%) Even including 6.1% increase, Florida loss costs would be around the average for the southeastern states (FL 1.14 vs. 6 state average 1.15) Addressing workers comp cost drivers legislatively may help towards the goal of stabilizing workers compensation rates for Florida employers 22