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How To Handle Workers Comp Emails – Suggestions For Inbound Messages

July 19, 2018 By JL Risk Management Consultants Leave a Comment

Workers Comp Emails – Handling Them On The Way In Saves Time And Aggravation

Handling Workers Comp emails can be a complicated, frustrating job function. In fact, I have received quite a few questions over the years about handling Workers Compensation postal mail and emails.

picture of directional workers comp emails sign

Wikimedia Public Use License – Dyon Joel

Tackling the rerouting of Work Comp emails can be daunting due to the different email systems in place – Hotmail, Gmail, Yahoomail, Outlook, and many others.

I will cover all of the major ones in this article –

Different Versions of Workers Compensation

OK, so I said this might grate your nerves, but one of the woes of WC on the Internet is the different names for Work Comp. I have already used three versions in this section.

The different versions of Worker’s Compensation are:

Work Comp
Worker’s Comp
Workers’ Comp
Workers Comp
Workers Compensation
Worker’s Compensation
Workers’ Compensation

Copy and paste each one of these into a Google search, and you will be amazed that each one gives different results. (Ouch!) If you separate workers compensation into two words, you are going to forward everything from your inbox that had the word workers or compensation to count as workers compensation. I have made that mistake in the past.

What can one do? One of the rules – see next sections – is to have emails from a certain sender (agent, adjuster, rating bureau, etc.) go into a certain folder.

Folder

The first task involves setting up a folder in for items to be forwarded or move to that folder. This folder will be the landing place for all the emails you set up using certain rules.

Workers Compensation is always a good folder name.

Business/Employer System Emails

To be safe, if you have a systems administrator, do not do this on your own. That is the SysAd’s job, so let them do it. Due to my tech background, I set my own incoming email rules into place. Setting up the algorithm enables an email recipient to handle workers comp emails very quickly and efficiently.

Done wrong, and you can wipe out all your emails or crash the system.

The keyword here is the incoming rule. That is where you can direct any email to any folder, delete it, or perform 80+ functions to a certain set of incoming emails.

Microsoft Outlook 2013 is what I use for emails. Your system may vary, so the SysAd’s input is critical. If your SysAd says to leave it alone, then that is what you must do – or they can email me for any clarifications.

Instead of me droning on, I thought I would direct you to the proper Microsoft Outlook instructions. <<<Click here. It is all there. Microsoft created a great page there. Watch the versions. Check out the subsections in that webpage on how to create more rules.

Hotmail/Livemail

Hotmail rules can be found here. Thanks and good job to Lifewire for the rule breakdown.

Yahoomail

Click here for Yahoo Filters – they claim to have over 1,000 filters – wow!

Gmail

Gmail Inbox organization rules can be found at this link. – kudos to PC Magazine for their Gmail Inbox Tips

The smartphone apps for each of the services may be slightly different.

J&L Risk Management Consultants is not responsible if you blow up your inbox. Remember, to ask for help from someone with a tech background if this seems overwhelming or you get to a point of no return in setting up your workers comp emails.

(sm) Hotmail, Gmail, Yahoomail, Outlook, Lifwire, and PC Magazine are all screenmarks of their respective owners.

Filed Under: Emails Tagged With: Gmail, Hotmail, Outlook, US Postal Service, Yahoomail

Captive Tax Advantages Recently Take Huge Hit In US Tax Court

July 18, 2018 By JL Risk Management Consultants Leave a Comment

Captive Tax Advantages – Tax Court Ruling – One To Read Up On

Some Captive tax advantages may have been eroded with a recent US Tax Court decision. The case is Reserve Mech. Corp. v. Commissioner, 2018 Tax Ct. Memo LEXIS 87.

picture of Anguilla Captive Tax Advantages Island

Wikimedia Public Use Roy Googin

The three articles that started quite a buzz in the captive world are from: (LexisNexis full article behind paywall)

Captive Insurance Times

Captive.Com

LexisNexis

If you are interested in Captives, and you should be if you are involved with any facet of Workers Compensation, the articles are very much worth a read. If you perform a Google search on

Reserve Mech. Corp. v. Commissioner

one will find volumes of information.

Many companies, captive administrators, attorneys, and other people involved with captives have issued statements and opinions on the Reserve Mechanical case.

The PDF of the entire 66 page US Tax Court decision is here. You will need a PDF reader to read it. This decision may be one to download and read for yourself. The decision is a complicated one. The bottom line is the owners of the captive could not avoid a 30% tax on the captive insurance agreement. The captive tax advantages were not allowed.

Many of the legal, captive, and insurance pundits pointed to the Conclusion Section III (page 62). The first part of that section is below.

________________

III. Taxability of Reserve’s Revenue

We concluded that Reserve did not issue insurance or reinsurance contracts during the tax years in issue and therefore it did not receive more than 50% of its gross receipts from insurance premiums. See secs. 501(c)(15), 816(a).

—————————–

One has to draw their own conclusions. The 14 articles on Captives that I wrote can be found here. The article on rent-a-captive turned out to be one of the most popular ones on this website.

We shall see what the future holds for onshore and especially offshore captive tax advantages.

Filed Under: Captives Taxed Tagged With: US Tax Court

NCCI State Advisory Forums – Definitely Worth The Time – Free Of Charge

July 12, 2018 By JL Risk Management Consultants Leave a Comment

NCCI State Advisory Forums – Great Workers Comp Data At Your Fingertips

Many NCCI State Advisory Forums have been calendared through the end of 2018. The Workers Comp data shared by NCCI at these forums analyze a large number of data points.

For example, below is one of their very helpful charts.

Graph NCCI State Advisory Forums Loss Time Claims

This handy chart was from the Oklahoma State Advisory Forum in 2017. Where can you find such great data, well, at these forums. A graph is worth a thousand words. One can easily draw 20 conclusions from this one chart.

I had always thought that I could just wait until after the NCCI State Advisory Forums posted to their website; read the charts; and understand what the data means without having to attend the forums. I was wrong as many times the presenters will add in commentary that is not on the charts, graphs, etc.

I attended the Virginia State Advisory Forum last year. I see that another is scheduled the first week of August. I have another commitment. North Carolina (our HQ state) does not use NCCI for their Workers Compensation ratings, instead they are an independent bureau.

The upcoming calendar through the end of 2018 is below. The NCCI has only two rules to attend the freebies, yes gratis State Advisory Forums. Some of the NCCI State Advisory Forums are part of a combination of meetings (Agent Workshops and Open Houses).

There is no charge to attend these forums, but registration is required. You are welcome to attend the forum for every state where you are writing or involved in workers compensation insurance.

Virginia SAF The Westin Richmond 6631 West Broad Street Richmond, VA 23230 804-282-8444	August 1, 2018
Kentucky SAF Capital Plaza Hotel 405 Wilkinson Boulevard Frankfort, KY 40601 502-227-5100	August 9, 2018
West Virginia SAF Four Points by Sheraton Charleston 600 Kanawha Boulevard East Charleston, WV 25301 304-344-4092	August 16, 2018
Iowa SAF Des Moines Marriott Downtown 700 Grand Avenue Des Moines, IA 50309 515-245-5541Note: Open House and Agent Workshop at this location. See registration for details.	August 29, 2018
Illinois SAF Chicago Marriott Oak Brook 1401 West 22nd Street Oak Brook, IL 60523 630-573-8555Note: Open House and Agent Workshop at this location. See registration for details.	August 30, 2018
District of Columbia SAF Hyatt Regency Washington on Capitol Hill 400 New Jersey Avenue Northwest Washington, DC 20001 202-737-1234	September 6, 2018
Maryland SAF Hyatt Regency Baltimore on the Inner Harbor 300 Light Street Baltimore, MD 21202 410-528-1234	September 7, 2018
New Hampshire SAF Manchester Downtown Hotel 700 Elm Street Manchester, NH 03101 603-625-1000	September 7, 2018
Missouri SAF Courtyard by Marriott Columbia 3301 Lemone Industrial Boulevard Columbia, MO 65201 573-443-8000	September 12, 2018
Hawaii SAF Hilton Waikiki Beach 2500 Kuhio Avenue Honolulu, HI 96815 808-922-0811	September 20, 2018
Alabama SAF Renaissance Montgomery Hotel and Spa at the Convention Center 201 Tallapoosa Street Montgomery, AL 36104 334-481-5000	September 21, 2018
Colorado SAF Hyatt Regency Denver Tech Center 7800 East Tufts Avenue Denver, CO 80237 303-779-1234	September 27, 2018
New Mexico SAF Sandia Resort & Casino 30 Rainbow Road Northeast Albuquerque, NM 87113 505-796-7500	October 3, 2018
Arizona SAF Phoenix Airport Marriott 1101 North 44th Street Phoenix, AZ 85008 602-273-7373	October 5, 2018
Tulsa, Oklahoma SAF Marriott Tulsa Southern Hills 1902 E 71st St. Tulsa, OK 74136 918-493-7000	October 9, 2018
Oklahoma SAF Embassy Suites Oklahoma City Downtown Medical Center 741 North Phillips Avenue Oklahoma City, OK 73104 405-239-3900	October 10, 2018
Tennessee SAF Nashville Airport Marriott 600 Marriott Drive Nashville, TN 37214 615-889-9300	October 12, 2018
Oregon SAF The Duniway Portland, A Hilton Hotel 545 Southwest Taylor Street Portland, OR 97204 503-553-7000	October 17, 2018
Connecticut SAF Marriott Hartford Downtown 200 Columbus Boulevard Hartford, CT 06103 860-249-8000	October 19, 2018
Alaska SAF William A. Egan Civic and Convention Center 555 West Fifth Avenue Anchorage, AK 99501 907-263-2800	October 25, 2018
Kansas SAF The Eldridge 701 Massachusetts Street Lawrence, KS 66044 785-749-5011	October 25, 2018
Mississippi SAF Hilton Jackson 1001 East County Line Road Jackson, MS 39211 601-957-2800	October 26, 2018
Louisiana SAF Hilton Baton Rouge Capitol Center 201 Lafayette Street Baton Rouge, LA 70801 225-344-5866	November 9, 2018
Nebraska SAF The Lincoln Marriott Cornhusker Hotel 333 South 13th Street Lincoln, NE 68508 402-474-7474	November 13, 2018
Idaho SAF Boise Centre 850 West Front Street Boise, ID 83702 208-336-8900	November 28, 2018
South Carolina SAF Embassy Suites by Hilton Columbia Greystone 200 Stoneridge Drive Columbia, SC 29210 803-252-8700	November 29, 2018
Texas SAF Hyatt Regency Austin 208 Barton Springs Road Austin, TX 78704 512-477-1234	November 29, 2018
Georgia SAF Hotel Indigo Atlanta – Vinings 2857 Paces Ferry Road SE Atlanta, GA 30339 770-432-5555	November 30, 2018
Florida SAF Hyatt Regency Orlando International Airport 9300 Jeff Fuqua Boulevard Orlando, FL 32827 407-825-1234	December 5, 2018
Utah SAF Salt Lake City Marriott City Center 220 South State Street Salt Lake City, UT 84111 801-961-8700	December 6, 2018

All meetings, charts, and materials are copyrighted by the National Council on Compensation Insurance including the NCCI State Advisory Forums.

Filed Under: NCCI Tagged With: District of Columbia, Illinois, Iowa, Kentucky, Virginia

Workers Compensation Large Deductible Policies – Are They Really Worth It?

July 10, 2018 By JL Risk Management Consultants Leave a Comment

Workers Compensation Large Deductible Policies – Are They A Bargain?

Are Workers Compensation large deductible policies worth a look for cutting costs? One great way to start is by going over the definition of these hybrid-types of policies.

picture of workers compensation large deductible policies old west

Public Use License – Paramount – Wikimedia

The idea to write this article was generated from quite a bit of buzz on whether high deductible health insurance policies are a great avenue for providing health insurance to one’s family or business.

Many states have their own sets of rules on large deductible policies. The National Council o Compensation Insurance (NCCI) basically defines workers compensation large deductible policies as having a $100,000 or more deductible.

Many people in the insurance industry refer to a large deductible policy as any policy with a $250,000 or higher deductible. I have not seen many policies below the $250,000 but they do exist.

To write this article, I will have to talk in overall generalities as there are so many different types of deductible policies, I could write a book on the different ways to underwrite these policies.

One misconception is that some companies seem to think they are self insured of sorts with a large deductible. A few differences between self insurance and workers compensation large deductible policies are your company:

Has a Mod with large deductible policies, not so with self insurance (big surprise often)
Files are being handled by a carrier, not a Third Party Administrator, you are still being insured
Still pays a premium or file adjustment fee per $100 of coverage –many versions of this
Can still “bust your deductible” without realizing it – the nasty aggregate deductible

An aggregate deductible is defined as the total claims volume deductible not per claim. A company may never reach the $250,000 deductible limit. However a rash of medium-sized claims will go over the aggregate deductible.

I have seen many large deductible programs survive for many years. The employers that seem to have troubling policy years are the ones that do not budget in enough for Risk Management and Safety.

I will not cover how the large deductible policies are charged and billed premiums due to numerous versions.

The bottom line – bargains do exist. Make sure you have the right advice before pursuing workers compensation large deductible policies.

Filed Under: High Deductible Policies, Large Deductible Tagged With: aggregate deductible, E-Mod, Third Party Administrator

Workers Compensation Medical Software vs My Semi Annual Search For Apps

June 28, 2018 By JL Risk Management Consultants

Workers Compensation Medical Software Companies Say – How About Us?

Workers Compensation medical software companies have been chatting with us by email, calls, LinkedIn, comments, etc. over the past few weeks. As you may know I have written a number of articles on the lack of workers compensation technology including apps for iPhones and Android phones.

picture of boy looking at workers compensation medical software binoculars

Wikimedia License Jrod2

I searched for technological advances at the NWCDC conferences over the past few years. I discovered a few companies that were on the cutting edge including a genetic pharmaceutical company and two online doctor visit providers.

In fact, I have called the Android/Iphone searches “going into the rabbit hole.” << a tip of the hat to Charles Dickens.

Workers Compensation medical software company owners and their marketers have informed me directly or indirectly that I may have overlooked them. I am not and will not endorse any companies. However, I will refer back to the article where I set out the rules I was using to find the Workers Comp apps. If not, the credibility of my searches would have been less than zero.

For 2018 Android searches –

Be free
Not be a veiled advertisement
Have at least 10 votes on the ratings – this prevents the app providers from rating themselves highly. – this is a new requirement
Have at least 3 stars or higher rating – this is a new requirement
Have some useful function – (that it actually worked)
Be closely related to Workers Comp
Appear in the Google Playstore – some websites provide apps that are not in the Playstore. A great marketing idea would be to put them in the Playstore as blatant advertising. Some recommended apps no longer appear in the Playstore.

The rules were not very picky. #3 in the above list kept the providers from rating themselves highly and not the app users.

For 2018 Iphone (Apple iStore ) apps , the same rules applied to my searches. The one astonishing discovery noted was the lack of workers compensation apps for iPhones.

I appreciated the contacts from various software companies – actually medical treatment platforms. This means that my searches will bear more fruit in the future – at least (hopefully) from workers compensation medical software companies.

Filed Under: apps Tagged With: Android, Apple, Google Play Store, Iphones

Workers Compensation Reserves – Fee Schedule Hidden Benefit

June 27, 2018 By JL Risk Management Consultants

Workers Compensation Reserves More Accurate With Fee Schedules

Workers Compensation reserves (Total Incurred minus Paid) receive an accuracy boost with fee schedules. Why? – Let us go into the mind of an adjuster getting ready to set permanent file reserves at 60 days.

picture of archer workers compensation reserves target

Wikimedia License – Jethrothompson

BTW, this articles stems from an article I wrote last week. I promised in that article to mention how fee schedules help increase reserve accuracy.

Very few adjusting staffs sit down with a medical reserve and read it out of the state fee schedule. Usually, the adjuster has a list of blanks to fill in to come up with the file reserves. Areas such as surgery, hospitalization fees, physical therapy, etc. are listed on the sheet.

The Workers Compensation reserves at the 60 day mark are for the life of the file. An experienced adjuster with 7+ years into their career has a great feel for reserving in a state with fee schedules. The states with Usual & Customary (U&C) are more of a negotiated price. If you have ever received a U&C bill in a health insurance matter, you are shaking your head – yes. It is by zip code and area of specialty and on and on.

With fee schedules, the adjuster can easily say -OK- the price of treatment for a non-compound ulna fracture (after filling in the aforementioned blanks) is $23,545.00. With U&C, the adjuster creates even more of an estimate as the adjuster has to know the price of medical treatment for every specialty in every zip code. Whew! – that is not easy.

I became very experienced in the U&C area after I received two boxes of paper files from a failed captive in a run-off situation. Some of the providers had not been paid for quite some time. All the injured employee bills originated in non-fee schedule states. The ever complicated negotiation was on – by each zip code, and even some of the U&C Zip Codes were split.

In a fee schedule based state, I could have sent the bills for processing through a bill review company. The charges would have been paid – possibly with an applicable late fee. The task turned out to be not that easy.

Workers Compensation reserves with a fee schedule state have one set of numbers to use in the complete state – in most cases. A few fee schedules have a synthetic add-on such as BR (By Report).

A disclaimer – I am not a U&C health insurance expert. I am more versed in Workers Compensation reserves.

Filed Under: Workers Comp Reserving Tagged With: Captive, U&C, workers comp claims adjuster

Stay at Work Washington L&I ‘s Unique Program – Guest Post

June 21, 2018 By JL Risk Management Consultants

Stay at Work -How WA State Companies Can Be Reimbursed 50% of an Injured Worker’s Wages While on Light Duty

Stay at Work sounds like a great unique program for employers and injured employees.

Two months ago, Mr. Kohler (see below) contacted me. He wanted to see if I would be interested in posting a guest post on the unique state of Washington’s Workers Compensation system.

graphic of worker lifting improperly stay at work

Public License – Wellcome Foundation, UK

I admit that I do not allow very many guests posts. Washington’s L&I (think monopolistic) is unto itself on many aspects of Workers Compensation. Mr. Kohler made me an offer that I could not refuse. Below is the article he wrote verbatim.

___________________

The Washington State Department Labor and Industries (L&I) has a unique program called “Stay at Work” that is designed to help employees stay on the job after an injury claim has been filed. The program is geared to meeting both the needs of injured employees and employers that are worried about managing all of the costs associated with an employee injury claim.

What is “Stay at Work”?

“Stay at Work” is a financial incentive program that reimburses employers for some of the costs of transitioning an injured worker to temporary, light-duty jobs while they recover from their injuries. Eligible employers are able to get reimbursed from L&I for eligible expenses.

The program was created to deal with the issues faced by both employers and employees when an injured employee is kept off the job of injury for months at a time.

The employee, even with worker’s compensation, payments can see as much as a 30% to 40% reduction in their take-home pay. Also, the longer an employee is out of work, the more difficult their recovery becomes and the harder it is to get back to work.

“Stay at Work” encourages employers to find temporary light-duty jobs for injured employees so that they can continue to participate in the workplace. This improves their health outcomes and allows them to avoid a reduction in their take-home pay.

How Does “Stay at Work” Help Employers?

The “Stay at Work” program also significantly helps employers. Instead of dealing with all of the costs associated with an injury claim, the employer is able to be reimbursed:

50% of injured worker’s base wages for light-duty or transitional work
Expense reimbursement for training, tools, and clothing

This program not only reduces the costs the employer faces in dealing with an injury claim, it allows the employer to still take advantage of the skills and knowledge of the injured employee while they heal. It also makes it more likely that the employee will be able to return to full duty.

Key Eligibility Requirements

Some of the key eligibility requirements for the “Stay at Work” program include:

Pay workers compensation premiums to L&I
By the employer at the time of the injury on the claim, or have your experience rating affected by the claim
Have written approval for light-duty or transitional work from the employee’s health care provider
Apply for reimbursement of eligible expenses within one year of incurring the expenses

The “Stay at Work” program gives employers the chance to get some help with the often-excessive costs of managing an employee injury claim. The program is good for employers and employees.

Spencer Kohler – ARM, V.P. Marketing, Risk Finance/Washington Manufacturers Council provided this Stay at Work article.

Filed Under: Stay at Work Program Tagged With: light duty, monopolistic, Washington L&I

Workers Compensation Fee Schedules Win Again – WCRI’s Free Study

June 19, 2018 By JL Risk Management Consultants

Workers Compensation Fee Schedules = Less Costly Claims and Premiums

Virtually all Workers Compensation Fee Schedules cut comp costs across the board. Check out this search for fee schedules articles on this website. WCRI just published a massive study on workers compensation fee schedules. The study covers 87% of the workers comp benefits paid in the US.

pic of student studying workers compensation fee schedules

Public Use License Wikimedia Gnarlycraig

WCRI Says Freebies On This One

Dr. Rebecca Yang and Dr. Olesya Fomenko’s extremely comprehensive study covers 35 states. These two researchers are data geniuses along with all the staff at WCRI.

For many years (over 11) I have written numerous articles on fee schedules. Why?- because they are governmental interventions that usually totally works to reduce the cost to employers, carriers, and all other parties. Next week, I will cover the hidden side of fee schedules that are just as important.

Virginia just enacted a fee schedule. For some reason, I thought Virginia would never have a fee schedule. Some tweaks will likely be needed for their fee schedule.

From the WCRI press release and website:

The study, WCRI Medical Price Index for Workers’ Compensation, 10th Edition (MPI-WC), compares medical prices paid in 35 states and tracks price changes in most states over a 10-year span from 2008 to 2017 for professional services billed by physicians, physical therapists, and chiropractors. The medical services fall into eight groups: evaluation and management, physical medicine, surgery, major radiology, minor radiology, neurological testing, pain management injections, and emergency care.

One interesting development pointed out by WCRI is the following states had major fee schedule changes:

Arizona
California
Colorado
Illinois
Kentucky
Massachusetts
North Carolina
Texas.

The rating bureaus such as NCCI (most of nation) and WCIRB (California) both provided numerous articles on fee schedules reducing costs.

The following is a sample of the WCRI study’s findings: (directly from their website)

Prices paid for a similar set of professional services varied significantly across states, ranging from 26 percent below the 35-state median in Florida to 158 percent above the 35-state median in Wisconsin in 2017.
States with no fee schedules for professional services had higher prices paid compared with states with fee schedules—39 to 168 percent higher than the median of the study states with fee schedules in 2017.
Changes in prices paid for professional services exhibited variation across states, spanning between a 17 percent decrease in Illinois and a 39 percent increase in Wisconsin over the time period from 2008 to 2017.
Most states with no fee schedules experienced faster growth in prices paid for professional services compared with states with fee schedules—the median growth rate among the non-fee schedule states was 30 percent from 2008 to 2017, compared with the median growth rate of 6 percent among the fee schedule states.

I think we can draw a direct conclusion from the studies by NCCI, WCIRB, and especially WCRI. States can only help themselves by enacting and properly adjusting their workers compensation fee schedules.

Filed Under: fee schedule Tagged With: Arizona, California, colorado, Fomenko, Illinois, Kentucky, Massachusetts, NCCI, North Carolina, Rebecca Yang, Texas, WCIRB, WCRI

$250,000 Claim Reserve Level – Why Is that Number So Important?

June 15, 2018 By JL Risk Management Consultants

$250,000 Claim Reserve Level Creates Many Critical Responsibilities

The $250,000 claim reserve level causes many necessary actions. Some of them are obvious. The other not-so-obvious actions are just as important.

Picture of Turkish Money $250,000 claim reserve level

Public Use License with permission

Please note that the Reinsurer and Excess Insurer are the same for this article.

Usually, a claim that reaches this level involves Vice President or Examiner approval to input the reserve into the system. The checklist action plan can be enormous at this level to the claims adjuster.

Some of those tasks are:

Reinsurance reporting – This area can slip by if one is not careful. The $250,000 claim reserve level will likely cause some type of flag to the reinsurer. It never looks good if the reinsurer has to ask the claims staff for the report. The reinsurer should have some prescribed report they wish to receive at the $250,000 and higher claim reserve levels. Each reinsurer may require a totally different type of report.

Employer reporting – Completion of this task needs to occur before they reserves are entered into the system. Apprising an employer of this reserve level will save many headaches in the future. Many times we receive loss runs where a large reserve exists on the file with no explanation.

Assigning to Field Case Manager or Rehabilitation Nurse – When a file hits the reserve level, better late than never to assign out a rehabilitation nurse Is there any reason to not assign it out to one? Medical control is mission critical along with a strong return to work plan. The rehab nurses are one of my favorite risk management techniques.

Subrogation Liens Must Be Covered – An interesting fact from a report by Mark Walls of Safety National is 24% of all huge claims in their inventory result from automobile accidents. Obtaining a police report is an easy task. Do not be the adjuster that forgets to cover their subrogation. We see no effort to pursue subrogation in files quite often. Writing a subrogation lien letter takes such a short amount of time.

Employer Involvement – Claims that reach this level must be followed closely by the employer. Did you send the employee to your carrier or TPA’s recommended industrial-minded physician? Do you have a modified duty job available? Are you in contact with the injured employee and keeping up with their medical treatment? What restrictions does the injured employee have at this point? An active employer usually reduces the cost of the claim while providing their injured employee with the best care.

These are a few things to cover when a claim is initially set or increases to a $250,000 claims reserve level.

Filed Under: Reserves Tagged With: excess insurance, rehabilitation nurses, reinsurers, subrogation

WCIRB Pure Premium Rates Are Not Insurance Carrier Rates

June 12, 2018 By JL Risk Management Consultants

WCIRB Pure Premium Rates Not The Same As Workers Comp Insurance Rates (Usually)

The WCIRB pure premium rates generated a few calls over the last two weeks. Insurance companies file their own loss cost multipliers or LCM’s that deviate from those rates.

question mark wcirb pure premium rates in circle

Wikimedia Public Use License

The WCIRB (Workers Compensation Insurance Rating Bureau) is the rate bureau for specifically California.

The insurance carriers can increase or decrease their rates from the WCIRB pure premium rates. The WCIRB pure premium rates are also referred to as advisory rates.

A definition of advisory pure premium rates by the WCIRB: (See this online PDF File for a Rate Filing Example. )

Pure premium rates, which reflect loss costs including loss adjustment expenses per unit of exposure, are only advisory and insurers are not required to use either the proposed or the approved pure premium rates in establishing the rates it will charge.

The WCIRB pure premium rates have to be approved by the Insurance Commissioner at a rate hearing. The Commissioner has rejected any pure premium rate increases in the past.

The one great development is that companies are researching their policy information. Reading your policy is the first step in reducing your Workers Compensation premiums.

Please note that I am only referring to the rates. I am not referring to the Classification Codes. If your company has what you feel are inaccurate classification codes, those may be disputed. And where do you find the procedure? Yes, that is right – in your Workers Compensation policy.

The Insurance Commissioners in all states require that it be in every policy. No, really – it exists inside your policy.

The pure premium rates are reviewed for changes constantly by the WCIRB’s Actuarial and other committees. The WCIRB publishes any rate change recommendations on their website in various reports. The reports are usually produced on a semi-annual basis.

You may want to surf their website for more subjects beyond the WCIRB pure premium rates.

Filed Under: pure premium rate Tagged With: Class Codes, classification codes, LCM, WCIRB