Term Of The Day – Carve Out
Workers Comp Carve Out tis a hybrid benefit package that applies to just the Workers Comp Policy.
An option allowed in some states, including California, where an employer and the union for the employer’s workers agree to collectively bargain a separate schedule of Workers’ Compensation benefits. This schedule of benefits differs from the statutory program imposed by the state.
Certain states do not allow this type of program as they wish to have uniform Workers Compensation benefit rules and laws. According to the State of California Department of Industrial Relations a key feature of most carve-outs is an alternative dispute resolution process.
The goals of a carve-out may include:
- Improve safety programs and have fewer injury and illness claims.
- Increase access to quality medical providers and medical evaluators.
- Lower costs of medical care.
- Reduce disputes.
- Improve collaboration between unions and employers.
- Increase satisfaction of all parties.
- Provide the opportunity for continuous improvement by renegotiating the terms of the carve-out on an as-needed basis.
California’s programs are geared towards the construction industry. Everything that exists in a carve out program should be pre-negotiated including a list of treating physicians and how to handle disputes between parties.
Adjusting claims for these arrangements requires the adjuster to follow a predefined set of rules that may differ from regular Workers Compensation adjusting.
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