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June 2011

Is CMS Overpricing Workers Comp Future Pharmacy Benefits?

Is CMS Overpricing Workers Comp Future Pharmacy Benefits? Does the CMS inflate Workers Comp future pharmacy payouts?   A trend in Workers Comp claim settlements is slowly changing the landscape of closing out files. Many insurance carriers, TPA’s, Captives, etc. are rejecting the Center for Medicare/Medicaid Service’s (CMS) valuation of

Workers Compensation Is Zero Sum Game

WC Is A Zero Sum Game Of Sorts I often advise investment groups when they look to invest in the Workers Compensation market – namely ancillary services such as Medicare Set Asides, Physical Therapy (PT), PBM’s, etc. One motto I have stuck with over the years is the Workers Compensation is

Monopolistic State Funds vs Competitive State Funds

Monopolistic  vs Competitive State Funds All competitive state funds are a hybrid sort of insurance carrier. A few weeks ago, I posted on whether State Funds are necessary for Workers Compensation coverage. One of the blog readers posted a response which pointed out that State Funds should be analyzed by

Workers Compensation Premium Audit Bill – Your Four Choices

Four Choices For A WC Premium Audit Bill Over the years, we have received the most communications from employers when a premium audit bill has hit their desk and the payment is now due. Often, the bill has been sitting for a few weeks and the insurance carrier is now

Workers Compensation Safety Programs – Are They Really Worth It?

Workers Compensation Safety Programs – Best Way To Save $$$ Workers Compensation safety programs are always worth the expended funds.   One of the areas that employers seem to sharply decrease their budgets during economic downturns is safety. As Treasurer of the NC Mid State Safety Council, I can attest

Four Workers Compensation Success Measurements

Four Workers Compensation Measurements Of Success My last post had covered the four Workers Compensation measurements of success or failure. Instead of combining both voluntary market and self insureds into one post I thought it best to separate them into two posts. The four measurements of success for the voluntary

Workers Comp Success (or Failure) Bottom Line Measurements

Workers Comp Success Bottom Line Measurements Workers Comp success (or failure) bottom line measurements are readily available for employers.  I have read on a few blogs and received questions recently concerning how a Workers Compensation program can most easily measure its success or need for improvement. This is a very

Assigned Risk Pool With a .85 E-Mod – How Can This Happen?

Assigned Risk Pool E-Mod With A Low E-Mod The Assigned Risk Pool looks like a failure even with a low E-Mod.  I recently received two calls on a very sore subject with certain groups of employers. One exact question was – How in the world can my company be placed

Very Important Upcoming Date For January 1 Policies

Important Upcoming Date For January 1 Policies Renewal Over the last few months, I had been covering a plan on how to reduce E-Mods. The important upcoming date for January 1 renewals is your Unit Stat date. The Total Incurred (Paid + Reserves) is tallied six months after your policy

Two Questions on EMR From One Of Our Readers

Two Questions on EMR One of our readers had  two good questions on EMR. I often see you write about the E-Mods or X-Mods in your blog. Is an EMR the same thing as the E-Mod? This was a good question from one of our newsletter readers. The Workers Compensation

Workers Comp Costs – Six Quick Methods To Start Reduction

Six Quick Methods To Lower Workers Comp Costs (Part I) The Six Workers Comp Costs reduction methods are listed in two articles. My last article post pointed out that there are six ways to save on Workers Comp costs. They are:   1. Filing First Reports of Injury (FROI) Timely

Three Ways Experience Mods Can Penalize Your Company

Three Ways To Penalize Your Company’s Experience Mods Actually, E-Mods (X-Mod, Ex-Mods) do not actually directly penalize your company’s Workers Compensation premiums. However, there are a few situations where your company’s E-Mod can experience a very sharp increase. I thought I would list three. There are others. Having numerous claims

Three Top Ways Experience Mod System Can Help Your Company

The Experience Mod System’s Hidden Good Side The Experience Mod system can actually silently help your company. The Workers Compensation Experience Modification Factor (E-Mod/X-Mod/Ex-Mod) system can seem complicated and cause very high premiums at times. Three times over the last few weeks, I have heard or read different inaccurate comments



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