• Home
    • Workers Comp Audit Stress Reducer
  • About Us
    • Cutting Workers Comp Costs – About Our Company
    • President – James J Moore, AIC, MBA, ChFC, ARM
    • Safety Consultant – Glen DuLac
  • Work Comp Consultants
  • Free Info
    • Definitions
    • Free Speech
  • Testimonials
  • FAQ
  • Manuals
  • Six Secrets
  • Blog
  • Contact Us

J&L Risk Management Consultants

Work Comp reserve reviews premium audits for employers

icons
Call us today! 1-800-813-1386
WORKERS' COMPENSATION PREMIUM REFUNDS POSSIBLE.
Home » Archives for April 2016

Archives for April 2016

Colorado Workers Comp Single Payer Conundrum

April 7, 2016 By JL Risk Management Consultants

Colorado Workers Comp Single Payer Plan Up For Vote This Fall

The vote for Colorado Workers Comp single payer plan will occur this fall. One of the major components of a 24-hour single payer plan is that Workers Comp may no longer exist inside this type of health plan.Logo Of Colorado Workers Comp Single Payer Graphic

Universal health care will be on the ballot in a major move by single payer advocates.  ColoradoCareYes has gathered well over the minimum 100,000 petition signature to put single payer health on the ballot.

Why is the topic covered – it may be coming to a state near you as this is akin to the Oklahoma and Texas Opt Out Plans.

While this is not federalization of Workers Comp, the plan may look  similar to ObamaComp if it ever came into existence.   Colorado has been on the forefront of many issue lately including the non-medical legalization of marijuana.

Vermont disbanded their Universal Healthcare due to the overburden to the state’s budget.   One of the striking parts of the amendment is that even if a citizen has their own healthcare policy, they would still have to pay the Colorado Care premiums – ouch!

Colorado’s Amendment 69 would also address Workers Compensation- but the medical part only.  Employers would still have to buy indemnity only Workers Comp <<guessing a little on that one.  Would Colorado allow a plan such as AFLAC to substitute for an indemnity policy?

Pinnacol Assurance of Colorado, of course, came out against measure due to the severe increase in employer taxes.   Pinnacol functioned as a monopolistic type fund in Colorado for many years but then was privatized over the last decade.

Vector Colorado Workers Comp Single Payer EmployerIf Amendment 69 is voted in, then it will be an interesting time in Colorado at the end of this year.  All eyes will be on Colorado from both the healthcare and workers compensation industry.  The Colorado Workers Comp single payer conundrum will be in an operational mode.

How would a WC carrier write an indemnity only policy and how would they control the medical treatment that the indemnity payments center on for an injured employee?  There are so many WC questions with no answers.

©J&L Risk Management Inc Copyright Notice

Filed Under: Colorado Tagged With: amendment 69, colorado care yes, indemnity, Opt out, Pinnacol, single payer, universal healthcare

Workers Compensation Records Retention Question

April 7, 2016 By JL Risk Management Consultants

Workers Compensation Records Retention

The subject of Workers Compensation Records Retention is not as popular pre-2010 for some reason.   We do receive a question on this topic every few months.Vector Illustration Of Files Workers Compensation Records Retention Different Color

Workers Compensation mail headaches was covered a few years ago.  I recommend reading that older article.

We received the question – How long should we (employer) hold onto Workers Compensation records such as policies, premium audits, claims info, Experience Modification sheets, and other similar records?

That is a tough “overall” question to answer as each state has specific record requirements.  The length of time to retain records can vary greatly.

The best overall way to handle the records is to digitize them and keep them forever.   That does seem extreme.  However, there are many Workers Comp files where the “disease statutes” kick in once an injured employee “has been diagnosed” with an occupational disease.    Having claims records can be a make-or-break situation.

Document Workers Compensation Records Retention In DrawerAlso, when we perform any type of data analyses or forecasting, the more data there is into the past, the better that we can predict the future.  Business cycles of up to 20 years are present in much of the data we have reviewed for certain clients.

This kind of goes against the current actuarial position of the most recent data holding more weight than very old Workers Comp data.   Of course, this is a debatable point.

My advice to to retain all Workers Comp data permanently by digitizing it using a scanner.   A scanner is a relatively cheap investment.   Any of our clients that have Workers Comp data digitized has saved $$ on our services.

Most data arrives in digital form nowadays.  Copying it to a reliable thumbdrive that has security will always have your Workers Comp data at your fingertips.   Asking your agent to be a data storage provider is not the best advice.  Agents do retain limited data for quite some time.

A 128gb thumbdrive  such as the one in this article can be found for $35 or less.  That size will hold approximately 1,664,000 pages of scanned data.  Only having Workers Comp related data on the thumbdrive will save data retrieval headaches later.

Workers Compensation can be assigned to a certain person in the office to make sure all the data is in one place. Workers Compensation records retention can be an easy process unless you are searching for a piece of paper from 12 years ago.

Article provided by James J Moore, AIC, MBA, ChFC, ARM. All articles are original content. Check out the full website at www.cutcompcosts.com

Filed Under: records retention Tagged With: actuarial, scanner, thumbdrive

North Carolina vs Texas Formulary – WCRI Study

April 6, 2016 By JL Risk Management Consultants

North Carolina vs Texas Formulary Now Tabled Until 2017 and Beyond

A North Carolina vs Texas Formulary study by WCRI caught my eye a few weeks ago.  I decided to look further into the comparison.

WCRI Logo North Carolina vs Texas Formulary Text Graphic

(c) wcrinet.org

The state of North Carolina has tabled a Workers Compensation formulary until 2017 and beyond. Workers Compensation Research Institute (WCRI) had performed a great study last month comparing and contrasting a proposed North Carolina vs Texas Formulary.

As a side note, critics of eliminating informal medical networks in Texas had commented earlier as to a negative effect on their Workers Compensation system.

The main aspect of the WCRI study was how a closed formulary would have affected the supply and price of various medications.   WCRI used the Workers Comp figures available from state employees as the comparative database.

According to the study there were 183,000 prescriptions filled at a cost of  $29 million for the years 2012 – 2014.   The results were that under different scenarios, a savings of up to  $8.7 million would be incurred for the 14,000 state employees.

WCRI had noted that 23% of all  the North Carolina prescriptions were non-formulary accounting for 39% of the costs.    

An example of the astounding data in the study was –

For long acting  opioids 91% of the North Carolina prescriptions were non-formulary.   Topical analgesics which were non-formulary amounted to 99% of that type of prescription.

The enacting of any legislation has been tabled to the future.   From this study, one would have to say that the savings for North Carolina are there once legislated into action.

The very intensive study can be obtained from the WCRI here.

The CMS provided a great page on a discussion of formulary and non-formulary here.

©J&L Risk Management Inc Copyright Notice

Filed Under: WCRI North Carolina Tagged With: analgesics, CMS, opioid, WCRI

Workers Comp Adjusters – Feel Good Friday

April 1, 2016 By JL Risk Management Consultants

Video By Rising Medical Solutions Is A Pick-Me-Up For Workers Comp Adjusters

Picture Of Doctor Workers Comp Adjusters Holding FilesUnfortunately,  Workers Comp adjusters have been and will always face the brunt of the WC process.   I have often defended adjusters and the whole WC system against the likes of ProPublica and the general click-bait WC environment –  that is what we call social media of today.   The environment has gone for the lowest common denominator – the sometimes fallible WC insurance claims system.

I usually only read the opinions on claims originating from a person that has served some capacity in the WC claims side.    In other words, you have to ride in that saddle before you can talk about the horse.

The video is three+ years old.  Rachel Fikes and her group put together  as simple video.  Simple is good in most instances.  I first met everyone from Rising last May at a WC think-tank in Chicago.   They were a good group of people.  That was my first time for an extended stay in vibrant yet eclectic Chicago.

Rising Medical Solutions did not pay me any incentive for running their video.   Great marketing is indirect marketing.   The video is about Workers Comp adjusters and, in fact, the whole claims staff, and their valuable worth in the claims process.

So here is the link to the video – in fact, it has its own website.  Click here for the video.  Make sure you have the sound on for the full effect.

Sip your coffee or other beverage and enjoy.

©J&L Risk Management Inc Copyright Notice

Filed Under: workers compensation claims adjuster Tagged With: propublica, rachel fikes, Rising Medical Solutions

Email Subscription

Search this website:

Work Comp Claim File Audit ExpertWork Comp Expert WitnessWork Comp ConsultantRecommended Workers Comp Premium AuditorWorkers Comp Auditor-Loss Run XModworkers compensation refund specialist
Workers comp premium audit expertworkers comp expert witness auditorworkers comp consultant 8810
Top workers comp consultant NCCI blogRecommended workers comp expert WCIRB blogger

About Me

My Photo
James J Moore
Raleigh, NC, United States

James founded a Workers' Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L's mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers' Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James's educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James's articles or interviews on Workers’ Compensation have appeared in the following publications or websites: • Risk and Insurance Management Society (RIMS) • Entrepreneur Magazine • Bloomberg Business News • WorkCompCentral.com • Claims Magazine • Risk & Insurance Magazine • Insurance Journal • Workers Compensation.com • LinkedIn, Twitter, Facebook and other social media sites • Various trade publications

 

Recent Posts

  • Reserve Review Schedule – Are You Behind Or Ahead?
  • Insurance Academy – Presenting – Webinar Tomorrow 130 PM Eastern
  • XMod Formula Simplified(?) By California’s WCIRB
  • Asia Workers Compensation Error Correction On Old Post
  • Reevaluating Pain Management – Out Front Ideas Webinar April 10th
  • 2018 WCRI Conference – Top 10 Things I Learned Over Two Days Time
  • WCRI 2018 Conference Boston MA – Blogging It Live
  • 2018 WCRI Annual Data Conference Two Weeks Away In Boston – Going?
  • Opioid Study Shocker – Or Was It Really A Surprise Conclusion
  • 88th Annual North Carolina Statewide Safety Conference May 15-17 2018

Archives

  • April 2018
  • March 2018
  • February 2018
  • January 2018
  • December 2017
  • November 2017
  • October 2017
  • September 2017
  • August 2017
  • July 2017
  • June 2017
  • May 2017
  • April 2017
  • March 2017
  • February 2017
  • January 2017
  • December 2016
  • November 2016
  • October 2016
  • September 2016
  • August 2016
  • July 2016
  • June 2016
  • May 2016
  • April 2016
  • March 2016
  • February 2016
  • January 2016
  • December 2015
  • November 2015
  • October 2015
  • September 2015
  • August 2015
  • July 2015
  • June 2015
  • May 2015
  • April 2015
  • March 2015
  • February 2015
  • January 2015
  • December 2014
  • November 2014
  • October 2014
  • September 2014
  • August 2014
  • July 2014
  • June 2014
  • May 2014
  • April 2014
  • March 2014
  • February 2014
  • January 2014
  • December 2013
  • November 2013
  • October 2013
  • September 2013
  • August 2013
  • July 2013
  • June 2013
  • May 2013
  • April 2013
  • March 2013
  • February 2013
  • January 2013
  • December 2012
  • November 2012
  • October 2012
  • September 2012
  • August 2012
  • July 2012
  • June 2012
  • May 2012
  • April 2012
  • March 2012
  • February 2012
  • January 2012
  • December 2011
  • November 2011
  • October 2011
  • September 2011
  • August 2011
  • July 2011
  • June 2011
  • May 2011
  • April 2011
  • March 2011
  • February 2011
  • January 2011
  • December 2010
  • November 2010
  • October 2010
  • September 2010
  • August 2010
  • July 2010
  • June 2010
  • May 2010
  • April 2010
  • March 2010
  • February 2010
  • January 2010
  • December 2009
  • November 2009
  • October 2009
  • September 2009
  • August 2009
  • July 2009
  • June 2009
  • May 2009
  • April 2009
  • March 2009
  • February 2009
  • January 2009
  • December 2008
  • November 2008
  • October 2008
  • September 2008
  • August 2008
  • July 2008
  • June 2008
  • May 2008
  • April 2008
  • March 2008
  • February 2008
  • January 2008
  • December 2007
  • November 2007
  • October 2007
  • September 2007
  • August 2007
  • March 2007
  • February 2007
J&L Risk Management Consultants, Inc.
8366 Six Forks Road, Suite 101
Raleigh, NC 27615
(800) 813-1386
▲Return to top of page
Copyright © 2018 J&L Risk Management Consultants, Inc.

Website Design by Redwood [ Design - Print - Web ]