Health and Workers Comp Insurance Ripe for Combination
After finishing up the recent article on indemnity-only claims, one of the questions that I have had for years is “when will health and workers comp insurance combine into one line?”
This question was covered a few times in prior articles such as 24 hour coverage and the ease that the Affordable Care Act would have had in adding the two coverages together.
Just before the pandemic, this article covered how the combo idea was in the rearview mirror.
Now, after the indemnity-only article linked to earlier, 24 hour coverage may be again up for debate. The passage from the combined workers comp rating bureaus’ study on the effect of the pandemic that made me write this article was:
A typically small claim, representing a few weeks of indemnity payments. Examples include mild cases where a positive COVID-19 test was not reimbursed through WC, quarantine claims (where covered), and/or claims where the medical was paid by another payer.
NCCI presented at AIS 2022 that indemnity-only claims accounted for almost 50% of the COVID-19 claims.
Past Attempts at Combination
Carve outs were an attempt to combine health and workers comp insurance. The AFLAC model is an example of where health and indemnity benefits are paid simultaneously.
The last big initiative to for 24 hour coverage was Colorado’s Amendment 69 which was overwhelmingly voted against in 2016. The amendment would have created ColoradoCare. Coloradans voted almost 3 to 1 against establishing this program. (Wow)
Now, with the added impetus of workers comp claims partially being pad outside the system, should the discussion start again as to why or why not health and workers comp insurance should be combined into a monoline?
Bottom Line – Future Health and Workers Comp Insurance Changes
As I have advised many times in past articles, anyone attached to the workers comp industry should be ready for changes. One only has to point out how many insurance industry workers now work entirely from home? Could you have seen that twenty years ago? (No)
I am a huge advocate for “outside the box” training such as subrogation and now probably health insurance. Workers comp personnel may have to become more specialized in health insurance would be my crystal ball projection.
If you are an agent, adjuster, or anyone that requires a license to handle property and casualty insurance, health and workers comp insurance requires two different licenses – one wonders why.