What is an Experience Modification Rate and How Does it Effect My Business

Posted on November 14, 2014 by Curt Sieve

Your Experience Modification Factor (also known as the Experience Modification Rate)  will only apply to your workers’ compensation policy.

Your Experience Mod (X-mod) compares your workers’ compensation claims experience to other employers of similar size operating in the same type of business. Table with an example of an Experience Modification Rate If you have fewer claims than other companies of the same size and industry you will receive a higher Experience Modification Rate. This ratio is used against your annual premium and results as a discount. Experienced companies that monitor their workers’ compensation premium understand and utilize their Experience Mod annually. Understanding your experience modification rating and monitoring is another area in which you can reduce your Workers’ Compensation rates and costs.  Companies who effectively manage their Safety Programs not only understand how this works but also have assigned someone to monitor this on a regular basis.

It has a direct correlation to how much you pay in Workers’ Compensation Premiums. 

Where to find what your Experience Modification Rate is You will receive an updated Experience Modification Rating Sheet each year prior to your policy renewal date. Your Experience Mod is also listed on the declarations pages of your workers’ compensation policy but this will reflect last years Mod rate. You will want to contact the NCCI directly or your respective State Insurance Bureau and they will send you a copy of your new rate, which will be used for this years premium cost. Most companies whose annual premium are in excess of $5,000 and have been in business for more than 3 years will receive an Experience Modification Rate.

The requirements could vary per state and will if you have an individual Bureau that handles the rating outside of the National Council on Compensation Insurance (NCCI). Each year insurance carriers report to the calculating agency your class codes, payrolls and losses for the last five years.

The computing agency uses three complete years of data ending one year prior to the effective date of the rating period. For example, a rating in 2013 normally will not use 2012 but would include 2011, 2010, and 2009 in the formula. Don’t forget about your current years claims.

These usually present the greatest opportunity for cost reductions. Remember this years claims will affect your Experience Mod next year. How claims affect my Experience Mod Medical-only claims Workers compensation claims that require medical treatment only are usually less severe so employers should not be penalized when they occur. Consequently, any medical only claims are reduced by about 70% before they enter the formula.  You can take advantage of this by ensuring that injured employees remain at work when possible or return to work within the waiting period.  This is where an effective claims management and return to work program can have a dramatic effect.

Lost time claims The first $5,000 of a lost time claim is counted at full value. The dollar amounts after $5,000 is discounted. There is also a large claim cap limit to protect you from a catastrophic loss. Because the first $5,000 of each loss goes into the formula dollar-for-dollar, severity is a factor.

A single claim valued at $20,000 has less effect on your Experience Mod then 10 claims valued at $2,000. Companies seeking to minimize their workers’ compensation premiums should focus their safety efforts on reducing the frequency of lost time claims.

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Where to Begin When Writing a Safety Program

Posted on September 14, 2014 by Curt Sieve

A formal safety program is a set of written documents that describe a company’s safety policies, priorities, and responsibilities.  The program is designed to bring structure and consistency into a company’s accident prevention efforts.  Without a written document, your safety program might be like a construction crew without a blueprint, or a factory without a production plan. Making sure that everyone who comes to work leaves at the end of the day in the same good condition as when they arrived should be a goal of every company whether its an office based environment or a construction site.

Each different place has risks and hazards that can cause work related injury.  A safety program, whether it is formal or informal, will not succeed without unconditional management buy in. Whether or not the safety program succeeds or fails falls squarely on the shoulders of management and owners.  A consistent culture which makes it unacceptable to “throw caution to the winds” in the name of production, customer service, or profit, is essential to the welfare of the people and the company. 

This will have a direct result on Workers Compensation premiums The Following checklist is an outline, but not an end all solution. As with all checklists, this one is designed to identify important elements of a safety program.  Some elements may not be applicable to your operation, and, there may be others which you need which are not listed here. It is important to analyze your business by taking a day and going back through each function of your company to see if there are areas that need to be added to the program.  You should not assume that if all elements are implemented, that a complete safety program is in place. Only the management and ownership of an organization can determine whether or not a safety program is adequate to protect its people and property. As with everything you will need to conduct meetings from time to time and maybe even set up incentive based plans to ensure safety is always on the forefront of your employees minds.

  1. Regulatory Compliance and Recordkeeping
  2. Employee Involvement and Communication
  3. Safety Committee
  4. Inspections and Audits
  5. Human Resources Programs
  6. Hazard and Incident Analysis
  7. Special Safety Procedures (i.e. Safe lifting, First Aid, etc)
  8. Hazardous Materials
  9. Proper use of Equipment and Machinery
  10. Transportation and Fleet Safety
  11. Property Safety and Protection
  12. Responsibilities of Management, Supervisors, and Employees
  13. Safety Rules
  14. Disciplinary Policy
  15. Safety Meetings

This list is a grouping of basic categories that can get you started to forming your own Company Safety Program.

Most carriers and agents should be more than happy to help you set one up as well. Remember why a written safety program is important. As workers, we need to know what is specifically required of us, to perform our job safely.

As supervisors, we need the tools and guidance to help us manage a safe production process.  As management, we must continually protect the workforce because it is our greatest asset. A tremendous hidden benefit of a well designed and ran Safety Program is the reduce premium required for workers compensation insurance. Reduce your claims and your experience modification factor will decrease overtime.

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EPLI Coverage

Posted on February 21, 2014 by Melinda Langworthy

A fast growing product in the insurance markets is employment practices liability insurance (EPLI).  EPLI is a relatively new form of liability insurance. It provides protection for an employer against claims made by employees, former employees, or potential employees.

EPLI covers discrimination (age, sex, race, disability, etc.), wrongful termination of employment, sexual harassment, and other employment-related allegations. It covers your entire firm, including its Directors and Officers.

As soon as a company starts to hire employees, EPLI should be purchased. Most investors and directors will require that you carry this coverage as part of your Directors and Officers Liability Insurance since they can also be held liable in suits relating to employment practices.

An EPLI Suit can happen to any company. It could be a joke told in the break room, an employee you had to fire, or a person you chose not to hire. Every employer faces the reality that it will be the target of legal action from past, present, and prospective employees. Even if the claim is groundless or fraudulent, the defense of a suit can be expensive in time, resources, and financial cost.

In the mid-2000’s, EPLI was still predominantly a product only large companies purchased.  Employees suing an employer do so, largely, to get the substantial financial awards associated with settlements. The range of small business cannot sustain a quarter-million-dollar award and stay in business.

Price reductions in 2005 by many insurance carriers helped the growth of EPLI for companies with 50 or fewer employees who chose to purchase EPLI coverage.  EPLI insurance pricing is usually built on a formula based on employment size and industry.

For the first 50 employees, a target premium would be around  $400 annually; however a minimum premium of $1000 is more likely for many industries.

Analysis of annual claims totals suggests that EPLI claim rates correspond to unemployment rates.  From 2007-2008 total claims jumped 13% as mass layoffs increased by roughly a third.  In 2012, charges of retaliation, race, and sex discrimination (including harassment and pregnancy) were the most common types of discrimination.

If you’re considering an EPLI policy to help protect you from massive overtime claims from workers who say they were misclassified, forget it. Insurers still aren’t covering wage-and-hour claims. EPLI language usually excludes coverage for claims under the federal Fair Labor Standards Act “and similar state laws.”

Something to watch for is third party liability.  EPLI generally covers three types of claims: 1) wrongful discharge, 2) unlawful discrimination,  and 3) unlawful harassment.

Under most EPLI policies, the “wrongful act” must arise from an “employment practice” as defined in the policy and an “employee” must make the claim. Some insurance carriers are adding new coverage to the EPLI policy, third-party coverage. Simply put, third-party liability extends potential claimants to include anyone (i.e. customers and vendors) who has contact with the business or its employees.

All that is required for a third party to bring a claim is harassment, coercion, or discrimination of the third party by the insured. No employment relationship need exist between the claimant and the insured. Certainly, this was not the intent of the EPLI policy. The objective was to insulate employers from the increasing number and costs of employment suits. However, given the changes in the marketplace, this coverage is being offered more readily and merits some attention and understanding.

All companies should assess whether EPLI coverage makes sense for them.  The best protection of all is to have good policies and practices in place, stay familiar about employment matters.  When issues arise be proactive and preventive it will go far in limiting cost, exposure and liability.

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New Mexico’s Workers Compensation Problem

Posted on February 21, 2014 by Alex McFarland

Getting injured on the job is a risk that we all take as employers and employees. Workers Compensation Coverage is coverage that will protect all parties involved from the owner of the company, to the injured worker. If you do get hurt and there is coverage in place, you as the worker, will not have to pay anything for urgent care, rehabilitative care, and in some instances, would receive a portion of your pay if you were not able to return t work in a timely manner.

New Mexico's Workers Compensation

What happens if you get hurt at work due to being under the influence of drugs or alcohol? In the state of New Mexico, you are still covered by the vague wording of a law. Regardless of if you test positive for alcohol or illegal drugs, you are still able to qualify for New Mexico Workers Compensation benefits if you re injured on the job. Period.

In the next couple of weeks, New Mexico is going to try and introduce a bill that will close the door on the prior loophole, in the hopes to save those with workers compensation coverage and insurance companies thousands of dollars in claims each year.

According to Builders Trust of New Mexico, workers compensation claims are 20% higher in New Mexico than the national average, and premiums are increasing up 4%, while premiums in 19 other states are falling. (30 states rates have remained the same or increased.)

As it is written now, NM Workers Comp claims may be denied only if drugs or alcohol were the only factor in causing and work place accident. As a result it is extremely difficult to deny a claim because there is almost always another factor involved in a work place injury.

For any bill that does not involve revenue or appropriations must be requested form the governor for it to be debated, but as of this, the governor had not yet confirmed this would be on the agenda.

Washington State and Colorado have both made recreational marijuana legal in 2014, it will be very interesting to see just how many other states legalize recreational marijuana. This could require all states to refine and amend their workers compensation laws to change. Only time will tell.

Get more information about New Mexico workers compensation insurance or get a quote.

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Oklahoma Supreme Court to Review New Workers Compensation Laws

Posted on January 15, 2014 by Shannon Dye

The new laws that are set to take place for Oklahoma workers next year are being argued as unconstitutional.

Oklahoma Workers Compensation Reform

Attorneys are set meet with the Oklahoma Supreme Court on December 10th to present their case. They will be arguing that the new state law to create an administrative workers compensation system is biased and not business friendly.

Proponents for the new laws claim it is needed to make Oklahoma more business friendly, reduce costs for businesses, quicker turn around time on claims and will ensure that injured workers are treated fairly while being provided the medical care needed to return to work.

The new law would allow employers to opt out of the system as long as they provide equivalent benefits to injured workers.

Opponents of the law state that the new laws are unconstitutional for the following reasons:  the opt-out section of the law treats some employers and employees differently from others, combining multiple topics on a single bill and many other provisions as well.

The big question now is, how is  Oklahoma going to handle worker’s compensation cases? The Governor of Oklahoma, Mary Fallin, stands behind the new laws and does deem them as constitutional. Gov. Fallin has made the following statements:

“For decades, Oklahoma has had one of the most expensive and inefficient workers’ compensation systems in the country, a constant obstacle for business owners looking to expand operations or create more jobs,” the governor said at the time.

“Senate Bill 1062 completely overhauls our flawed workers’ comp system, dramatically reducing the costs to businesses and freeing up private-sector resources that can be invested in jobs rather than lawsuits. Additionally, our reforms ensure injured workers are treated fairly and given the medical care needed to return to work.

“This is an important pro-growth policy that will help us attract jobs and build a stronger and more prosperous Oklahoma.”

These statements have caused a stir with state senator Harry Coates and representative Emily Virgin along with the Professional Firefighters of Oklahoma.

“As a longtime businessman, I recognize that it’s necessary to have workers’ compensation rates as low as possible. In fact, I believe we need a workers’ compensation administrative system, just not the unconstitutional and unworkable system created by Senate Bill 1062,” Coates said at the time.

“It’s wrong that a firefighter or any other injured worker should have to pay back benefits after returning to work. This is just one of many problems with this new law.”

Oklahoma is in direr need of workers compensation reform. The program is out dated, expensive and the process is slow. While the new bill does include some great requirements, it does not appear to have the best interest of the injured workers included in the bill. The new bill is flawed and does need to be revised but can the 2 sides come to an agreement to create a new bill that will satisfy the business owners and employees? We will have to stay tuned as we watch this play out on December 10th.

Buy Oklahoma workers compensation insurance today.

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MIssouri Workers Compensation Rates Likely to Rise in 2014

Posted on January 15, 2014 by Shannon Dye

Missouri business owners can expect to see an increase in their MO workers compensation rates in 2014. The rates will likely increase by 11.6% in “loss costs” for anticipated 2014 claims. The National Council on Compensation Insurance (NCCI) filed the request with the Missouri Insurance Department on Aug 30th, 2013.

These are not formal rates for MO but are used by carriers to determine their rates for an upcoming year.

The NCCI attributes 7.6% of the proposed increase to the experience portion of loss costs. After showing steady improvements after reforms were passed in 2005, the loss experience in Missouri has been worse than expected for the past two years. An NCCI summary of its filing said the state is experiencing growth in both the number and size of large losses — those defined as greater than $500,000 — as well as growth in the number and size of large losses exceeding $3 million.

In regards to claims, medical costs contribute to 63% of the benefits paid out. Medical costs have increased drastically and do not show signs of decreasing any time soon. Indemnity claims only contribute to 37% of the costs.  Brent Butler, the government affairs director at the Missouri Insurance Coalition, said ” Missouri remains the only state without a prescription drug monitoring system, the lack of which could lead to greater medical costs and insurance rates because the situation leaves Missouri insurers prone to abuse by opioid addicts.”  This could be one explanation to the huge increase in medical claims for the state of Missouri.

Another reasons for the increase is due to Missouri’s troubled Second Injury Fund.

A law that took effect this year is meant to help bail out the strapped second injury fund by, shifting some of the claims from the fund to the worker’s compensation system.

The law also allows Missouri officials to increase a surcharge on workers compensation premiums from 3% to 6% in 2014 to go towards the second injury fund.

There has been an increase in the amount of claims that are $500,000 or more. Meaning that Missouri insurer’s have had to pay out a significant amount. The frequency of these large claims are more than what the second injury fund brings in. Which is part of the reason that the second injury fund is in trouble.

It is highly recommended that Missouri business owners review their policy’s in 2014 to ensure that they are getting the possible rates. With a projected 15% increase, you almost can not afford to not shop your policy.  At Workers Compensation Shop.com, we’re experts at insurance and would be happy to provide your business with numerous Missouri workers compensation insurance quotes.

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California Senate Bill 863- Impact on Workers Compensation Insurance Premium

Posted on January 15, 2014 by Tim

Everyone in the workers compensation industry has been following California’s legislative debates and work on Senate Bill 863. This goal of the bill was to help resolve some of the issues plaguing workers compensation in CA.

Insurers in California have been struggling to write workman’s comp profitably for several years now and the industry has been running a combined score well into the 1.20’s to 1.30’s. Simply put, a combined score is the ratio of money an insurer pays out for every $1 it takes in. It’s the same principle as if you handed me $1 right now and I gave you back $1.25 — that won’t keep me in business for very long.

That’s what’s happened in California in recent years, and a few insurers have gone bankrupt as a result. Why is that bad for the employers in California? Because this means that there are fewer valid markets willing to write workers compensation in CA today than there were a few years ago. The law of supply and demand applies, and with fewer carriers and known industry losses, the rates have been going up significantly.

So, that’s where we get Senate Bill 863. The bill attempts to make significant changes to several areas of payments on workers compensation claims. Here are some of the key aspects addressed:

  • Increases permanent disability values
  • Simplifies the permanent disability rating method
  • Resolves medical treatment disagreements through independent medical review
  • Resolves bill payment disputes through independent bill review
  • Simplifies the supplemental job displacement voucher system
  • Requires payment of a filing or activation fee for liens
  • Improves medical provider networks
  • Updates the Official Medical Fee Schedule
  • Establishes fee schedules for copy services, interpreters, vocational experts, and in-home health care
  • Provides additional payments for workers with disproportionate wage loss.

It’s actual impact has yet to be known and carriers aren’t confident that this will be a major change in the ultimate pricing — at least not immediately. Many carriers do expect at least a few pieces of the legislation to have a positive impact.

The independent medical review (IMR) was established to provide a quick, efficient way of resolving medical treatment disputes. The goal is to reduce the timeline on disputes for treatment of injured workers to about 40 days. This system has been fully in place since July 1, and carriers are seeing results.

“The IMR process is proving effective and is keeping medical decisions out of the hands of the courts,” the insurer Employers Insurance said in a written statement regarding SB 863. “71% of reviewed IMR cases for the industry have resulted in denial of treatment. We expect to see a positive impact on medical payments as these accelerate.”

Employers said that Maximus (the IMR organization) is overloaded with requests currently and they are behind the timeline goal, but they think that backlog can be cleared by the end of the first quarter of 2014.

The impact on lien decisions is still very much up in the air. To this point, the courts are holding to the intent of the new law and firmly dismissing cases where no filing fee is paid without requiring a petition from the defendant. However, there was a recent court decision that placed an injunction on the activation fees for legacy liens, which will result in those liens remaining in the system and force carriers like Employers to settle/litigate many liens that they had expected to be dismissed under the new legislation.

The permanent disability changes are still too new to tell whether carriers are being impacted by these changes. Employers feels it can start to accurately evaluate this portion of SB 863 by June of 2014.

Given the scope of influence this bill has, I do believe it can have a positive impact on the California system. This may create a slow change in pricing and carriers’ willingness to insure employers in CA, but it is at least a positive first step toward bringing work comp prices back in line with the majority of the country.

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Workers Compensation Hardening Market and Quoting Options

Posted on January 14, 2014 by Justin Bartmess

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Missouri Workers Compensation in 2014

Posted on January 14, 2014 by Josh Frerking

As we begin the new year, many business owners have something else on their mind. With health care changes coming into effect on 01/01/2014 that’s not all that will be changing.

In Missouri, workers compensation is going to see some big shifts from what we had last year. The big shift is another year of rate increases, which has been evident of the hardening of the insurance marketplace in Missouri as well as hopes of opportunities to come.

Missouri Workers Comp Insurance

The state of Missouri is seeing one of the nations highest rate increase recommendations in the country with  NCCI (National Council on Compensation Insurance)  recommending over a 10% increase for workers compensation rates.

This can be a result of many factors and most likely a combination of them all. Part of it is a natural “hardening of the marketplace” whereas all carries are seeking to increase rates.  This is partly needed to offset higher than expected loss ratios during the past few years as well and to increase profitability in general.

There is no question the marketplace for workers compensation is a night and day difference than it was just 2 or 3 years ago. Prices are not the only thing that have changed, despite seeing a strong market hardening nationwide we have seen good, profitable clients see 20-30% rate increases throughout the country.  Insurance company appetites have been even more invasive on the marketplace than the price has. For some small businesses, their insurance policy can be the difference between getting a project or not.

The cost of a policy being non-renewed for some high-risk industries can sometimes mean the business not having any other options besides the state fund pool, which can oftentimes be crippling for a company. Many employers in Missouri have a local Mutual company to thank for keeping their doors open in times like these and that company is Missouri Employers Mutual.

With an aggressive approach to loss prevention, safety training and proactive claims management this insurer has found a way to offer coverage for a lot of businesses that would otherwise be left stranded or forced to go to the state fund.

Despite seeing another rate increase with many carriers this year, we do have a lot to be thankful for here in the Show-Me State. In 2012 we were ranked 36 out of 51 (including DC) for the highest rates ranking putting us at lower average rates than 70% of the country.

The state of MO is working towards resolving issues with the fiscal mess of our second injury fund.  The rate increases carriers are expecting for the upcoming year have generally not been over the 10% increase recommendation and have also included the 3% Second Injury Fund increase which comes from the attempt to fund the Second Injury Fund in Missouri.

A move for confidence which hopefully clears up a black eye on the system and helps boost efforts for business growth in Missouri for the upcoming years to come.

With these kinds of increases in premium rates, business owners are not the only ones who notice this change. The increase in premium can also factor how many carriers are competing for your business. Carriers know that this will cause many businesses to shop their insurance which is good because a carrier that last year thought the risk was just a little higher than the premium might now say “ok” and you now have one extra carrier competing for your business.

Or if you have your coverage through the State Workers Compensation Fund in Missouri that 10% increase in premium rates might be the difference maker to get a competitive market carrier to quote for you which many times could show a savings of 20% or more in your premium.

If you have your policy with the state fund in Missouri make sure you call an insurance agent to shop your workers compensation because this is one way this rate increase for everyone else could be great news for your company.

The long and short of this is that we will see some changes and increases come to many companies in the Missouri workers compensation marketplace during 2014.  This is a natural occurrence with any industry not just Insurance, however the best way to prevent this is to make your company the most desirable of an investment to the insurance market as possible.

The Missouri market has done a good job of this for our state as a whole as we have a lot of carriers who are being more aggressive here than they are throughout other states in the country. Setting your business apart in this way will help make these companies compete for your business and give you the best rates possible.

An independent insurance agency like The Insurance Shop can help advise you on how to make your more desirable to get the best rates possible in Missouri.  Get workers compensation insurance today.

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I Saw That Injury Coming

Posted on January 14, 2014 by Josh Frerking

As an insurance agent I am trained to think of the worst case scenario and plan for it. The insurance business is no question a numbers game which comes down to doing everything you can to prevent accidents from happening in the first place.

Many of you have probably seen the articles about the top 10 most dangerous/deadly jobs in the US or something similar.  These are good news worthy jobs, showing high danger statistics the areas we typically look. They all really look fun, like fishermen, Loggers, Farmers and Truck drivers. Ironically all of which have had some sort of reality TV show in the past couple of years.

As an insurance agent, I like to watch these shows but maybe I’m not the super macho man you expect on Axe men or Ice Road Truckers (My dad is a trucker though…. does that help?). I like the exciting life of the office. 75 and Sunny year round, no chance of a 1,000 lb animal trampling me or falling off a boat into sub zero water just so some guy can have a crab cake on his lunch break. I chose a life with the simple “safe” route or so I thought…

Obviously dangerous jobs come with their typical hazards, but lets face it; most of us don’t face a high danger type of work environment on a daily basis. I am talking to you Mr. call center, or bookstore, attorney’s office or online insurance agent. Reality shows help us realize how safe we really are and the great work environments most people get to deal with in the safe controlled environments we are in. The problem is, we get distracted and forget about some of the simple dangers that really do make up a large portion of workplace injuries throughout this country.

Here are a few that are common types of injuries that can be noticed in most everyday jobs:

Motor Vehicle Accidents–

One of the leading causes of workplace related injuries and workers comp claims is from vehicle accidents. This is something that many of us may do from time to time or every day as part of our daily work tasks. This is huge for several reasons; cars go fast, people don’t always wear safety equipment and some people are bad drivers. The worst part about these is you can do everything write as an employer and have the best employee driving and an accident can still happen even if its not your fault.

Slip and Fall-

Anyone who has a business where your customers come into your facility are often worried about slip and fall hazards for their customers. It’s a bad situation, you have a customer injured, they probably wont come back to your business and they will probably cost you money either directly or indirectly. These can be similar hazards for an employee that works for you. This risk can be reduced through policy  implementations such as making sure your employees have the proper non-slip shoes, keeping up on everyday housekeeping duties to prevent the slipping areas  in the first place and being cautious of potential hazards as well.

Overexertion-

This can be from moving, lifting, and  pulling type of activities. Something as simple as an employee lifting a box of files from a shelf could strain their back, shoulders, hip, knee, neck etc each of these potentially turning into thousands of dollars in medical payments and lost wages. Overexertion is often one of the most expensive injuries because it can literally happen to just about anyone.

I work with many businesses everyday to help them lower their workers compensation premiums. I always recommend that you put in a safety plan, drug free workplaces, slip resistant flooring, driver training program, etc.;  but the implementation of these programs are what make it successful. I outlined 3 types of workplace related injuries that can happen to most people in most types of business. Consulting with an insurance agent like the ones at The Insurance Shop can help identify some other more specific hazards your company might encounter as well to help keep the workplace safe and minimize the cost of your workers comp insurance.

Give us a call today at 888.611.7467 for a free consultation and insurance quote.

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