 |
 |
 |
 |
 |
 |
|
|
|
Around AASCIF |
Quick Links
|
|||
|
Around AASCIF is a regular feature of the AASCIF News. It briefly covers items of interest submitted by AASCIF members or gleaned from their websites, newsletters, and other published news sources. To ensure that your organization is included, send information to Patrick Andersen, c/o Communications—15th floor, State Compensation Insurance Fund, P.O. Box 420807, San Francisco, CA 94142-0807, (415) 703-7013,Fax (415) 703-7028, pwandersen@scif.com. Final deadline for submission is the first Friday of the second month of each quarter. AlbertaFollowing the decision of Mary Cameron to step down as President and CEO of the Workers' Compensation Board at the end of February, Board of Directors Chairman Rick LeLacheur agreed to act as interim President and CEO. An executive search firm will identify and interview candidates in the hope of locating a permanent replacement by fall. LeLacheur has served as president and CEO of Economic Development Edmonton and of the 2001 World Championships in Athletics. About four dozen gas and oil drilling companies joined the WCB in holding a week of safety programs and discussions with workers in January. Oil company CEOs visited frontline workers at oilrigs, refineries, manufacturing facilities, services centers and drilling operations throughout Alberta to promote safe practices and listen to workers' safety concerns. WCB figures show that 783 new lost time claims were filed in the oil and gas sector in the first 11 months of 2001, down 6 percent from the same period in 2000. British ColumbiaThe Workers' Compensation Board issued a new guide and series of ergonomic brochures designed to prevent injuries in the hospitality industry. In 2001 there were 6,500 accepted claims for the hospitality sector, exceeded only by the health care, construction and retail sectors. CaliforniaA 33-year-old man was sentenced to six months in jail for workers' compensation fraud, according to the Los Angeles Times. A former gardener for the City of Los Angeles, he claimed to suffer from a severe back and shoulder injury but was videotaped carrying furniture, a bed, boxes and a bicycle. In addition to the jail sentence, he was ordered to pay $61,000 in restitution. Gov. Gray Davis signed a bill increasing the maximum weekly workers' compensation benefits from $490 to $602. As a tradeoff for the increase – which according to various estimates will cost between $2.4 billion and $3.5 billion a year – the bill provides return-to-work incentives and other measures that the Department of Industrial Relations says could save businesses $1.5 billion per year. In a rare call for a mid-term rate increase, the Workers' Compensation Insurance Rating Bureau submitted a filing with the California Department of Insurance for a 10.1 percent increase in pure premium rates. The WCIRB said loss development had deteriorated to the point that the increases made effective on January 1 were already inadequate.
ColoradoWorkers' compensation premiums for some employers in high-risk industries are jumping as much as 30 percent, according to the Denver Business Journal. The turmoil has caused several insurance carriers to leave the state in the past two years, sending more business to Pinnacol Assurance, the paper reported. HawaiiThe Hawaii Employers' Mutual Insurance Company has moved to its new home. The street address is now 1001 Bishop Street, Pauahi Tower, Suite 1000, Honolulu, HI 96813. HEMIC's mailing address remains P.O. Box 3376, Honolulu, HI 96801. The phone numbers are unchanged except for the fax number for the administrative office, (808) 522-5510. The Hawaii Insurance Division approved the NCCI's advisory loss cost filing for new and renewal policies. The original filing proposed an increase of 9.1 percent but it was later revised to 4.1 percent for industrial classifications. Some physicians complain that they can no longer afford to treat injured workers because the reimbursement rates for workers' compensation are too low, reported the Pacific Business News. According to a study by the Hawaii Medical Association, the state's reimbursement level is the fifth lowest of the 39 states with workers' compensation fee schedules. Workers' comp reimbursement is set at 10 percent above the Medicare rate, which has decreased since 1995. MaineA Portland man who had collected workers' compensation benefits for a disabling back injury while secretly working as a carpenter pleaded guilty to tax evasion and mail fraud in U.S. District Court. According to the Maine Employers' Mutual Insurance Company, the man fraudulently collected more than $70,000 from 1997 to 2000. To make matters worse, the man failed to file tax return in 1997, 1998 and 1999, attracting keen interest from the Internal Revenue Service. While worker's compensation benefits are tax-free, they become taxable if they are fraudulently obtained; if the man was not reporting his income from his carpentry business to MEMIC, investigators reasoned that he might not be reporting it to the IRS either. In a case reported by the Bangor Daily News, a 41-year-old woman who had been collecting workers' compensation benefits since 1993 was seen dancing on a pool table in a bar. When her case was subsequently referred to the Workers' Compensation Board for investigation, two doctors reported that although the woman limped in and out of their offices, her ability to walk appeared to improve significantly when she thought no one was looking. The WCB ruled that she had "intentionally misrepresented her incapacity" and ordered her to pay a fine and restitution.
ManitobaDoug Sexsmith was named the new President/CEO of the Workers' Compensation Board. Formerly a senior executive of IBM Canada Ltd., he has worked with numerous public sector organizations throughout Canada to help improve their operations and enhance service delivery. He also spent 20 years in the Manitoba government, most recently as associate deputy minister of family services. His government experience has ranged from front-line service delivery to Treasury Board functions. MarylandAs a result of legislation passed during the 2000 session of Maryland's General Assembly, IWIF is subject to more conservative Risk Based Capital (RBC) reserving standards. Key legislators and Maryland's Insurance Administration support a 2002 legislative proposal that would phase in theRBC requirements over five years, which is similar to the phase-in period granted to other P&C insurers. At close of business - 2001, IWIF had referred 24 claimants and six policyholders for prosecution, and identified and billed $2,894,542 in premium fraud and avoidance and collected $959,654. Recoveries to date are $378,802 in claimant fraud and $7,326,721 in soft dollar reserve takedowns. In April IWIF will sponsor a half-day Premium Fraud Awareness Seminar featuring some of the nation's leading experts in this area. The presenters include: investigators from the Hartford and Liberty Mutual, a forensic accountant from Kroll Risk Consulting, a database expert from LexisNexis and attorneys from several premier law firms. Admission is free, but pre-registration is required. For further information contact Jerry Landsman, IWIF's Director of Fraud Investigations, at (410) 494-2450 or jlandsman@iwif.com. IWIF's second-generation Document Management System was implemented in December and has created multiple opportunities for business process efficiencies. The system meets all the original project goals including complete integration with IWIF-WCIS – the enterprise-wide insurance application, both for viewing documents and creating paperless work-flows throughout the organization allowing for substantially improved operations. An example of the improvements is the paying and approval of circumspect medical bills by adjusters online. The new system, based on Gauss Enterprise's VIP 8 platform, is substantially faster than IWIF's previous imaging system – for viewing and elapsed time required for scanning and indexing documents. IWIF is adopting a three-year policy for small business owners. Policies that generate $500 or less in annual premium will feature a three-year fixed rate. Coverage is not affected and the savings generated by reduced administrative costs will help IWIF to maintain the lowest possible cost for coverage. Further information about this and other IWIF programs can be obtained from the newly launched IWIF website www.iwif.com. Joe Gillian, formerly with Zenith Insurance, has been hired as the new Director of Loss Control. Joe is a 25-year insurance professional who will lead IWIF's safety strategy design and implementation while communicating IWIF's safety mandate to policyholders, agents, and the State of Maryland. Janeen McLean has been promoted from Territorial Marketing Director to Service Director where she is responsible for customer service, imaging, and distribution. Janeen has been with IWIF for the past two years and came to us with over 20 years experience in the insurance industry. Most recently she was the District Marketing Manager for National Grange Mutual covering the Maryland/Delaware area. John Holladay is IWIF's Director of Claims Quality Assurance and Audit. John comes to IWIF from The Hartford, where he accrued more than 23 years of liability and workers' compensation experience. His most recent positions include those of Quality Assurance Leader and Assistant Claims Center Director where he managed a 100+ member claims staff. Paige Beck has been promoted to IWIF's Director of Corporate Management. Her knowledge of IWIF's processes and procedures, extensive background in Internal Auditing, and procurement made Paige the ideal candidate for this position.
MinnesotaThe Minnesota House and Senate voted to override Gov. Jesse Ventura's veto of a budget package that includes taking $230 million from the Special Compensation Fund (SCF), which pays supplemental benefits to injured workers and pays the costs of administering the state's work comp system. Since the SCF is financed through assessments on work comp insurers, raiding it means assessments will need to rise. That will push pricing up several additional percentage points on top of the steep pricing increases employers already are seeing. SCF legislation is also progressing, however, to change the SCF assessment base to premium, rather than paid indemnity benefits, which would eliminate the need for insurers to reserve for future assessments. The state Department of Labor & Industry reported workers' compensation costs leveled off in 2000 following a five-year decline, according to the City Business journal. Total costs amounted to $1.37 per $100 of payroll, down 45 percent from the average cost for the period 1989 through 1994. MissouriMissouri Employers Mutual Insurance (MEM) has restructured some of its key departments to provide more seamless coverage and better service to policyholders and producers. MEM created an Operations Department consisting of Policyholder Services, Claims and Information Services. It will be lead by newly appointed Vice President of Operations Dina Schultz. She was previously the director of Corporate Projects for MEM, where she was heavily involved in the company's yearly planning process, overhaul of the policy management and project management systems, and analysis of Missouri Employers General Agency. "As MEM has grown from a company with $0 in premium in 1995 when we first opened our doors to a projected $170 million this year, we are constantly striving to find new ways to enhance our operations to more efficiently serve the employers of Missouri," said MEM President and CEO Dennis Smith. "With Dina's commitment to operations' excellence, I am confident we are well on our way to meeting this challenge." The Underwriting Department was also reorganized, creating a Key Account Team of underwriters handling accounts $10,000 and less, as well as a Middle Market Team that handles accounts greater than $10,000. Within each of these teams, underwriters will still maintain their geographic emphasis. "This reorganization will allow us to specifically service the needs of these different types of accounts," said Smith. "By doing so, we provide the most optimal level of service possible to our producers."
MontanaThe MSF Board of Directors approved a $4 million dividend (5.7 percent of premium) to eligible policyholders with superior safety records. This marks the fourth consecutive year that MSF has been able to return dividends to its most safety-conscious employers. During the last legislative session the Montana State Fund (MSF) was granted the authority to establish a charitable giving program to promote civic goodwill and enhance the success of selected worthwhile causes in the state. "Our goal is to support organizations and programs that contribute to both safety and community well being in our state," said Carl Swanson, MSF president. "We appreciate the support we have received from both the legislature and our Board of Directors to allow us to lend a helping hand in our communities for deserving projects. It gives us the chance to be the good corporate citizens that we need to be." After considering a number of options, MSF established the ACE program (Assistance to Charitable Endeavors). Under the guidelines any non-profit, tax-exempt organization in the state can apply for funds to be matched on a one-to-one basis from another source. Applications are reviewed quarterly, and the competition for funds is keen. The first ACE recipient was the East Helena Head Start Program, whose application to help purchase playground equipment captured the spirit and philosophy of the ACE program. Head Start serves 3- to 5-year-old children from families at poverty level. The children are currently being bused to a playground with equipment designed for older children, setting up the potential for accidents. The grant will allow the Head Start program to install age appropriate equipment in a vacant lot next door to their location, allowing children to play in safety while helping them to develop their motor skills. The playground will also be available for use by the East Helena community. The MSF Board of Directors approved a $4 million dividend (5.7 percent of premium) to eligible policyholders with superior safety records. This marks the fourth consecutive year that MSF has been able to return dividends to its safety-consious employers. New YorkThe New York State Workers' Compensation Board issued 6,200 legal judgments against employers in 2001. Quoting WCB Chairman Robert Snashall, the Albany Business Review reported that the board froze almost $70 million in assets to encourage employers to pay fines levied against them. Approximately $9.7 million in fines were levied last year; the money is placed in the Uninsured Employers Fund to pay benefits to workers injured while working for uninsured firms. North DakotaDavid H. Ystebo and Bob Indvik were reelected as chair and vice chair, respectively, of the North Dakota Workers' Compensation Board of Directors in January. Other members of the board include Dr. Charles Dahl, Richard Johnsen, Evan Mandigo, Kenneth Sokoloski, Cal Kolling, Sindy Keller, Nancy Slotten and Denny Schneider.
Northwest Territories and Nunavut
OhioThe Bureau of Workers' Compensation (BWC) will mail an estimated $66 million in bonus checks to 2,755 Ohio public employers later this year for attending a Public Employer Summit exploring how to improve workplace safety and manage workers' compensation costs. The public entities are receiving a 25 percent bonus based on their premiums for the 2001 policy year, provided that they each had at least one official attend the summit. "I'm pleased that so many leaders attended and hope they will adopt one of our programs and invest in workplace safety," said BWC Administrator/CEO James Conrad. Since 1997 private sector employers have decreased their rate of injuries while public employers have continued to experience increasing medical costs and lost time claims because of workplace injuries. A Cincinnati chiropractor owes the state more than $126,000 for billing the BWC for treatment of injured workers when no treatment was done. The chiropractor's downfall began when he billed for services allegedly performed in his office on dates when the injured worker was confined to a hospital bed. Investigators reviewed payment records and interviewed other former patients and discovered a pattern of fraudulent billing. For instance, one woman was "treated" 76 times over a period of several years after she stopped seeing the chiropractor. The BWC was billed for services allegedly performed on a man on dates when he was not even in the chiropractor's office. The chiropractor's guilty plea in the case was significant, according to Conrad. "Provider fraud cases are difficult to investigate and prosecute because of the amount of material and detail involved," he said. Last year the BWC's investigators identified $88.6 million in savings and referred 256 fraud cases to the state Attorney General.
OntarioThe Workplace Safety & Insurance Board distributed $2.2 million in rebates to 128 members of the Ontario General Contractors Association at a ceremony in January. The companies participated in a pilot Safety Groups Program in 2000, which succeeded in improving their workplace health and safety performance. The WSIB also launched a new ad campaign with the slogan, "Safety Starts with You." Glen Wright, chair of the WSIB, announced that Brock Smith would head up a program to offer consultations throughout the province on technical issues surrounding workers' compensation coverage. Findings from the consultations will be forwarded to the Ministry of Labour. OregonA hearing aid company agreed to change its advertising to avoid suggesting that hearing aids would be paid for by workers' compensation. According to the Portland Business Journal, the firm had indicated in newspaper and telephone directory ads that it could assist in getting workers' comp carriers to pay for consumers' hearing aids. The Attorney General's staff disabused the firm of its theories, asserting that only claims adjusters could determine whether a claim is compensable, subject to review by the Workers' Compensation Board.
PennsylvaniaGov. Mark Schweiker announced that maximum weekly benefits for new workers' compensation beneficiaries would increase from $644 to $662 in January. He asserts that the state has saved $3.3 billion in workers' compensation costs from 1995 through 2001. Prince Edward IslandThe third annual Conference on Workplace Health & Safety will be held April 16-17 in Charlottetown. One workshop during the conference will focus on how to create a workplace safety program; in December all places of business with 20 or more regularly employed workers will be required by law to have a safety program in place. Other workshops will cover due diligence, stress management, prevention & profitability, soft tissue injuries, industrial ergonomics, indoor air quality, and accident prevention for teenaged workers. Rhode IslandThis year the Rhode Island General Assembly is considering a record number of bills having to do with workers' compensation. Representatives of labor, business and various special interest groups have submitted more than 80 pieces of legislation. These bills include revisions to the procedure for resolving workers' compensation disputes, the method for calculating the payment of benefits, the amount of benefits and the interaction with health-care providers. It is expected that only that legislation which favorably impacts all interested parties will pass, with the goal of continuing one of the real success stories of workers' compensation reform. More specifically, as part of its reform, Rhode Island created a workers' compensation "Advisory Council" in 1990. This council is statutorily made up of representatives of labor, business, insurance, the legislature, and the Workers' Compensation Court, as well as the Department of Labor and Training and the Department of Business Regulation. This council reviews proposed legislation and then makes recommendations to the legislature as to the efficacy of the proposed changes. This process eliminates wholesale change simply for the sake of change and has led, for the past 10 years, to a fairly stable environment. Many observers hope that this process will again work to effectuate only those changes that will work to the best interest of the system as a whole.
SaskatchewanThe fifth annual Compensation Institute was to be held March 25-26 at the Saskatchewan Centre for the Arts in Regina. The free event offered tips on how to prevent workplace injuries, and manage injuries when they occur. The Workers' Compensation Board called for abstracts to be submitted for the Fall 2002 Case Management Conference to be held September 26-27 at the Quality Inn in Saskatoon. Texas
Even though the Lone Star State is the lone state that does not mandate workers' compensation coverage, 65 percent of employers do participate in workers' compensation plans. According to National Underwriter, this represents an increase of 9 percentage points in the past eight years. But the San Antonio Business Journal reports that many employers are considering dropping out of the workers' compensation system due to escalating costs. Groups representing employers support a proposal to impose a medical fee schedule to corral costs, while physicians' groups protest the fee schedule proposal arguing that it is as much as 250 percent more expensive to treat workers' compensation patients than Medicare patients. Utah
WashingtonThe Department of Labor & Industries (L&I) reached a settlement that allows Wal-Mart to remains self-insured but prohibits the Arkansas-based retail chain from self-administering its workers' compensation claims in Washington for at least the next eight years. L&I had moved to decertify Wal-Mart's self-insurance program after five audits between 1993 and 1999 showed that that company failed to open legitimate claims and did not process claims timely. As part of the settlement, state regulators will closely monitor Wal-Mart's workers' compensation claims. According to L&I, the settlement is contingent on Wal-Mart building a $40 million regional food distribution center in Washington. The retailer has also donated $175,000 to Kids' Chance, which provides scholarships to children or survivors of workers catastrophically killed or injured on the job in Washington. L&I announced a series of workshops and measures designed to reduce injuries to workers. Working with the Washington Restaurant Association, L&I launched a program to reduce injuries to teenaged employees in restaurants, which employ 50 percent of teen workers. The first workshop was held in Yakima. L&I also announced a series of workshops on ergonomics to be held in cities throughout the state. West VirginiaThe Bureau of Employment Programs recently announced it had filed injunction suits against three employers that together owed more than $125,000 in back taxes, interest and penalties to the Workers' Compensation Division. The injunctions call for the firms to cease business. YukonThe government will hold off for now on its plans to change the Workers' Compensation Health & Safety Board. As part of a restructuring program being conducted throughout government, the chair of the board was to serve at the pleasure of the Premier rather than be accountable to the board. According to the Whitehorse Star, the basis for the change was to make the workers' compensation board more accountable to taxpayers. However, it was pointed out that the board receives its funds from employers, not taxpayers. Now, any changes in reporting relationships will wait at least until an examination by the auditor-general is completed in June.
|
|||||
|
|
Home | About Us | Directory | News & Events | Library | Contact Us | Member Sign-in |
Following
the retirement of Gerry Meier, the Workers' Compensation Board
announced the appointment of Penny Ballantyne as president and
CEO. She has previously served as deputy minister of the departments of
Health and Social Services; Education, Culture and Employment; and Municipal
and Community Affairs. She is also past president of the Northwest Territories
Housing Corporation.
Texas
Mutual Insurance Co. announced the addition of 
The
Workers' Compensation Fund announced the appointment of Allen Goodwin
and Ben Llaneta to the positions of vice president and assistant
vice president, respectively. According to BestWire, Goodwin will oversee
the underwriting department, which consists of three divisions. Llaneta
will head the risk management division. Both are veterans of Superior
National Insurance and Zenith Insurance Group.