GET TO KNOW YOUR INSURANCE POOLS By Brad Wilson, Marketing Insurance Benefits, Inc. Gary Drewes, Marketing Hagan Benefits, Inc. Dan Mostek, Loss Control Safety Benefits, Inc.
Why do you NEED Work Comp? It’s the LAW SDCL 62 Workers Compensation is regulated by the Department of Labor
Who is Covered? ? ? • Employees • Elected & Appointed Officials • Volunteers SDCL 62 -1 -5. 1 states that Volunteers must be listed in the entity’s official minutes
When Does It Apply? § Work-related injuries/illnesses § Doesn’t include mental injury arising from emotional, mental or nonphysical stress § Employment or employment related activities must be a major contributing cause Determined by SD DOL
When Does A Claim Need To Be Reported? Employee has 3 days to notify Employer has 7 days to notify Work Comp Carrier Insurer has 10 days to notify the Department of Labor This is according to South Dakota Codified Laws: 62 -6 -1 and 62 -7 -10 and 62 -4 -37 PLEASE REPORT ALL INCIDENTS
Statutory Reasons to Decline a Claim! Statute #62 -4 -37 Intoxication Illegal use of Drugs
Hope this looks like an accident! Self-inflicted Injury WILLFUL Misconduct (Horseplay) Refusal to Use Safety Equipment
Benefits of Workers’ Compensation Medical (no deductible) Disability (2/3 of Salary) 2010 -2011 Max. $630 Min. $315
Benefits - Continued Rehabilitation i. e. Retraining or Education Death Benefits - $10, 000 funeral expenses
How much does Work Comp Cost? ? The pricing is developed from YOUR payroll! Each job description has a separate. Example: Highway code is 5506 and the rate is $6. 46 per $100 of payroll
What is an “Experience Modifier” A mechanism to measure YOUR claims experience compared to all other insureds. Frequency Severity
Control Costs with your Experience Modifiers begin at a 1. 00 Based on YOUR past 3 years of claims experience your pricing will go up with frequent or severe claims or down with fewer claims
Cost of Bad Claims Experience Class Description Codes Payroll 5506 Streets & Road $100, 000 7720 Law Enforcement $100, 000 8810 Clerical $100, 000 Rate $6. 46 $3. 31 $0. 38 Contribution $6, 460 $3, 310 $ 380 Total Contribution Experience Modifier $10, 150 (BAD EXPERIENCE) MODIFIED CONTRIBUTION 1. 30 $13, 195
Benefit of Good Claims Experience Class Description Codes Payroll 5506 Streets & Roads $100, 000 7720 Law Enforcement $100, 000 8810 Clerical $100, 000 Rate Contribution $6. 46 $3. 31 $0. 38 $6, 460 $3, 310 $ 380 Total Contribution $10, 150 Experience Modifier (GOOD EXPERIENCE) 0. 70 MODIFIED CONTRIBUTION $7, 105
Payroll Audits Contributions or Premiums are Calculated on an estimated Payroll amount. At the end of the year, an “audit” Is performed.
Other Important Points
Job Classifications? ? ? Employee’s Payroll is classified by the employee’s job duties – NOT by Department • • • Jail Employees – Code 7720 Clerical – Code 8810 – Incl. Dispatchers, Hwy Dept Secretary & Commissioners Assessor, Building Inspectors – Code 9410 Highway Workers – Code 5506 Miscellaneous Volunteers – Code 9015 a Volunteer vs. Paid Firefighter/EMT’s
What Determines an Independent Contractors? 1. 2. 3. 4. Control – Must have flexibility in performing job function Responsibility of costs to perform the job – supplies, equipment NOT paid by payroll – an expensed item Written Contract Discuss these Contracts with your States Attorney.
INDEPENDENT CONTRACTORS Request: Certificates of Insurance If you DO NOT have those in your File, the cost of the Contract must be Added to YOUR Workers Compensation Premium – in addition injuries can be assessed to your WC.
SDCL 62 -1 -5. 1 Volunteers serving state or political subdivision without pay – Computing or imputing wage – Certain persons not deemed volunteers Any volunteer worker rendering services or for any in agency, department, institution, or instrumentality of the state or of any of its political subdivisions, including counties, townships, school districts, or municipalities, whose services have been duly recommended to the officer or appointed thereto by such officers or governing body, shall for purposes of this title be deemed an employee of the state or the political subdivision, as the case may be. The appointment shall be entered into the official records or minutes of the entity.
Federal - Child Labor Laws “Children” under 16 – CANNOT RUN MOWERS “Children” under 18 – CANNOT RUN POWER DRIVEN EQUIP SUCH AS POWER SAWS CANNOT DRIVE VEHICLES OVER 6, 000 LB SUCH AS DUMP TRUCKS CANNOT BE AN UNSUPERVISED LIFEGAURD UNLESS RED CROSS CERTIFIED – NEVER HANDLE CHEMICALS
Return to Work Reasonable accommodations Part-time work
Importance of Return to Work Programs Return the employee to pre-injury income Expedites recovery – self-esteem Improves Morale – injured Employees & Co-workers! Reduces Claim Costs thus Saves the Employer money
Indirect vs. Direct Costs For every 1 spent by workers’ compensation an additional 4 to 6 (not covered by insurance) is a COST TO YOU! Examples: ü Time to file claims ü Overtime paid to get the job done ü Time to train replacement workers ü Morale issues with other employees
New Injury Reporting Hotline Easy first point of contact for injured worker Nurse will triage the injury Reduces the time lag for reporting the injury Gives the employer or medical provider a contact number for authorizations Increases communication between everyone involved in the claims process This will ultimately reduce the overall cost of claims 85% of claims cost are caused by 15% of claims
SDML Workers’ Compensation Fund Premium (Contribution) Comparison to Standard Market SDML Std Mkt Renewal Credits Yes No Loss Control Credits Yes No Equity Credits Yes No
SDML WC Fund Comparison – Continued SDML Rates Policy Fee Taxes Loss Control Std Mkt s es L NONE Yes NONE FREE Yes NONE Mo re Approximate Savings with SDML WC – 20%
Members of the SDML Work Comp Fund 368 Members 65 of the 66 Counties 44 Conservation Districts
SDML Work Comp Fund Board of Trustees Dennis Falken Brookings County Alvin Fjeldheim Campbell County Bob Wilcox SD Assoc of County Commissioners Francis Toscana, Chm Lead-Deadwood Sanitary District Jodi Friedel City of Spearfish Karl Alberts City of Aberdeen Mike Grosek City of Webster Stanton Fox City of Watertown Yvonne Taylor SDML
POOL ADMINISTRATORS Insurance Benefits, Inc. Hagan Benefits, Inc. Karen Ripperda, Administrator Brad Wilson, Marketing Gary Drewes, Marketing Ladene Bachtell, Underwriter Christa Lee, Underwriter Jeff Pederson, Administrator 800 -233 -9073 877 -273 -1712
What is a Pool? Risk-Sharing!! • A group of similar exposures formed to share losses. • Authorized by the Joint Power Act. • Owned, by the members – Governmental Entities of the State of South Dakota
South Dakota Public Assurance Alliance • • Gary Drewes, Marketing Ladene Bachtell, Underwriting Christa Lee, Underwriting Jeff Pederson, Administration
Who is Covered? ? County Employees Elected & Appointed Officials Volunteers
What is Covered? ? ? Counties Cities/Towns Special Districts i. e. Townships/ Conservation Districts
SDPAA Lines of Coverage General Liability Public Officials Liability Law Enforcement Liability
Auto Liability Auto Physical Damage Property Coverage Boiler & Machinery
SDPAA Specialized Features ØEmployment Practices Liability – Included Ø Civil Rights Violations - Included ØVolunteers are Included as Employees ØBlanket Property Limits ØReplacement Cost
How much does the SDPAA Pool Cost? ? The pricing is developed from YOUR budget, exposures, equipment & property! Liability rates have not changed since 1987 – thus a stable market!!
Does your Liability and Property Claims Experience Matter? Contributions can be reduced with Good Claims Experience
AL G ON LIN SI D ES AN OF S H PR IM LA C Jeff Jares, Claims Administrator
Member/Claim Involvement Adjuster & Member Discuss Settlement The Best Interest of the Member is Considered
RE F !! E Doug Kirkus, Loss Control Administrator
Property Surveys ØBuildings valued correctly ØNew Buildings covered ØOld Buildings deleted
What are YOUR Benefits of a POOLING CONCEPT! ØStabilized Rates ØNo taxes and fees ØProfits belong to the Members ØRetention nearly 100%
SDPAA Board of Directors • Ted Eggebraaten, Brookings County • Terry Weisenberg, Lawrence County • Mike Wiese, Brown County • Dennis Olson, Chm. , City of Brandon • Tracy Turback, City of Sioux Falls • Mike Hall, • City of Sioux Falls • Jim Borszich, • City of Huron • Jeff Heinemeyer, • City of Madison • Jerry Krambeck, City of Spearfish
ENDORSES SDML WC Fund and the SDPAA
LOSS CONTROL SERVICES Dan Mostek Safety Benefits, Inc. (888) 313 -0839
Introduction Doug Kirkus has been involved with providing safety and loss control services for the Pools since 1995 Today we have 7 staff working with Pool members Doug Kirkus - Dan Carlson Dan Mostek - Janet Sporrer Todd Everson - Sue Kirkus Kelly Everson
Employment Practices Hotline SDPAA entities currently carrying Government Officials Liability coverage can use service Questions that concern employment practices will be taken Hiring, discipline, termination Questions concerning personnel policy and employee manuals SDPAA has contracted with 2 law firms with expertise in employment law
Services Overview Member is entitled to 1 hour of free legal service for each SEPARATE inquiry If more than 1 hour is needed, the Member may extend the use of the service at their own expense When a call is accepted, Member entity becomes a client of firm for purpose of call and attorney/client privilege is activated Only information about call that is necessary for billing purposes will be provided to SDPAA
How Does Service Work Contact SBI at (888) 313 -0839 You will be asked a series of questions Who is calling Your location Exact nature of the call Once approved, attorney from one of approved law firms will return call and consult caller about inquiry Lisa Marso – East River Don Knudsen – West River
Voter Redistricting Hotline Works the same but deals with redistricting issues Counties have to complete redistricting by February of 2012 SDPAA members are entitled to 2 hours of legal advice for each situation Sara Frankenstein of Rapid City one of the Midwest’s leading legal experts Counties that have larger minority populations and Commissioners that are elected by Districts are really going to be watched by ACLU To activate contact our office at (888) 313 -0839
Law Enforcement Policy Project PATC developed model policies and procedures in 12 high risk critical areas of law enforcement specifically for South Dakota Have added several new policies since the initial project SDPAA funding updates for 3 years Entities receive 5% loss control credit on Police Professional Liability coverage for signing participation agreement PATC provides free monthly training webinars for SDPAA members Free video training downloads will be able within the next 30 days
Jail Policy Project PATC has developed 31 model policies and procedures specifically for SD jails in several high risk areas Draft manual is completed and is now being reviewed Train-the-trainer classes sometime in May or June These will be available free to all jails covered by the SPAA
On-Site Surveys By contract we visit each member once every 3 years Visit members with highest loss ratios more often Designed to assist members with safety and loss control Make written recommendations designed to make the workplace as safe as possible for employees and reduce your chances of being sued Loss Control Credits are given for cooperation and responding to our recommendations
Property Valuations 2008 - Completed on-site valuations for all SDPAA members with Property Coverage Process of revisiting everyone started in 2009 and will complete in 2012 Important to do self-inspections of facilities Report any new additions or acquisitions to Hagan Benefits
All Day Safety Training - MSHA Offer 35 classes that began on January 5 th 7 hours of training These classes qualify towards 8 hours of MSHA Annual Refresher training requirements Most County Highway Departments have to comply with MSHA compliance officers are busy 2 SD counties fined last summer
Other On-Site Training Classes DDC EVOC – Police, Fire, Ambulance Harassment Prevention for Employees and Supervisors Back Injury Prevention Jail Suicide Prevention Forklift Safety Accident Investigation for Supervisors Bloodborne Pathogens Safety Committees Self-Inspections of Facilities PPE Lockout/Tagout Confined Space Entry Coaching the CDL Operator Ergonomics Playground Equipment Inspections Trenching/Excavation Safety Non-Violent Crisis Intervention Public Officials Liability Improving Performance Appraisals Customer Service
ATV Safety Training New “hands-on” class being offered this year Free to Pool members Participants will be certified through the ATV Safety Institute Encourage all ATV operators to attend this training especially County Weed and Search and Rescue employees
“Take Time for Safety” 37 different training topics Includes Trainer Outline, Handout, Quiz, Answer Sheet, Attendee Roster and Training Certificate Have added 8 new topics this year Available on CD or subscription service
DVD-Video Library Can be accessed through Pool websites and ordered on-line www. sdmlwcfund. com www. sdpaa. org Have 100 s of titles available Add new titles each year
On-Line Training Access through Pool websites www. sdpaa. org www. sdmlwcfund. com 22 general courses 4 supervisory level courses Free to Members Easy to navigate
Safety Awards Can qualify for 3 different levels Bronze, Silver and Gold Not competing against any other entity Just have to meet criteria for each level Platinum Level Combined Loss Ratio - < 60% Presented at annual Safety Award Luncheon sponsored by the SDPAA and SDML WC Fund News release sent to local newspapers 2010 Bronze – 7; Silver – 7; Gold – 35; Platinum - 20
Annual Safety Conference Sponsored by the 2 Pools, Insurance Benefits, Claims Associates and Safety Benefits Different safety and loss control topics are covered 2011 Conference is at Cedar Shores – Oacoma on November 16 th & 17 th
Essential Physical Job Functions You don’t want to hire someone that is physically unable to do the job or has a pre-existing condition Cannot legally ask an applicant “how is your health? ” or “have you had previous work comp claims? ” Can ask them if they can perform the essential physical functions of the job
SDML WC Fund Has hired occupational health experts to develop these and they have been validated Members can obtain a copy from us How can you tell if the applicant is being truthful? Pre-Employment/Post-Offer Physical Only has to be performed on the person you are offering the job to and job offer can legally be withdrawn if can’t physically do the job Cheapest investment that you will ever make Also valuable in protecting the County when bringing back an injured employee or an employee who has health issues
QUESTIONS? ?
Dan Mostek Safety Benefits, Inc.
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