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Workers' Comp 101 Topics

  1. What is Worker's Compensation?
  2. Are All Injuries Compensable?
  3. Managing the Process
  4. Who Pays for Insurance?
  5. The Hidden Cost of Workers' Compensation
  6. Lower Your Experience Modification Factor
  7. Who are the Players?
  8. Where Do I Get Help?
  9. Abbreviations
  10. Glossary of Workers' Comp Premium Terms


 

 


Who Pays for Insurance?

We often mistakenly believe that the insurance company pays for injury losses and accident costs. This is not true.

Although some companies have guaranteed cost insurance where all losses are covered, many companies have deductible coverage.

  • This means that the insurance covers only huge catastrophic losses over the deductible amount, typically $500,000 or one million dollars
  • In this insurance arrangement, your company pays for all losses within the deductible amount

    Thus, the company has "retained" the first $500,000 or one million dollars exposure of each loss

Companies that have guaranteed cost coverage with no deductible still need to be concerned about workers' compensation because their premium costs are based on their loss experience, also called their experience modification factor or "mod."

  • This means that past history of losses forms the basis of what an insurance company will charge your company for workers' compensation insurance premiums
  • In this way, a company's loss history determines how much they will be charged for workers' compensation insurance.

Every dollar you pay for injuries comes directly from your company's bottom line. To determine how much workers' compensation REALLY costs, try our Sales to Pay for Accidents Calculator.

Remember: In addition to the cost of workers' compensation premiums and losses, you also pay for a third-party administrator (TPA) or insurance company to administer claim benefits.


How Losses Are Categorized

Workers' compensation costs fall into three categories -
Incurred, Paid and Reserved
.

Paid Losses     Money spent on a claim
Reserved     Money set aside (outstanding) for future payments
Incurred Losses     Combined total of paid plus reserved amounts
   


Next Topic: The Hidden Costs of Workers' Compensation



"Workers Compensation Management Program: Reduce Costs 20% to 50%"

To learn more about how to lower your workers compensation expense, read the guidebook from Advisen and the Workers Comp Resource Center, Workers Compensation Management Program: Reduce Costs 20% to 50%, which covers the following:

•   BONUS CHAPTER! Process Overview for Workers Compensation Managers
Workers Compensation Basics
•   Fundamentals of Cost Containment
Best Practices Roles and Responsibilities
Management Commitment
Employee Communications
Controlling Fraud and Abuse
•   Return to Work and Transitional Duty
Claim Reporting
•   Other Indemnity Cost Containment Services
•   Directing Medical Care
Medical Cost Containment
Physical Therapy & Physical Rehabilitation
Pharmacy Benefits Management
Training Supervisors
Working with the Insurance Company and TPA
•   Claim Resolution and Settlement
•   Safety and Loss Control

Workers Compensation Management Program 2012: Reduce Costs 20-50%
Learn more about the comprehensive guidebook from Advisen and the Workers Comp Resource Center: Workers Compensation Management Program: Reduce Costs 20% to 50%.

Learn more: Workers Compensation Management Program: Reduce Costs 20% to 50%
Learn more about included documents, bulk pricing, and custom imprinted covers for brokers, carriers, and associations.



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