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Source: CHSI

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Source: WorkCompCentral

Click here to view the article in the Reno Gazette Journal.

Source: www.rgj.com - Reno Gazette Journal 

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Source: Insurance Journal

Claimant attorneys are acutely aware of missteps by employers and insurers during the workers' compensation claims process. So listen up, employers and claims payers, as we've asked three seasoned attorneys from different parts of the United States to suggest how to be more proficient...

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Source: Risk & Insurance Magazine www.riskandinsurance.com

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Source: Adjuster.com

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Source: Workers' Comp Executive

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Source: WorkCompCentral

The Home Improvement Self-Insurance Group (HISIG), a California Workers’ Compensation program, achieved a significant milestone this month by surpassing $100 million in total payroll for its 135 members statewide. Scanlon Guerra Burke Insurance Brokers (SGB) of Woodland Hills, California, the program’s master broker, specializes in workers’ compensation coverage and sees HISIG as an innovator in loss prevention and management.

“These payroll figures are a testament to HISIG’s strength,” says recently appointed SGB senior vice president Rusty Russell. “We expect many more qualified retailers to join up in 2011.”

After five years of relatively stable rates, workers’ compensation premiums are on the rise again. Weary of the insurance merry-go-round, a growing number of independent business owners are pooling resources with like-minded retailers to purchase more cost-effective self-insurance plans.

“HISIG is a fabulous organization for independent hardware and retail stores. It saves money and gives better protection and support for our employees,” says Garth Smith, owner of Dale Hardware in Fremont and chairman of HISIG.

HISIG launched in 2005 after changes in state regulations allowed companies in similar industries to create self-insurance pools. The group’s membership asserts that self-insured programs offer greater value than traditional plans, with such advantages as:

HISIG members often experience first-year premium reductions of 10 percent; Evidence shows that HISIG members have fewer claims, less fraud, better training to help workers avoid on-the-job injuries, access to innovative safety technologies, stable costs and return of surplus costs; HISIG research shows that medical and indemnity claim days are typically cut in half within in two years; A third-party administrator handles claims but HISIG members have ultimate decision-making power, giving them greater control over the handling of employee injuries and safety issues within their own stores.

“The home improvement self-insurance group is expanding by leaps and bounds in California,” says Russell of SGB. “We expect continued growth in this sector, especially as rates for traditional plans are expected to increase by as much as 27 percent next year.”

Scanlon, Guerra, Burke (SGB)
For over 40 years, SGB has served the business community by providing the very best insurance coverage available. SGB has become one of the largest and most trusted privately owned insurance brokerage companies in Southern California and commands the attention of a majority of the dominant insurance carriers. The agency was named “Insurance Agency of the Year” by Insurance Journal Magazine and the Insurance Brokers and Agents Association of the West. For more information, please visit www.sbginsurance.com

Home Improvement Self-Insurance Group (HISIG)
HISIG is a California Workers' Compensation program approved and regulated by the Office of Self-Insurance Plans, Department of Industrial Relations. All Workers' Compensation self-insured groups in California are required to maintain claims reserves at a level 50 percent higher than required for insurance companies. The Home Improvement Self-InsuranceGroup is managed by CHSI, a design-management firm for self-insured groups in Workers' Compensation. For more information, please visit www.hisig.com

CHSI Technologies announced Thursday that it has hired David Neubert as vice president of sales. CHSI Technologies began operations to market its patent pending CHSI Connections™ Management System software solution to the alternative risk insurance industry at the first of this year.

Mr. Neubert brings 18 years of experience in the workers’ compensation industry to CHSI Technologies. Mr. Neubert started his career in the industry as a Workers’ Compensation claims examiner with a large insurance carrier and subsequently moved to the software industry.  His more recent experience is in providing claims administration, policy administration, medical bill review software/service and RMIS (Risk Management Information systems) solutions to the insurance industry.  He worked as a client development manager for Valley Oak Systems, which was then acquired by Aon eSolutions in March 2007.  After the acquisition, he held the position of a territory vice president.

“I am extremely pleased to announce the appointment of David Neubert to the position of vice president of sales.” said Eric Robinson, COO of CHSI Technologies.  “This position will enable CHSI Technologies to maximize new prospect opportunities and accelerate the sales cycle from discovery to closure while providing current staff the ability to focus their attention to successfully implement and support our new clients.”

About CHSI Technologies:
CHSI Technologies offers a suite of software solutions designed to diminish the time and effort involved in policy administration for the alternative risk insurance industry. The technology integrates dissimilar systems so that access to information is available on a real-time basis. The web-based solutions provide complete policy administration that link claims information and financial data for critical risk management decisions. CHSI Technologies is headquartered in Las Vegas, Nevada. Contact us at 866-930-9742 or visit www.chsitechnologies.com.

With rates expected to increase again next year – by as much as 27 percent – about 15 to 20 stores have joined a statewide network, the Home Improvement Self-Insured Group, which is member-funded and returns remaining dividends to those within the group, in this case home-improvement stores.

The group, founded in 2005, now has about 120 members throughout the state. It recently received state approval to provide coverage to an expanded list of retail stores and expects to see significant growth in the future, said Jim Scanlon, chief executive officer of Scanlon Guerra Burke, a Woodland Hills brokerage that is leading the expansion.

“The group operates at cost structures that are not onerous like an insurance company, and profits return to members,” Mr. Scanlon said. “Really this was born out of a tradition – California workers’ comp premium is either going up or down. It rarely is ever flat.”

And therein lies the appeal to store owners.

“Even though workers’ comp is on regular major carriers, historically I was looking at the long term, and I know rates will probably go up again,” said Will Jopson, owner of Cloverdale Ace Hardware, which has 23 full- and part-time employees. “So I’m in for the long term and looking to control expenses.”

Mr. Scanlon said members are provided with more attention to detail, and the emphasis is on resolving employee claims as fast as possible without jeopardizing safety or rushing legitimate claims.

Lingering claims can cripple an employer with lost productivity, with legal expenses and increased rates just a sampling of issues that can arise. Unsettled claims as well as the number of claims have the potential to increase an employer’s experience modification rating, which in turn increases premiums.

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Reprinted Courtesy of North Bay Business Journal.

By Dan Verel, Business Journal Staff Reporter.

Still, the cost of the required coverage inched up often, Stanley said, usually without explanation.

Fed up, Stanley opted for a change late last year, dropping his large insurance company’s policy to join a self-insured group of small, independent retailers like himself. He’s already paying a little less, and in a year or two he should be saving even more.

“I’m not saving a huge amount, but like I say, what I hope to recoup is the benefit of getting something back,” Stanley said. “Part of your premiums are repaid to you over time if you stay in it (the insurance fund) and it continues to grow.”

Ojai Lumber made the same change at the start of 2008. Richard McArthur, the store’s manager, estimated he’s paying nearly 20 percent less than what the giant State Compensation Fund charged to cover his 12 employees. More important to him, however, is that the self-insured group does a better job of handling claims and getting injured workers back to work more quickly, he said.

“We sometimes had to wait months to get someone cleared to go back on the job,” McArthur said.

The two Ventura County retailers are among 110 members statewide of the Home Improvement Self-Insured Group, an organization of small- to medium-sized lumber yards and hardware retailers working to provide more efficient, less costly workers’ comp coverage to members.

California has 26 self-insured business groups so far, and membership is growing rapidly. Nearly 400 businesses opted for self-insurance last year, a trend noted for five years, said James Ware, chief of the state’s Office of Self Insurance Plans, which regulates the groups for the Department of Industrial Relations.

Like traditional insurance companies, self-insured groups must comply with myriad state regulations that include underwriting, which sets annual premiums and standards based on closely monitored actuarial studies, said Jim Scanlon, CEO of Scanlon Guerra Burke Insurance Brokers. The Woodland Hills-based company is senior broker for the Home Improvement Self-Insured Group. Injury claims are processed by independent claims administrators.

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Source: Ventura County Star
By: Jim McLain

Overall, this legislative session has offered a mixed bag on workers’ compensation issues. Legislation that would control increasing medical costs or address the destabilizing court rulings handed down last year on permanent disability ratings haven’t materialized. On the other hand, some bills that would have dramatically increased costs were stalled in fiscal committees. (See AB 1994 and AB 1603).

Below are summaries of several workers’ compensation bills where legislative action continues:

AB 933 by Assemblymember Paul Fong (D-Cupertino) would prohibit physicians from reviewing requests for medical treatment (also known as “utilization review”) unless the physician is licensed in the state of California. This bill would also impose new re-application requirements for Medical Provider Networks. It is supported by labor unions, California-based physicians and lawyers for injured workers, who want UR doctors under control of the state Medical Board. It is opposed by employer organizations, local government groups and the state agency that oversees California’s workers’ compensation system, who say that a state license unnecessary because California uses national treatment guidelines and that the bill will limit the supply of UR doctors and drive up costs. (Governor Schwarzenegger vetoed similar legislation in 2008.)

AB 2253 by Assemblymember Joe Coto (D-San Jose) would double the maximum time after retirement (from 5 to 10 years) that cancer developed by firefighters is still presumed to be work-related. The bill is supported by public safety labor unions and lawyers representing injured workers, who say the time span between exposure and cancer symptoms can be longer than the current 5-year maximum. The bill is opposed by employer groups, local governments and taxpayer groups who say the bill will increase costs for cities and counties by making virtually any instance of cancer among firefighters compensable as a workers’ compensation claim.

AB 2397 by Assemblymember Jose Solorio (D-Santa Ana) would double the amount of time (from 1 to 2 years) that public safety officers are eligible to receive their full salary if they are off work due to a workplace injury, subject to an agreement with their employer. Under current law, public safety officers can receive their full wages in lieu of temporary disability benefits or longer under a negotiated salary continuation plan. The bill is supported by public safety labor unions and lawyers representing injured workers who say added flexibility is needed in providing salary continuation to injured safety officers. The bill is opposed by employer and local government organizations who say that the bill could result in up to four years of mandated wage replacement benefits at substantial cost to local governments.

AJR 42 is a resolution by Assemblymember Solorio that expresses the California Legislature’s support for a bill pending in Congress known as the Medicare Secondary Payer Enhancement Act. The MSPEA would address delays and uncertainties that exist today in calculating how much to reimburse the federal government for Medicare expenses that should be paid for instead by a third party under a liability or workers’ compensation settlement. This resolution is supported by WCAN, local government, small business organizations, and lawyers representing injured workers.

Source: Workers' Compensation Action Network

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More and more California employers are diving into pools. They’re not swimming, though. They’re getting workers’ compensation insurance.

Taking advantage of a provision of the 2003 workers’ compensation reforms, they’re seeking lower rates and better service by self-insuring in industry groups.

Take Chip Kurzeka, owner of Franklin’s Hardware in Woodland Hills. Not only has his premium dropped 10 percent in the four years since he jumped into a pool with other home improvement businesses, but sometimes he gets a refund. That happens when the pool finishes the year with more money than required by state law.

“We’ve been very pleased with this program,” Kurzeka said.

These self-insurance pools give employers more control over how claims are handled and can keep a lid on costs. But it can be risky. If claims costs increase for those in the self-insured group, state law requires the members to put in more money to ensure the pool remains solvent.

In traditional workers’ compensation insurance, employers purchase coverage from insurance companies, sometimes using a broker to find the best deal. But in a self-insured pool, each employer member puts its own money into the cooperative and a third-party administrator oversees the handling of claims.

Over the last six years, businesses have grouped to form nearly three dozen of these pools in industries from trucking to auto dealerships to credit unions and private secondary schools.

However, six pools have voluntarily disbanded because the employer members didn’t want to make additional contributions to meet the state requirement of 135 percent of the anticipated cost of claims. And in a seventh pool, made up of building contractors, claims hit the point where the state had to bring in a conservator to run the pool until it could be disbanded and all the members could find other workers’ compensation coverage.

But that risk has not deterred employers from joining self-insurance groups. Since 2005, the number of employers participating in these groups has tripled, topping 2,500 last year, according to figures from the state Office of Self Insurance Groups, a unit of the state Department of Industrial Relations. Much of that growth took place despite a steep drop in overall workers’ compensation premiums that resulted from the 2003-04 reforms. In the last year, premiums have bottomed out and, in some high-risk industries like construction, have started to rise again.

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The Home Improvement Self-Insured Group (HISIG), a California Workers’ Compensation program, has received state approval to provide coverage to an expanded list of retail store operations.  HISIG, launched in 2005 to help employers control Workers’ Comp costs in the retail home improvement sector, added its 110th member on June 1. The regulatory approval takes immediate effect and will make HISIG the only Workers’ Comp self-insured group program available to many types of retail stores.

Some of the stores the group hopes to attract include sporting goods, drug stores, hobby and crafts, electronics, beauty supply, art supply, gift shops and other stores that fall into the broadest retail classification used by the Workers Compensation Industrial Rating Bureau.
 
Garth Smith, owner of Dale Hardware in Fremont and the Chair of the Board of Trustees, expects significant growth ahead for the California Workers’ Compensation program.

“There are a number of trends in California Workers’ Comp that worry employers.  The reforms of 2004 that controlled runaway costs are under heavy pressure from applicant attorneys and you can see some erosion. In HISIG we have introduced programs like our nurse triage that have been very successful in helping our members help employees and control costs.  We are excited that more retail stores are going to be able to take advantage of what we have been able to do.”

The HISIG expansion will be lead by Scanlon Guerra Burke of Woodland Hills and their selected team of other California insurance agencies.   SGB became the master broker for the HISIG program when they added Rusty Russell to their team in April.  Russell was the broker who worked with employers to establish the Home Improvement Self-Insured Group in 2005.