State Risk Pool Is Option for All Employers, Not Necessarily Where You Want To Be

Every Employer Has Option for Workers Comp Coverage

 

Every employer who is required to have workers’ compensation insurance has at least one option to purchase their insurance coverage.  The option all employers have is their state’s assigned risk plan or pool.  Assigned risk plans or pools are state created insurance options for employers who are unable to find an insurance company who will sell them a workers’ compensation insurance policy.

 

Assigned risk plans and pools can be a life-saver for employers who would otherwise have to close their business due to a lack of workers’ compensation insurance.

 

All but 4 states provide either an assigned risk plan or pool to provide workers’ compensation insurance coverage to those employers who cannot find coverage elsewhere.  (The 4 states that do not have an assigned risk plan or pool are the four monopolistic states of North Dakota, Ohio, Washington and Wyoming where the state sells workers’ compensation insurance to all employers, except state-approved self-insured employers).

 

The National Council on Compensation Insurance (NCCI) administers the assigned risk plans in 18 states and the District of Columbia.  The other 29 states administer their own plan or pool.

 

 

Often Considered Insurer of Last Resort

 

Assigned risk plans/pools are often considered the insurer of last resort.  If the employer can obtain insurance anywhere else, it is normally the employer’s best bet, as an assigned risk plan is often the most expensive option.  Assigned risk plans are expensive because they are required to accept employers with unsatisfactory claims history and higher than normal severity exposure.

 

Certain occupations are considered “risky” and very few workers’ compensation insurers will consider insuring employers in these high risk occupations if their loss history is poor.  This includes high risk fields of logging, mining, farming, trucking, construction and heavy manufacturing.  Employers in these and other hazardous occupations often have no choice but to obtain their workers’ compensation insurance through the assigned risk plan or pool.

 

 

Often Only Choice for New Business

 

In addition to employers with unsatisfactory loss ratios, assigned risk plans will often be the only choice for the new business (in business less than three years) which has no loss history on which an insurer can calculate a premium. Once the employer has a three year loss history, the employer is normally able to obtain workers’ compensation insurance in the voluntary market.

 

Very small employers who are in a relatively low risk business can end up in assigned risk plan because the premium a workers’ compensation insurer can receive from them is below the cost of underwriting the policy. (Many insurers will not write a policy with a premium under $2,500 per year).

 

In most assigned risk plans the employer must be able to show that they were turned down by a workers’ compensation insurer licensed to write workers’ compensation insurance in their state before the assigned risk plan will issue an insurance policy.  (Some assigned risk plans will require the employer provide three or four rejections letters before they will write the employer who has been in business for more than three years).

 

 

Many States “Assign” Employer to an Insurer

 

In many states the assigned risk plan/pool does not actually sell the insurance to the employer.  Instead, they “assign” the employer to an insurer doing business within the state.  While the insurer is required to accept the employer who has already been turned down by other insurers, the insurer is often allowed to surcharge their regular insurance premium to offset the additional risk they are required to accept.  The employer normally does not have any input in the selection of their insurance carrier, who is assigned on a random basis.

 

Assigned risk plans often use retrospective rating where the employer who has an unsatisfactory loss ratio while a part of the assigned risk plan is charged additional premium after the policy year, subject to a cap on the maximum additional premium that can be charged.

 

Multi-state employers often have a difficult time with assigned risk plans as the plans normally restrict their coverage to the state where they are located.  If the employer has any employees in another state/jurisdiction, then the employer has to find another insurer or another assigned risk plan to provide workers’ compensation coverage for the employees in the other jurisdiction(s).

 

 

Employers in Assigned Risk Plan Should Take Steps to Improve

 

Employers who find themselves with their insurance through an assigned risk plan should start immediately to take steps to improve their loss history.  Employers in high risk occupations can often obtain insurance on the voluntary market when they improve their loss history and it becomes better than average. If you need assistance on improving your safety programs and reducing the number of workers’ compensation claims, please contact us.

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

 

New York State Fund Is Not The Carrier You Want To Owe Money

New York State Fund Has More Power Than Any Carrier

 

If a NY employer owes unpaid premium to the State Insurance Fund (NYSIF) and the employer is owed money by a branch of New York state government, the State Fund has an expedited method of collecting. It can, and almost certainly will, see that the premium is withheld from payments due on any contract with state government, an advantage no private carrier possesses. Furthermore, this method bypasses such details as a lawsuit.

 

The basis for this is contained in a decision this week from the Appellate Division, Third Department – “Suburban Restoration, Inc. v Office of the State Comptroller”, NY Slip Op 070221. The decision recognizes that NYSIF is, for nearly every purpose, a state agency, although it is uniquely paid by assessments on insurance companies, not by taxes.

 

 

 

Connected to Inner Workings of Central Computer

 

That might seem to be a small distinction but it leads to a feature which confers upon it enormous power – it, alone among comp carriers, is connected to the inner workings of the central computer of the State of New York. It is, therefore, a mouse-click away from all the information it needs to collect any unpaid premium from a contract with the State of New York.

 

It is generally supposed that the decision will mainly affect construction contracts, but it could equally apply to selling pencils and paper to SUNY. In turn, many employers might wish to rethink using a comp carrier that can bypass every legal protection and unilaterally demand, and collect, payments.

 

 

 

Disputes Heard in Court of Claims

 

If the employer wishes to dispute the charges and collections there is a double surprise awaiting. As long as there is unpaid premium (or ALLEGED unpaid premium) access to new state contracts may be cut off. And legal disputes cannot be brought in the regular state courts – they must be heard in the Court of Claims, a court which handles suits against the state and which, it is rumored, tends to see the state’s point of view a bit more clearly than other courts.

 

 

Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. medsearch7@optonline.net

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com.  Contact:  mstack@reduceyourworkerscomp.com.
WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com
MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

 

If You Can Not Get Workers Comp Coverage, Look to the State Fund

There is an alternative to commercial insurance companies or self-insurance for your workers compensation needs.  In about 20 states, including the three largest states, California, Texas and New York, there is a state sponsored insurance company that competes with the private insurance market for workers compensation policies and premiums.  They are often referred to as the State Fund.

 

 

In some of these states, the state government takes an active role in the operation of the state insurance companies and the insurance company is a quasi-governmental agency.  In other states, the state created and funded the insurance company, but no longer operates or manages it.  (WCxKit)

 

 

Each of these state operated insurance companies is domiciled in the state where they operate and they do not issue policies outside of the state boundaries.

 

 

The State Funds have come about because of the difficulty employers can have in securing workers compensation coverage, especially if they are in a high risk line of business.  Employers who have excellent safety programs are coveted by the commercial insurance companies.  The modification factor used to establish premiums reflects the lower than average loss experience of these companies.

 

 

The opposite holds true for companies who have higher than average loss histories.  The standard insurance companies are not interested in obtaining the business, resulting in it being difficult for those employers to obtain workers compensation insurance.

 

 

A poor loss history is not the only reason employers will end up in the State Fund.  The state legislators in every state are often tinkering with the workers compensation laws.  Changes in the laws such as increases in the maximum weekly indemnity benefit rate, or the number of weeks an employee can collect benefits, makes for great vote buying strategy for state legislators, but results in increased cost to the workers compensation insurance companies.  When the insurance companies are not allowed to raise the premiums proportionally to the additional claims cost, they become selective in whom they will insure.  With cost increasing faster than premiums, very few insurance companies will write policies.  When they do write policies, they are very selective.  This results in employers with decent loss histories being pushed into the State Funds.

 

 

State Funds, like standard insurance companies, strive to assist the policyholders in reducing the number of insurance claims they have.  The State Funds often offer various services to the policyholders.

 

Guidance in establishing a Return-to-Work program

Offering comprehensive loss control programs including on-site inspections

Ergonomic evaluations

Educational materials including posters, pamphlets, safety manuals

OSHA compliance assistance

Anti-fraud programs

Wellness programs

In about a dozen states the State Fund is the insurance company of last resort.  The State Fund offers insurance coverage to all employers, often at a price that is slightly higher to much higher than what the insurance policy would cost from a standard insurance company.

 

 

When an employer cannot obtain workers compensation insurance from any other source, the department of insurance will mandate the employer be provided insurance by the State Fund.  Of course, the State Fund charges an appropriate premium to reflect the higher exposure to claims when they insure these employers.

 

 

The single state coverage of the State Funds often makes them a poor choice for employers who have operations in multiple states. For instance an employer who has operations in both California and Nevada can insure his California operations through the State Compensation Insurance Fund, but will have to locate another insurer for the workers compensation policy to cover the Nevada operations. (WCxKit)

 

 

State Funds are occasionally a smart choice for the employer.  The premium charged can be lower if the charter does not mandate the making of a profit.  The added services listed above – provide the policyholders with more value than the employer can purchase separately.  Check with your state Department of Insurance to see if there is a State Fund available in your state.

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%Contact: RShafer@ReduceYourWorkersComp.com.

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com.  Contact:  mstack@reduceyourworkerscomp.com.

 

 

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SUBSCRIBE:  Workers Comp Resource Center Newsletter

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

 

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