Tag workers comp quotes

“But you accepted this risk last year!”

How often do underwriters hear that? Often, a risk that was accepted last year is declined this year even though it appears nothing is changed. Sometimes the reverse happens. You’ll hear that something they declined from you last year was just accepted this year, and even worse, through another agent or PEO.

Why?

Why do underwriting standards change? What causes this?

We’ll discuss several things that can change:

• Medical expenses
• Carrier direction
• Rates
• Legal expenses
• Political climate
• Surplus

Increased Medical Expenses

These are constantly spiraling upward. Rather than reducing them, as originally intended, it is now apparent that the “Affordable Care Act” has nearly doubled the cost of medical care. This comes from numerous sources but seems to be centered around increased paperwork, taxes and administrative cost.

The cost of a cut finger nearly doubled, according to our PEO Pros actuarial staff, going from $300 with a $20,000 reserve up to $550 with a $40,000 reserve. The reserves are set based upon actuarial history of re-opened claims that involve further medical attention, lost wages and of course, (the big one) legal expenses.

Change in Carrier Direction

Carriers will often change direction of work covered due to numerous reasons. Some of those reasons include a change in ownership, change in AM Best rating, and determination of risk management spread. The company actuaries determine the optimum “spread” of risk, often called a “balanced portfolio.” The ideal balance is a mix of high risk (higher premiums), medium risk (moderate premiums) and low risk (very low premiums.) If a company finds itself unbalanced in one particular area it is a good business practice to shift the underwriting back to the proper balance.

Change in Rates

Many states are “administrative”, which means the rates per code are set by the National Council on Compensation Insurance (NCCI). In other states, the rates are approved by the state workers’ comp board. Getting a rate change in those states can be a long and cumbersome experience.

In either case, a carrier can find themselves in a different balance situation when rates change. Obviously this can affect the appetite for particular codes.

In a code/rate change situation, the powers that be (including the actuaries) of the carrier may be pushing for a change in underwriting standards.

Change in Legal Expenses

Even though great strides have been made to limit how much lawyers can charge in representing an injured employee (including some precedent setting court cases) the expense of legal fees have continued to spiral upwards. Naturally, this can have an effect on underwriting standards.

One particular effect, known in the industry as the “TV effect”, is the attraction of certain kinds of accidents, incidents and injuries to the media (such as anything aviation related, for example), that is causing many carriers to shy away from those lines of employment. The belief is that high profile accidents and injuries attract the media (seeking ratings) which then attract lawyers (seeking improved public awareness of their services), and therefore those relatively safe (from an incidence and occurrence standpoint) codes become classed as high risk, due to the increased likelihood of expensive legal fees.

Different Political Climates

This can be directly related to the above paragraph but there are also situations where certain governmental type institutions will become ineligible to certain carriers. Municipalities, for example, have an unusually high percentage of suspected fraudulent claims. In particular, in the last few decades, there is an alarming trend to treat the workers’ comp insurance as “100% health coverage”, simply by claiming the accident occurred at work. Since an increased experience mod does not directly impact municipal officials (it’s not their money, they just pass the expense on to tax payers) the incentive to reduce fraudulent claims is removed. Legislation has been added to address this but it is self defeating, as after all, who enforces it but the government officials? A dilemma to say the least.

Change in Available Surplus

By far the biggest factor in underwriting guidelines is available surplus capital. All states require a carrier to carry a certain amount of surplus capital to offset catastrophic losses. If surplus is low, underwriters will be directed tighten up the risk window until more surplus can be found. On the other hand, when there is adequate surplus, carriers will be more likely to expand the riskier parts of their balanced portfolio.

These are just six reasons a carrier can change underwriting standards. If there are any we have missed, please use the contact form below to help us improve this article.

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Wouldn’t it be great if employers could make all their employee problems go away? Make them “Somebody Else’s Problem”?

We believe that when the Employee Leasing industry chose “PEO” as their new, politically correct moniker, they chose the wrong letters. We think they should call them Employer SEP’s – where the Employee Problems become Somebody Else’s Problems. When an employer and a PEO form a business partnership, defined by the Client Service Agreement (CSA), many of the risks and responsibilities are transferred (in whole or in part) to the PEO and are no longer the employer’s headache.

Will Tenney talks about the choice of the letters “PEO”

Some of the headaches that can be shifted or at least alleviated include:

Payroll Tax Liabilities

Since the employees are now employees of the PEO for tax purposes, and registered on the PEO’s FEIN, IRS payroll tax audits are not as much of a threat anymore. In most cases the client isn’t even involved. The PEO is audited, shows their records and it’s all over. In rare cases, a PEO might have to produce information supplied by the client, but this happens so seldom you might call it a Payroll Unicorn.

Workers’ Comp Claims

The PEO will be the employer of record, so they will be responsible for paying all workers’ comp premiums, and involved in negotiating the claims. In most states, the experience modifier will stay with the PEO, and the client will not be adversely affected in the future by past claims. In addition, the PEO has safety expertise, training and written programs to put in place to reduce the frequency and severity of claims.

Unemployment Claims

Similar to workers’ comp, this becomes the responsibility (and liability) of the PEO, who is the employer of record. The State Unemployment Tax Act rate (SUTA rate) of the PEO is the SUTA rate that gets affected (in most states. There are some exceptions) and the client can maintain a clean record. In addition, the PEOs are much more experienced at handling and negotiating claims and experience has shown they are much more effective at removing false claims.

Employee Lawsuits for Employment Practices

Again, since the PEO is the employer of record, some or all of the liability shifts to the PEO in these cases. This could include:

• Sexual Harassment
• Wrongful Termination
• Discrimination
• Unfair Hiring Practices

… to name but a few.

If you would like to make some of your employer problems become Somebody Else’s Problem, please feel free to use the contact form below, or call us at 407-490-2468

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More and more states are legalizing prescription cannabis (for medical use.) This has got people to thinking about how this can affect workers’ comp “Drug Free Workplace” programs.

Tuesday November 4th marks a landmark day in Florida as (by early polls) this amendment shows signs of passing by an overwhelming margin.

PEO Pros would like your input on the situation. Please use the contact form at the bottom of this post to give us your opinion, feedback, etc.

We found one very interesting article published by Mountain Land Rehabilitation, (excerpts shown below).

Can we continue to have a drug-free work place policy?
• Absolutely. In fact, some states specifically permit you to do so.
If an employee is using medical marijuana, is he/she responsible for notifying the employer he/she is using medical marijuana?
• No. (PEO Pros thinks that this will be changed in Florida, as use of medical marijuana will probably be proscribed in sensitive job capacities, such as driving, operating heavy machinery, or other critical positions.)
Does federal law trump state law?
• Yes, in most cases. However that is a continuing issue of debate.
Can we take adverse action against an employee who is legally using marijuana?
• Yes, with some state-specific exceptions.
How will this affect the Department of Transportation (DOT) Drug Testing program?
• It won’t at all. The DOT has issued a statement noting that there will be no impact to federal programs.
What happens if an employee who has a prescription for medicinal marijuana has an accident at work?
• This will depend on the specific state, along with the details within your workplace policy. Marijuana cannot be prescribed (with very limited exceptions). The use of marijuana can only be recommended by doctors. You may also be able to deny Workers’ Compensation benefits in states that allow you to do so.
Will Workers’ Compensation insurance cover the injury or will that be an exclusion due to the employee being under the influence? If not covered, will the employee have a legal claim due to his usage being tied to a medical need?
• So far nothing has changed in the Workers’ Compensation world with regards to marijuana use. Some states have specified that insurance does not have to cover medical marijuana.
Can any physician prescribe medical marijuana for any medical condition or are prescribers and conditions limited?
• Medical marijuana cannot be prescribed in any state (with one exception used in very limited instances). The use of marijuana can only be recommended in such states that allow for medicinal use. Each state law outlines who is able to make the recommendation and under what qualifying conditions.
We have staff in multiple states. What is the best way to standardize policies across the board?
• Due to the way state laws differ and are ever changing, you simply can’t standardize a policy across the board.
What if an employee lives in a state where marijuana is legal, but works in a state where it is not?
• Typically employers have the right to include the screening for marijuana in their drug-free workplace policy, but this can vary by state law. In general, employers are not required to impose legal marijuana standards in states where the personal use of marijuana is illegal.
Will a candidate’s state-issued marijuana drug card be proof enough that he can legally use the drug?
• This will depend on the criteria in each state. The recommendation card is only the result of the individual qualifying under state criteria.
How long does marijuana stay in your system?
• This will depend on many different factors, including but certainly not limited to: the frequency of use; potency of substance; method of ingestion; personal metabolism; and the method used for screening. The recent use of marijuana can be best detected via oral fluid (approximately 1-12 hour detection time window). Other screening methods include urine (approximately 2-30 day detection time window) and hair follicle (approximately 2-90 day detection time window).
How will legal marijuana use by employees impact our insurance rates?
• In most states, you cannot have insurance pay for marijuana. However, that doesn’t address the other health-related impacts that may or may not affect health insurance rates

Please give us your comments below.

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One of the unforeseen negatives of the Affordable Care Act was increased costs for workers’ compensation insurance, coming both from higher taxes assessed to insurance companies and higher costs of claims. The claims costs are on the rise due to more dependance on workers’ comp vs. traditional health insurance, increased medical costs and the big one, increased legal fees.

As the costs rise, the profit margins diminish. Naturally, the carriers are seeking to reduce their risks to maintain acceptable profit margins. This has led to a “hard market” where risks that were previously accepted are now being cancelled or non-renewed.

Staying “Off the Radar”

It is important to any employer who depends on having reliable workers’ comp insurance to remain off the radar of the carriers and their underwriters. The squeaky wheel get’s the grease, or on this case, the cancellation.

Here are some tips to stay off the radar:

1: Do not shop your workers’ comp policy right now. This will only draw attention to you or your company. Many lesser experienced agents use software that “shotguns” your application to several carriers, and several intermediaries who may duplicate your submission. Nothing sends a red flag to an underwriter more than seeing a submission come in from multiple sources at the same time.

2: Don’t do anything to jeopardize your policy. Don’t hide information, improperly describe working conditions or in any other way try to deceive your agent or your carrier. This is not the time to try to get them to change you to a lower priced code.

3: Do everything you can to minimize claims. Institute a safety program, and if you already have one, make sure everyone is following it.

4: Make sure your website does not advertise you doing “high risk” activities. We’ve seen landscaping company websites showing workers on the roofs of houses, cleaning out gutters. That is NOT in the landscaping comp code description.

5: Pay your premium on time and in full. Slow pay and low pay are great ways to get “on the radar.”

Below is a video of our lead agent John Will Tenney with further discussion:

If you would like more information please use the contact form below.

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As part of our strategic and contractual alliance with Stonehenge Insurance Solutions, we are happy to work with a growing Property and Casualty insurance agency, Hourglass PC.

Based in Tequesta, FL, Hourglass is expanding throughout the state, and eventually hopes to have offices nationwide.

Senior Agent Greg Siebern tells us, “We are focusing on the personal lines of home and auto, as well as the small business products such as general liability, workers’ compensation and business owner packages.”

As part of the marketing plan, Hourglass is sponsoring the Orlando Runners and Riders cycling team, Hourglass Cycling. On the belief that more and more business owners and C level executives are engaging in amateur sports such as cycling and running, Hourglass wants to take a leadership position in the Health and Wellness industry.

“Cycling is the new golf.” Will Tenney of PEO Pros tells us, “When you are riding in a group of 50 to 100 cyclists for several hours every weekend, there is conversation going on at all times. Where there is conversation there can be networking. Where there is networking, there is opportunity to help.”

Hourglass PC and PEO Pros have teamed up to sponsor an amateur cycling team

Jason Irving returns to us as a client with his new company, Engenium Staffing, a technical, engineering and professional recruiting and staffing firm.

“PEO Pros was and still is our best option for securing workers’ compensation and other insurance products.” Jason tells us, “We come here first and never need to go anywhere else. Now that they are partnered with Stonehenge Insurance and Hourglass Property and Casualty, they can take care of our other needs as well.”

We are happy to provide Jason and his company with workers’ comp, general liability, umbrella liability and even have one of our partner agencies working on his homeowner’s policy.

Here is a short interview with Jason where he tells us of some exciting positions available in his industry:

Why is pay as you go workers’ comp insurance the right choice for so many businesses these days?

What is Pay as you Go?
In this video clip, CEO John Will Tenney was interviewed by a local real estate office and answers a few questions about Pay as you Go Payroll and Taxes, as well as Pay as you Go Workers’ Comp. Both of these business options can help reduce costly audits and large bills at the end of a fiscal quarter, or the fiscal year.

A big thank you to Rick Aguirre of Remax Realty of Avalon Park for his help with the video.

Pay as you Go for Workers’ Comp
A “standard” workers’ comp policy comes with some “baggage” that many business owners would like to avoid. Not only are there extra fees for a “standard” policy and a possibly expensive audit every year, there are also some added risks. Why else are so many employers now looking at alternative methods? In today’s economy and business environment it pays to be flexible and innovative.

You may be asking what kind of baggage there is. Have you ever asked these questions?

• Who wants to pay a large premium deposit?
• What is this “expense constant” thing they charge?
• Why is it an estimate?
• Why is there an annual audit that usually ends up costing the business owner more money?
• Why is the timing on the big payment always so bad?
• Why are they telling me I am “mis-coded”?

Does any of this sound familiar in your business? How about these?

• Have you ever wondered why they can’t just take the comp premium at the same time you do payroll?
• Did you even know there are “Pay as you Go” workers’ comp insurance programs available?
• Is the only reason you are NOT doing pay as you go because you think it gives up control of your money?
• What is Pay as you go workers’ comp?”

All good questions. Here are some basic answers. (Please contact us to get more answers.)

Workers’ Comp premium is figured as a percentage of payroll for each employee in each “class code.” A “class code” is based upon the job description of the employee. For example, clerical employees and roofers have a different class code and of course a completely different rate of premium. “Mis-coding” is when the people are actually working at, or have different duties than those described in the class code.

PEO Pros functions both as a licensed insurance agency and employer consultants to assist employers in this area. Usually this involves placing the employer with a payroll service, or even a PEO. In many cases the payroll service is optional. Yes, you can still enjoy the transferred liability of a PEO without giving up your payroll.

The advantages to pay as you go services are many but here a few headaches that go away:

• Workers’ Comp annual audit is no longer needed
• Tax forms will be filed by the payroll service
• Large premium deposits go away
• Fewer problems predicting cost of employees
• Easier to add employees without incurring insurance increases
• Since reporting is more frequent (each payroll) changes in job description will likely result in less “mis-coding”

If any of this addresses a problem with your business or company, you may want to give us a call at 800.788.8343 or use the form below to contact us with your inquiry:

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PEO Services Workers Compensation Pay As You Go Comp Services Construction General Liability Health Insurance Broker/Agency Alliance Other Business Insurance Agent Appointment Other

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Has your workers’ comp coverage been denied or canceled? Not yet? Maybe it isn’t your turn just yet? If renewal time is coming up and you are worried, there are some steps you can take to make it easier.

What is involved in getting workers’ comp coverage? Understand that the insurance company is in the business of managing risks and they are taking a risk every time they add or renew a client. Your goal as a business owner then, along with your agent, is to convince the insurance company, or more specifically the underwriter, that you are a risk worth taking.

Here are the top 10 reasons why company owners either can’t get workers’ comp coverage or have it canceled or denied.

#10: Failure to be specific about what you do.
The ACORD form isn’t always enough. A detailed description of operations goes a long way in to convincing an underwriter that you are worth underwriting. It’s important to use percentages as well. For example, a lawn service company may want to say “80% residential and 20% commercial.” Make sure to list known excessive risk exposures too, such as how often you trim trees, or clean out gutters (involves getting on a roof.) Underwriters do not like surprises!

#9: Failure to maintain a safety program.
This is going to show up in your claims report sooner or later. A safety program not only has to be written, but enforced. Some roofers were seen working on a county school roof recently. They all had harnesses on but they were hooked to nothing. Doesn’t help much. Make sure your employees know the safety program and follow the rules.

#8: Spreading your company too thin.
So many companies try to do more than one thing. A famous person once said “If you try to be everything to everyone, you are going to end up being nothing to nobody.” Find your niche, stick to it, and don’t branch out in to other, riskier areas.

#7: “Shopping” your insurance around on a regular basis.
Sounds like a good business move doesn’t it? It’s not. Underwriters do not want to see your application year after year. Your company will get a reputation as a “policy jumper” and it will become more and more difficult to get a single company to take a chance on you.

#6: Underestimating your payroll to reduce premium.
Admittedly, a lot of times this is the fault of the agent. He or she underestimates your payroll to get you a lower quote. It has a downside, in that it makes you that much less attractive to the carrier. Report your payroll figures as accurately as possible. You plan on growing your company don’t you? It is OK to put that growth in your estimated payroll.

#5: Using too many subcontractors.
Lawyers have learned to “pierce the veil” and “climb the ladder” in subcontractor claims. If more than 20% of your business is handled by subs you are going to have a difficult time getting a traditional workers’ comp policy. Some companies have gone to strategic partner – referral arrangements, rather than subcontracting, because it separates the liability. Granted, you lose control of the cash flow but it is a lot easier to insure.

#4: Using “1099 employees”.
Let’s be clear, there is no such thing as a “1099 employee”. 1099s are reserved for independent contractors. Employees get W-2s. There is no middle ground. If you are paying employees as contractors, and therefore avoiding taxes and premium, sooner or later it will be revealed. The longer it takes to get caught, the more expensive it will be. Be very careful with this. Many states (and the IRS) are cracking down on this.

#3: Owning too many corporations or LLCs.
Workers’ compensation rules are different in different states, but all of them realize the potential cross-company liability of shared ownership companies. So much in fact, that there is a special form (ERM-14) that has a section dedicated to insuring companies with common ownership. While it may seem like a good idea to have multiple companies, most CPAs will tell you that the advantage is minimal compared with the extra paperwork and insurance difficulties. Check with your CPA of course, but it may be to your advantage to have different divisions within one company as opposed to having separate entities.

#2: Putting too much on your website.
Underwriters have the internet on their computers. They know how to use Google. Be assured they will comb every inch of your website to make sure you aren’t doing some high risk activity that you aren’t reporting. This has been the killing blow for several companies trying to get comp coverage. Which leads to the last, and most grievous error companies can commit:

#1: Lying to the insurance company (or agent).
Once you are caught lying on a form, or in an underwriting survey you are pretty much done for. We don’t know exactly how but we know that underwriters communicate with each other. We suspect they have a private Facebook group they tell stories in, and have good laughs about their latest “applicant.”

Never, ever, ever put false information on an insurance form. It’s in writing then and goes on your record. Don’t do it.

Why would anyone expect to find all their payroll, workers’ comp insurance and HR answers from one PEO?

Would you buy a suit that didn’t fit? So why expect one PEO to do it all?

Many business owners are frustrated that they can’t find the right payroll, workers’ comp or PEO solution that matches their business. Some small businesses feel “swallowed up” in the machine of a large, national payroll company. Larger businesses find that a local PEO or payroll provider just doesn’t have the experience, service or access to products that they need. There is no “One Size Fits All” in business.

Do any of these comments sound familiar?

• “My PEO doesn’t offer the services I need”
• “Nice fancy PEO website, but I know I am paying for it”
• “All we need is workers’ comp and payroll, why are we paying for all this other stuff?
• “We keep getting denied for workers’ comp coverage”
• “We’re tired of calling a machine. We want to talk to a person!”
• “Our rep? You mean this month’s rep? We’ve had 6 different reps in 6 months”
• “I wish my insurance agent could help us with more than just insurance”

Perhaps you might need a Custom PEO Solution. We may be able to help. Tell us what is missing. Please feel free to contact us using the form below.

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PEO Services Workers Compensation Pay As You Go Comp Services Construction General Liability Health Insurance Broker/Agency Alliance Other Business Insurance Agent Appointment Other

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Is it worth it to go get a workers’ comp exemption from the state?

“Oh I don’t need comp, I’m exempt.” Have you heard this before?

Perhaps it is best to start with a few definitions to clear things up.

In Florida, Every employer is subject to the workers’ compensation act, regardless of how many employees they have¹. The statute more or less states that an employer shall cover the expenses and lost time of any employee hurt on the job.²

An exemption from outside coverage is available from several states when there are certain conditions met, such as 1 employee or less, all employees are also 25% or more owners, etc. This exemption must be applied for, paid for and filed with the state.³

There are no “automatic exemptions.” No one is “exempt” by default. The state must approve the exemption.

Once an employer has received such an exemption, he or she is making a promise to the state that they will pay for all workers’ compensation claims with their own funds. In a phrase, they are “self-insured.”

Some employers argue that being self-insured is enough, since a lawsuit will only proceed against an insurance company. Please be advised that lawyers are aware that most small business owners have other assets, such as homes, cars, retirement funds, children’s college funds, etc. Since some collect a percentage based on what is recovered, it can be profitable to pursue private assets.

Exemptions No Longer Being Honored
Add to this confusion that many larger contractors and municipalities are no longer accepting workers’ comp exemptions in lieu of an actual policy. They have found that lawyers have learned to pierce the veil of an exemption and perform what is known as “climbing the ladder” to the actual contractor in the case of a sub-contractor injury. Exemptions do not protect the contractors.

So is it worth the fee ($50 to $100 for “construction” business based on the state) and the application to get an exemption? A small business owner may consider getting comp coverage instead. There are many options available, including direct policies, “pay as you go” polices from payroll companies (even Paychex and ADP are offering this now) or even the more extensive liability coverage available from a PEO (formerly Employee Leasing Company).

It is true that initially it would appear that an exemption is indeed cheaper. But as is the case with all insurance, consider this: What if something happens? What if someone gets hurt? What if the OWNER gets hurt seriously? Loses a limb or loss of an organ? A properly written and paid workers’ compensation policy will pay for all medical expenses, legal fees and up to two-thirds of lost wages for as long as the injury is in effect.

Choices: It’s left up to the business owner.
The business owner has a decision to make, to run with an exemption or to have peace of mind through a somewhat more expensive workers’ comp policy.
If a small business owner wishes to know more about exemptions, their relative uses and other options available, please use the contact form below.

The authors of this article had assistance from the members of The PEO Message, a Facebook group used to communicate within the PEO and Workers’ Comp industry. Specifically, thanks go to Doug Lilak, Christopher Yarn, Chad Filley, and Jeffrey Rendel for their valued input.

Notes:
From Florida Statutes Chapter 440
¹ 440.03 Application.–Every employer and employee as defined in s. 440.02 shall be bound by the provisions of this chapter.

² 440.02 (16)(a) “Employer” means the state and all political subdivisions thereof, all public and quasi-public corporations therein, every person carrying on any employment, and the legal representative of a deceased person or the receiver or trustees of any person. “Employer” also includes employment agencies, employee leasing companies, and similar agents who provide employees to other persons. If the employer is a corporation, parties in actual control of the corporation, including, but not limited to, the president, officers who exercise broad corporate powers, directors, and all shareholders who directly or indirectly own a controlling interest in the corporation, are considered the employer for the purposes of ss. 440.105, 440.106, and 440.107.

³ 440.05

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