NAI’s Certification Program Here’s what people are saying ...
Laura Hart [email protected] 225-635-4481 Kelly [email protected] … · 2018. 10. 23. · p Preliminary...
Transcript of Laura Hart [email protected] 225-635-4481 Kelly [email protected] … · 2018. 10. 23. · p Preliminary...
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MississippiOctober 26, 2018
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© Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved.
▪ The Future@Work® Video
▪ Countrywide Workers Compensation System
▪ Mississippi’s Workers Compensation System
▪ Mississippi Kids’ Chance
▪ Countrywide and Mississippi Labor Markets
▪ The Data Connection Video
▪ Legislative Issues
▪ Opioids and Workers Compensation
▪ Residual Market: Countrywide and Mississippi
▪ Guest Speaker—Barrett Hathcock, Manager, Compensation Insurance Services
Mississippi State Advisory Forum
2
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The Future@Work®
Video
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CountrywideWorkers Compensation System
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Premium decreased slightly in the most recent year
The combined ratio continues to show favorable results
Frequency declined again at the latest point
Medical and indemnity severity increased modestly
5
Countrywide Workers Compensation (WC)—An Overview
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p PreliminarySource: NAIC’s Annual Statement data; includes state insurance fund data for the following states: AZ, CA, CO, HI, ID, KY, LA, MD, MO, MT, NM, OK, OR, RI, TX, and UTEach calendar year total for state funds includes all funds operating as a state fund in that year
WC Net Written PremiumPrivate Carriers and State Funds
37.840.1 39.8
47.845.6 45.0
10
20
30
40
50
97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17p
Calendar Year
State Funds
Private Carriers
$ Billions
6
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Sources: DWP Change: NAIC’s Annual Statement Statutory Page 14 for all states where NCCI provides ratemaking services Components: NCCI’s Policy data
WC Direct Written Premium (DWP) Change by ComponentPrivate Carriers—NCCI States
2017 vs. 2016
Payroll
Loss Cost and Mix
Carrier Discounting
Other Factors
Change in Direct Written Premium: 0.0%
-0.4%
+0.4%
-4.2%
+4.4%
7
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Sources: Moody’s Analytics and NCCI
Increases in Payroll Continue to Drive Changesin PremiumForecast Change 2016–2017
1%
2%
3%
4%
Prof. &BusinessServices
Trade,Transport.,& Utilities
Education& HealthServices
Manufac-turing
FinancialActivities
Construc-tion
Leisure & Hospitality
All Other
1%
2%
3%
4%
Prof. &BusinessServices
Trade,Transport.,& Utilities
Education& HealthServices
Manufac-turing
FinancialActivities
Construc-tion
Leisure & Hospitality
All Other
+1.6%
WageRate
+3.4%
Payroll
+1.8%
Employment
8
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© Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved. 9
p PreliminarySource: NAIC’s Annual Statement Statutory Page 14Values reflect changes in average premium levels between years, based on approved changes in advisory rates, loss costs, assigned risk rates, and rating valuesIN and NC are filed in cooperation with state rating bureaus
WC Approved Changes in Bureau Premium LevelWeighted by Effective Date—NCCI States
Percent
-5.4
-9.7-10
-5
0
5
02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18p
Calendar Year
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p PreliminarySources: NAIC’s Annual Statement Statutory Page 14 and NCCI’s Financial Call data Rate/loss cost departure reflects carrier departure from NCCI’s rate level, which excludes a profit and contingency provision and expense constantBased on data for all states where NCCI provides ratemaking services, excluding TX
WC Impact of Discounting on PremiumPrivate Carriers—NCCI States
0.5
-25
-15
-5
5
97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17p
Policy Year
Percent
10
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p PreliminarySource: NAIC’s Annual Statement data
WC Combined Ratio—Underwriting Gain AchievedPrivate Carriers
122
93
115
89
97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17p
Calendar Year
Percent
11
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53 49
14 13
25 26
1 2
97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17p
p PreliminarySource: NAIC’s Annual Statement data
WC Combined Ratio by ComponentPrivate Carriers
Loss Ratio
Loss Adjustment Expense (LAE) Ratio
Underwriting Expense Ratio
Calendar Year
DividendsPercent
12
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p PreliminarySource: NAIC’s Annual Statement dataAccident Year information is reported as of 12/31/2017Includes dividends to policyholders
WC Net Combined Ratios—Calendar Year vs. Accident Year As ReportedPrivate Carriers
9489
9599
25
50
75
100
125
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017p
Calendar Year
Accident Year
Percent
13
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2010 and 2011 adjusted primarily for significant changes in audit activityp Preliminary based on data valued as of 12/31/2017Source: NCCI’s Financial Call data, developed to ultimate, premium adjusted to current wage and voluntary pure premium level, excludes high-deductible policies; based on data through 12/31/2016Values displayed reflect the methodology underlying the most recent rate/loss cost filingIncludes all states where NCCI provides ratemaking services; WV is excluded through 2011
WC Lost-Time Claim FrequencyClaims per $1M Pure Premium, Private Carriers and State Funds—NCCI States
-6.2 -6
-10
-5
0
5
97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17p
Accident Year
Average Annual Change: –3.7%(1997–2016)
Percent
14
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p Preliminary based on data valued as of 12/31/2017Source: NCCI’s Financial Call data, developed to ultimate, excludes high-deductible policies; based on data through 12/31/2016Values displayed reflect the methodology underlying the most recent rate/loss cost filingIncludes all states where NCCI provides ratemaking services; WV is excluded through 2007
WC Average Indemnity Claim SeverityPrivate Carriers and State Funds—NCCI States
$2
3.4
$2
4.4
2.7%4%
5
10
15
20
25
97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17p
Accident Year
Severity($ Thousands)
15
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p Preliminary based on data valued as of 12/31/2017Sources: Severity: NCCI’s Financial Call data, developed to ultimate, excludes high-deductible policies; based on data through 12/31/2016Values displayed reflect the methodology underlying the most recent rate/loss cost filingIncludes all states where NCCI provides ratemaking services; WV is excluded through 2007US Average Weekly Wage: 1995–2007 and 2012–2016, Quarterly Census of Employment and Wages; 2008–2011, NCCI; 2017p, NCCI and Moody’s Analytics
Relative Growth Rates—Indemnity Severity vs. Wage InflationPrivate Carriers and State Funds—NCCI States
97 98 99 00 01 02 03 04 05 06 07 07 08 09 10 11 12 13 14 15 16 17p
Accident Year Accident Year
Changes in indemnity claim severity outpaced changes in wage inflation by 1.9% per year, on average
Indemnity claim severity and wagesgrew at a similar rate
16
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p Preliminary based on data valued as of 12/31/2017Source: NCCI’s Financial Call data, developed to ultimate, excludes high-deductible policies; based on data through 12/31/2016Values displayed reflect the methodology underlying the most recent rate/loss cost filingIncludes all states where NCCI provides ratemaking services; WV is excluded through 2007
WC Average Medical Lost-Time Claim SeverityPrivate Carriers and State Funds—NCCI States
$2
8.8
$2
9.9
6.0%4%
5
10
15
20
25
30
97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17p
Accident Year
Severity($ Thousands)
17
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p Preliminary based on data valued as of 12/31/2017Sources: Severity: NCCI’s Financial Call data, developed to ultimate, excludes high-deductible policies; based on data through 12/31/2016Values displayed reflect the methodology underlying the most recent rate/loss cost filingIncludes all states where NCCI provides ratemaking services; WV is excluded through 2007Personal Health Care (PHC) Chain-Weighted Price Index: Centers for Medicare & Medicaid Services
Relative Growth Rates—Medical Severity vs. Price InflationPrivate Carriers and State Funds—NCCI States
97 98 99 00 01 02 03 04 05 06 07 07 08 09 10 11 12 13 14 15 16 17p
Accident Year Accident Year
Medical lost-time claim severity grew approximately 4.5% per year faster than medical care prices
Change in Medical lost-time claim severity and medical care prices tracked one another
18
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Mississippi’sWorkers Compensation System
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Mississippi Workers Compensation System—An Overview
Premium volume has
been stable inrecent years
Combined ratios continue to
show favorable results
Claim frequency continues to
decline
20
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Mississippi Workers CompensationPremium VolumeDirect Written Premium in $ Millions
354 354
0
100
200
300
400
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Calendar Year
Source: NAIC’s Annual Statement data
21
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Impact of Discounting on Workers Compensation Premium in Mississippi
3.9
-10
-5
0
5
10
03 04 05 06 07 08 09 10 11 12 13 14 15 16 17p
Policy Year
p PreliminaryBased on data through 12/31/2017
22
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Mississippi Combined Ratios
9794 91 91 90
100
2013 2014 2015 2016 2017
Accident Year
Sources: NCCI’s financial data through 12/31/2017 and NAIC’s Annual Statement data
23
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52.3
37.0
0.2
2013 2014 2015 2016 2017
Accident Year
Mississippi Combined Ratios by Component
Loss Ratio
Expense Ratio
Dividends
Sources: NCCI’s financial data through 12/31/2017 and NAIC’s Annual Statement data
24
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Mississippi Workers Compensation Percent Change in Lost-Time Claim Frequency
-3.2-2.0
-15
-10
-5
0
5
10
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Cumulative Change of –39.5%(2002–2016)
Policy Year
Percent Change
Based on NCCI’s financial data through 12/31/2017, on-leveled and developed to ultimate, premium adjusted to common wage level
25
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$2
0.3
$2
0.4
-6.2% +0.5%
0
5
10
15
20
25
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Policy Year
Mississippi Average Indemnity Claim SeverityLost-Time Claim Severity in $ Thousands
Cumulative Change of +15.2%(2002–2016)
Based on NCCI’s financial data through 12/31/2017, on-leveled and developed to ultimate
26
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$3
2.1
$3
1.6
+1.1% -1.7%
0
5
10
15
20
25
30
35
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Policy Year
Mississippi Average Medical Claim SeverityLost-Time Claim Severity in $ Thousands
Cumulative Change of +61.4%(2002–2016)
Based on NCCI’s financial data through 12/31/2017, on-leveled and developed to ultimate
27
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-3.2%
-7.9%
-6.1% -6.0%
-10.7%
-1.6%
-7.9%
-5.7%
-4.3%
-10.9%
3/1/2015 3/1/2016 3/1/2017 3/1/2018 3/1/2019*
Voluntary Assigned Risk
*Pending
28
Mississippi Filing ActivityVoluntary Loss Cost and Assigned Risk Rate Changes
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Mississippi March 1, 2019 Loss Cost Filing
Overall Loss Cost Level Change:
–10.7%
Change in Experience:
–8.0%
Change in Trend:
–3.0%
Change in Benefits:
0.2%
Change in All Other:
–0.1%
29
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-8.0%
-12.0% -12.2%-11.7%
-10.2%
Manufacturing Contracting Office & Clerical Goods & Services Miscellaneous
Mississippi March 1, 2019 Filing—Average Changes by Industry Group
Overall Loss Cost Level Change: –10.7%
30
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1.10
1.20
0.50
1.00
1.50
MS AL AR LA TN Region Country
Average Voluntary Pure Loss Costs Using Mississippi Payroll DistributionPure Loss Cost—All Classes
Based on approved rates and loss costs in various jurisdictions from filings using data valued as of 12/31/2016
31
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Reflects the most recent experience filing in each jurisdiction Due to the timing of the individual loss cost/rate filings, the figures shown may include changes from prior filing seasons
Current NCCI Voluntary Market Loss Cost/Rate Level ChangesExcludes Law-Only Filings
-19.0
-10.7
6.2
-20
-15
-10
-5
0
5
10
TN CT CO NC AR AK NH TX FL WV ME KY MT MS OR IA SC GA IL UT NE AZ IN SD MD AL KS LA RI NM ID DC VT MO VA OK NV HI
Approved PendingPercent
32
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Current Voluntary Market Rates/Loss CostsSoutheastern States
-19.0%
-15.9%
-15.4%
-13.4%
-13.0%
-10.8%
-10.7%
-9.2%
-8.7%
-6.4%
-5.6%
-2.6%
Tennessee*
North Carolina*
Arkansas
Florida*
West Virginia
Kentucky
Mississippi*
South Carolina*
Georgia
Alabama*
Louisiana*
Virginia*
3/1/2019
4/1/2019
7/1/2018
1/1/2019
11/1/2018
10/1/2018
3/1/2019
4/1/2019
3/1/2018
3/1/2019
5/1/2019
4/1/2019
33
*Pending
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Mississippi Kids Chance The Mississippi Bar
643 North State StreetJackson, MS 39202
Phone: 601-948-4471
Byron Carter
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Countrywide and MississippiLabor Markets
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National Economic Highlights and Their Impact on Workers Compensation
36
National Economic IndicatorPotential Impact on the Workers Compensation Market
Private employment growth continues to be near 2%
Continuing payroll and premium growth
Wage growth is increasing and expected to accelerate
Upward pressure on payroll and premium growth as well as indemnity severity
Medical inflation is forecast to rise Increases in medical costs per claim
Short-term and long-term interest rates have increased
Investment yields will increase across the spectrum of bond maturities
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© Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved. 37
Change in Private EmploymentPrivate Employment Growth Is Below Average
+2.2
+0.6 +1.5+2.1 +1.8 +1.8
-2
0
2
4
6
2016 Q1 2017 Q1 2018 Q1
Mississippi United States
Year-over-year percentage change; employment is for Total Private IndustryFrequency of observation: quarterly; 2015 Q1–2018 Q1 Sources: US Bureau of Labor Statistics, Moody’s Analytics, and NCCI
Percent
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Change in Average Weekly WagesWage Growth Is Below the National Average
+1.4+0.3
+1.7+1.2
+1.6
+3.2
-2
0
2
4
6
2016 Q1 2017 Q1 2018 Q1
Mississippi United States
Year-over-year percentage change; wages are for Total Private IndustryFrequency of observation: quarterly; 2015 Q1–2018 Q1Sources: US Bureau of Labor Statistics, Bureau of Economic Analysis, Moody’s Analytics, and NCCI
Percent
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AWW = Average Weekly Wage2018 Q1 year-over-year percentage changeSources: US Bureau of Labor Statistics, Bureau of Economic Analysis, Moody’s Analytics, and NCCI
Private Industry Payroll Growth DecompositionPayroll Growth Is Lower Than the National Average
+1.5 +1.8
+1.7
+3.2+3.3
+5.0
Employment
AWW
Payroll
-2
0
2
4
6
Mississippi United States
39
Percent
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Change in Employment by SectorEmployment Has Increased in Most Sectors in the Past Year
40
Employment numbers are rounded to the nearest hundredYear-over-year percentage change; frequency of observation: quarterly; 2018 Q1 Sources: US Bureau of Labor Statistics, Moody’s Analytics, and NCCI
WV +14.0 33,900 5 +4,200US +3.3
WV +7.4 21,700 3 +1,500US +5.4
WV +0.7 130,700 17 +900US +2.1
WV +0.8 47,000 6 +300US +1.5
WV +0.5 66,100 9 +300US +2.2
WV +0.4 26,900 4 +100US +1.8
WV –0.4 73,900 10 –300US +2.3
WV –0.6 56,200 7 –300US +1.7
WV –0.5 132,100 18 –700US +0.7
WV –12.0 8,300 1 –1,200US –1.3
WV –2.5 153,600 20 –4,000US +0.1
1-Year
ChangeYear-Over-Year Percent Change, 2017Q4
Sector
Size
%
Share
Government
Industrial Sector
Construction
Natural resources and mining
Education and health services
Manufacturing
Information
Leisure and hospitality
Other services
Trade, transportation, and utilities
Professional and business services
Financial activities
Year-Over-Year Percent Change, 2017 Q4
MS +5.0 112,900 10 +5,400US +2.5
MS +2.2 145,900 12 +3,200US +2.0
MS +1.8 136,600 12 +2,300US +2.0
MS +2.9 45,300 4 +1,200US +1.6
MS +2.1 44,700 4 +900US +3.5
MS +0.6 144,700 12 +900US +1.8
MS +0.3 232,400 20 +600US +0.9
MS +0.4 41,800 4 +200US +1.6
MS –1.4 9,700 1 –200US +6.6
MS –0.1 242,700 21 –300US +0.0
MS –5.1 11,200 1 –600US –1.7
1-Year
ChangeYear-Over-Year Percent Change, 2018 Q1
Sector
Size
%
Share
Information
Industrial Sector
Professional and business services
Education and health services
Leisure and hospitality
Financial activities
Government
Trade, transportation, and utilities
Other services
Natural resources and mining
Construction
Manufacturing
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–10% –5% 0 +5% +10%
Payroll Growth
–10% –5% 0 +5% +10%
AWW Growth
–10% –5% 0 +5% +10%
Government
Trade, transportation, and utilities
Manufacturing
Education and health services
Professional and business services
Leisure and hospitality
Financial activities
Construction
Other services
Natural resources and mining
Information
Employment Growth
Mississippi’s Payroll Growth Decomposition by Sector
41
AWW = Average Weekly Wage2018 Q1 year-over-year percentage change; sectors are in descending order by the volume of state payroll amountsSources: US Bureau of Labor Statistics, Bureau of Economic Analysis, Moody’s Analytics, and NCCI
≈+
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Headline Unemployment Rate, seasonally adjusted Frequency of observation: monthly; latest available data point: June 2018Source: US Bureau of Labor Statistics (BLS), www.bls.gov
Headline Unemployment RateUnemployment Rate Is Above the National Rate
US: 4.0
MS: 4.7
0
2
4
6
Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
42
2017 2018
Percent
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© Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved. 43
▪ Mississippi’s unemployment rate is above the US rate
▪ Payroll increased in Mississippi from gains in both wages and employment
▪ Trade, Transportation and Utilities is the private sector with the largest payroll in the state
▪ Payroll grew fastest in the Financial Activities, Professional and Business Services, and Manufacturing sectors
▪ Employment growth is below the US rate
▪ Employment growth in the Professional and Business Services sector outperformed the national average
▪ Employment in Trade, Transportation, and Utilities and Manufacturing grew less than these sectors’ national averages
Mississippi’s Labor Market
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The Data ConnectionVideo
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Legislative Issues
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As of September 30, 2018:
▪ NCCI has tracked approximately 844 state and federal workers compensation-related bills
▪ 474 of the bills are in NCCI states
▪ 94 bills have been enacted (includes all jurisdictions and federal)
Legislative Overview for 2018
46
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CA
ORID
WA
MT
NV
AK
UT
AZ
CO
NM
WY
TX
OK
KS
NE
SD
ND
MN
IA
MO
AR
LA
IL
WI
MI
IN OH
MS AL GA
FL
TN
KY
SC
NC
VAWV
PA
NY
NJ
MEVT
NH
MD
DE
CTRI
DC
MA
HI
States Not in Session
0–10 Bills Introduced
11–20 Bills Introduced
21–30 Bills Introduced
More Than 30 Bills
Introduced
2018 Workers Compensation Legislative Activity
47
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© Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved. 48
Top Five WC Legislative Trends in 2018Number of Bills by Category
111
97
91
68
67
First Responders
Court/Legal Issues
Reimbursement/Fee Schedules
Compliance
Definition of Employee
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NCCI’s Engagement at the Federal Level
NCCI works with Congress and federal agencies to educate and inform federal public policymakers on the impact of legislative and regulatory issues on the state-based workers compensation system.
49
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NCCI’s Engagement at the Federal Level (cont’d)
NCCI provides information and insights to several federal agencies, including:
▪ US Department of Labor (USDOL)
▪ National Institute for Occupational Safety and Health (NIOSH)
▪ Government Accountability Office (GAO)
▪ US Department of the Treasury
50
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Federal Insurance Office—Report on TRIP Effectiveness
Key findings:
▪ The Terrorism Risk Insurance Program (TRIP) is effective in making terrorism risk insurance available and affordable
▪ TRIP has not had the effect of discouraging or impeding property/casualty insurance
▪ TRIP serves as an important backstop for workers compensation insurance
51
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Mississippi Legislative Activity2018 Legislative Session
52
MS SB 2311—Enacted; effective July 1, 2018[Amends Mississippi Code Sections 83-11-1, 83-11-7, 83-5-28, 83-11-101, and 71-3-77]
▪ The bill impacted notices of nonrenewal when a replacement policy form is issued by the same insurer or when an insured is transferred to a licensed affiliate of the insurer, termed “affiliate transfers.”
▪ “Affiliate transfer” is defined, in part, as “when an insurer transfers, at renewal or policy expiration, its personal or commercial lines insurance policies to an affiliated licensed insurer that is a member of the same insurance group or same holding company as the transferring insurer. The issuance of a replacement policy form . . . or the transfer of . . . policies to a licensed affiliate insurer . . . are considered a renewal and will not be treated as a cancellation or nonrenewal. . . .”
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Mississippi Legislative Activity2018 Legislative Session
53
MS SB 2311—Enacted; effective July 1, 2018[Amends Mississippi Code Sections 83-11-1, 83-11-7, 83-5-28, 83-11-101, and 71-3-77]
▪ Section 71-3-77 addresses workers compensation and generally requires 30-day prior written notice of nonrenewal or cancellation to the Mississippi Workers’ Compensation Commission (WCC) and the insured.
▪ SB 2311 amended Section 71-3-77 and eliminated the notice requirement “when a replacement policy form providing the same or substantially similar coverage is issued by the same insurer, or when a transfer of an insured to a licensed affiliate of the insurer providing the same or substantially similar coverage occurs.”
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Mississippi Legislative Activity2018 Legislative Session
54
MS SB 2311—Enacted; effective July 1, 2018[Amends Mississippi Code Sections 83-11-1, 83-11-7, 83-5-28, 83-11-101, and 71-3-77]
▪ SB 2311 included the following notice requirements:
▪ 30-day prior written notice of any terms or conditions less favorable to the policyholder by the same insurer or by a licensed affiliate insurer for replacement policy forms
▪ 45-day prior notice to MS DOI and MS WCC of the transfer of policies by transferring insurer (notice must include name of transferring insurer, and name and financial rating of insurer receiving transferred policies)
▪ 30-day prior written notice (prior to policy term expiration) by transferring insurer to policyholder (notice must include financial rating of insurer receiving transferred policies)
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Opioids and Workers Compensation
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▪ Prescription opioids are a class of drugs used to treat moderate to severe pain, particularly chronic, intractable pain
▪ Prescription opioids include oxycodone (OxyContin®), hydrocodone (Vicodin®), and morphine
▪ Opioids bind to and activate opioid receptors on cells in the brain and body
▪ Pain signals are blocked, and large amounts of dopamine are released
▪ Misuse of opioids can slow down breathing, which can lead to death
What Is a Prescription Opioid?
56
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▪ According to the US Department of Health and Human Services (HHS), in 2016:
▪ 11.5 million Americans misused prescription opioids
▪ 2.1 million reported an opioid disorder
▪ 116 died every day from an opioid-related overdose
▪ According to the Centers for Disease Control and Prevention (CDC), in 2016:
▪ 40% of opioid overdose deaths involved a prescription opioid
▪ The number of overdose deaths involving prescription opioids was five times higher than in 1999
▪ The US prescribing rate for opioids was 61 prescriptions per 100 persons
Background
57
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▪ According to NCCI’s data, injured workers who were prescribed at least one prescription in 2016 received three times as many opioid prescriptions as the overall US opioid prescribing rate
▪ Workers compensation is directly impacted because injured workers are often prescribed opioids for pain
Impact on Workers Compensation
58
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Two in five Rx claims received an opioid in Service Year (SY) 2016
Claims
CostsOne in four dollarsspent for prescription drugs in workerscompensation isfor opioids
Spend
The average cost of an opioid Rx claim is four times that of a nonopioid Rx claim
Source: NCCI’s Medical Data Call, Service Year 2016; states included are AK, AL, AR, AZ, CO, CT, DC, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MD, ME, MI, MN, MO, MS, MT, NC, NE, NH, NM, NV, OK, OR, RI, SC, SD, TN, UT, VA, VT , and WI
Opioids Are a Significant Share ofWC Prescription Drug (Rx) Costs
59
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Physicians interviewed by NCCI pointed to four key factors that led to the rise in opioid prescribing and consumption:
How Did We Get Here?
60
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State regulators interviewed by NCCI shared that tools in the fight against the opioid epidemic include:
State Regulators’ Perspective
61
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In 2018, a large majority of states considered prescription drug legislation or regulatory changes, including:
▪ Drug formularies
▪ Limitation on physician dispensing and repackaged drugs
▪ PDMPs
▪ Prescription drug fee schedules
Federal:
▪ New Initiative to Stop Opioid Abuse and Reduce Drug Supply and Demand
▪ CDC Guidelines provide recommendations for prescribing opioid pain medication
▪ Legislation—Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act
Legislative and Regulatory Activity
62
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Claims professionals interviewed by NCCI said that there are four key elements that are critical for successfully managing claims involving opioids:
Claims Professionals’ Perspective
63
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Find It on ncci.com/Insights
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Residual Market: Countrywide and Mississippi
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© Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved. 67
▪ As of January 2018, NCCI provides Plan Administration services in the following states:
▪ AK, AL, AR, AZ, CT, DC, GA, IA, ID, IL, KS, MS, NH, NM, NV, OR, SC, SD, TN, VA, VT, and WV
▪ Other Plan Services: DE, IN, and NC
▪ As of January 2018, NCCI provides Pool Administration services in the following states:
▪ National Pool: AK, AL, AR, AZ, CT, DC, DE, GA, IA, ID, IL, KS, NC, NH, NJ, NV, OR, SC, SD, TN, VA, VT, and WV
▪ New Mexico Pool
▪ Tennessee Reinsurance Mechanism
▪ Financial and Actuarial Services: MA and MI
NCCI’s Residual Market Services
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Barrett HathcockManager, Compensation Insurance Services
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Source: Compensation Insurance Services
69
Mississippi Total Residual Market PlanEstimated Premium Volume in $ Millions
19
16
0
5
10
15
20
25
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Policy Year
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7.3%
6.4%6.1%
5.3%
4.8%
2013 2014 2015 2016 2017
Policy Year
Source: Compensation Insurance Services
70
Mississippi Residual Market SharePlan Premium As a Percentage of Direct Written Premium
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Source: Compensation Insurance Services
71
Mississippi Total Residual Market PlanPolicy Counts
2,661 2,592
0
1000
2000
3000
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Policy Year
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Source: Compensation Insurance Services
72
Mississippi Residual Market Number of Policies by Policy Size
0
500
1,000
1,500
2,000
2,500
0-5 5-10 10-25 25-50 50-up
Policy Size in $ Thousands
2015 2016 2017
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Source: Compensation Insurance Services
73
Mississippi Residual Market Total Written Premium in $ Millions by Policy Size
0
3
6
9
0-5 5-10 10-25 25-50 50-up
Policy Size in $ Thousands
2015 2016 2017
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Source: Compensation Insurance Services
74
Mississippi Residual Market Reinsurance Pool Net Operating ResultsEstimated Net Operating Gains and LossesAs of the Quarter Ending 6/30/2018
$2,138
$4,103
$1,086
($848)
-$2,000 -$1,000 $0 $1,000 $2,000 $3,000 $4,000 $5,000
2014
2015
2016
2017
Operating Gains and Losses in $ Thousands
Po
licy
Year
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© Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved. 75
▪ National
▪ Stable residual market share
▪ Manageable operating results
▪ Residual market premium declined slightly in 2017
▪ High levels of customer service satisfaction
▪ Mississippi
▪ Decrease in premium volume
▪ Decrease in residual market share
▪ Self-funded operating results
Please visit ncci.com for additional state and countrywide information.
Residual Market Summary
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Closing Remarks
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Supplemental Information
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Total Benefit Costs in Mississippi
42%
36%
38%
58%
64%
62%
Indemnity Medical
Regional states are AL, AR, LA, and TNBased on NCCI’s financial data through 12/31/2017
78
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Mississippi Indemnity and Medical Loss Ratios
0.52
0.38
0.81
0.59
2009 2010 2011 2012 2013 2014 2015 2016
Policy Year
Indemnity Medical
Based on NCCI’s financial data through 12/31/2017 at current benefit level and developed to ultimate
79
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Mississippi Claim FrequencyPer Million of On-Leveled Premium
30.8
18.7
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Policy Year
Based on NCCI’s financial data through 12/31/2017, adjusted to a common wage level
80
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Mississippi Average Indemnity Claim SeverityAverage Indemnity Claim Severity in $ Thousands
24.8
20.4
17.7
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Policy Year
Adjusted to Common Wage Level Actual
Based on NCCI’s financial data through 12/31/2017 for lost-time claims at current benefit level and developed to ultimate
81
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Mississippi Average Medical Claim SeverityAverage Medical Claim Severity in $ Thousands
27.4
31.6
19.6
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Policy Year
Adjusted to Common Wage Level Actual
Based on NCCI’s financial data through 12/31/2017 for lost-time claims at current benefit level and developed to ultimate
82
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Average Voluntary Pure Loss Costs Using Mississippi Payroll DistributionPure Loss Costs—All Classes
1.10
0.50
1.00
1.50
2.00
TX AR
WV IN UT
KS
TN OR
NV
DC
AZ
MS
SD NC
KY
AL
VA
NM NE
CO
MD
OK HI
NH
MO ID FL LA ME IA GA SC MT RI IL A
K
VT
CT
CW
State
Based on approved rates and loss costs in various jurisdictions from filings using data valued as of 12/31/2016
83
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Mississippi Average Claim FrequencyFrequency per 100,000 Workers—All Claims
2,774
3,020
2,597
2,205
3,564
2,962
3,076
789 1,985MS
AL
AR
LA
TN
Reg
CW
Lost-Time Medical Only
Based on NCCI’s Statistical Plan data
84
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20.4
MS AL AR LA TN
Average Indemnity Claim Severity in the RegionLost-Time Claim Severity in $ Thousands
Based on NCCI’s financial data
85
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31.6
MS AL AR LA TN
Average Medical Claim Severity in the RegionLost-Time Claim Severity in $ Thousands
Based on NCCI’s financial data
86
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Mississippi Distribution of Claims by Injury Type
75%
78%
72%
15%
15%
19%
10%
7%
9%
Medical Only Temporary Total Permanent Partial Fatal & Permanent Total
Regional states are AL, AR, LA, and TNBased on NCCI’s Statistical Plan data for jurisdiction/claim type combinations for which three or more cases exist
87
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© Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved. 88
Regional states are AL, AR, LA, and TNBased on NCCI’s Statistical Plan data for jurisdiction/claim type combinations for which three or more cases exist
Mississippi Indemnity Loss Distribution by Injury Type
33%
42%
49%
56%
51%
47%
5%
3%
6%
4%
4%
Temporary Total Permanent Partial Permanent Total Fatal
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Mississippi Medical Loss Distribution by Injury Type
30%
35%
47%
48%
45%
41%
8%
7%
13%
12%
12%
1%
1%
Temporary Total Permanent Partial Permanent Total Medical Only Fatal
Regional states are AL, AR, LA, and TNBased on NCCI’s Statistical Plan data for jurisdiction/claim type combinations for which three or more cases exist
89
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Glossary
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▪ Assigned Risk Adjustment Program (ARAP)—An assigned risk market program that surcharges residual market risks based on the magnitude of their experience rating modification.
▪ Calendar Year (CY)—Experience of earned premium and loss transactions occurring within the calendar year beginning January 1, irrespective of the contractual dates of the policies to which the transactions relate and the dates of the accidents.
▪ Calendar-Accident Year (AY)—The accumulation of loss data on all accidents with the date of occurrence falling within a given calendar year. The premium figure is the same as that used in calendar year experience.
▪ Claim Frequency—The number of claims per unit of exposure; for example, the number of claims per million dollars of premium or per 100 workers.
Glossary
91
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▪ Claim Severity—The average cost of a claim. Severity is calculated by dividing total losses by the total number of claims.
▪ Combined Ratio—The sum of the (1) loss ratio, (2) expense ratio, and (3) dividend ratio for a given time period.
▪ Detailed Claim Information (DCI)—An NCCI Call that collects detailed information on an individual workers compensation lost-time claim basis, such as type of injury, whether or not an attorney was involved, and the timing of the claim’s report to the carrier.
▪ Direct Written Premium (DWP)—The gross premium income adjusted for additional or return premiums, but excluding any reinsurance premiums.
Glossary
92
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▪ Indemnity Benefits—Payments by an insurance company to cover an injured worker’s time lost from work. These benefits are also referred to as “wage replacement” benefits.
▪ Loss Ratio—The ratio of losses to premium for a given time period.
▪ Lost-Time (LT) Claims—Claims resulting in indemnity benefits (and usually medical benefits) being paid to or on behalf of the injured worker for time lost from work.
▪ Medical-Only Claims—Claims resulting in only medical benefits being paid on behalf of an injured worker.
▪ Net Written Premium (NWP)—The gross premium income adjusted for additional or return premiums and including any additions for reinsurance assumed and any deductions for reinsurance ceded.
Glossary
93
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© Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved.
▪ Permanent Partial (PP)—A disability that is permanent but does not involve a total inability to work. The specific definition and associated workers compensation benefits are defined by statute and vary by jurisdiction.
▪ Policy Year (PY)—The year of the effective date of the policy. Policy year financial results summarize experience for all policies with effective dates in a given calendar year period.
▪ Schedule Rating—A debit and credit plan that recognizes variations in the hazard-causing features of an individual risk.
▪ Take-Out Credit Program—An assigned risk program that encourages carriers to write current residual market risks in the competitive voluntary marketplace.
▪ Temporary Total (TT)—A disability that totally disables a worker for a temporary period of time.
Glossary
94
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Appendix
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© Copyright 2018 National Council on Compensation Insurance, Inc. All Rights Reserved.
▪ Financial Aggregate Calls
▪ Used for aggregate ratemaking
▪ Statistical Plan for Workers Compensation and Employers Liability Insurance (Statistical Plan)
▪ Used for class ratemaking
▪ Detailed Claim Information
▪ In-depth sample of lost-time claims
▪ Policy Data
▪ Policy declaration page information
NCCI’s Workers Compensation Resources
96
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▪ Collected Annually
▪ Policy and calendar-accident year basis
▪ Statewide and assigned risk data
▪ Premiums, Losses, and Claim Counts
▪ Evaluated as of December 31
▪ Purpose
▪ Basis for overall aggregate rate indication
▪ Research
Financial Aggregate Calls
97
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Policy Year Financial Aggregate Data
1/1/2016 12/31/20161/1/2015 1/1/2019 12/31/2019
Policy Expiration Date
Policy Effective Date
Policy Year2015
Policy Year2016
Policy Year2019
98
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Calendar-Accident Year Financial Aggregate Data
1/1/2017 12/31/20171/1/2016 1/1/2020 12/31/2020
Policy Expiration Date
Policy Effective Date
Calendar-Accident
Year2016
Calendar-Accident
Year2017
Calendar-Accident
Year2020
99
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▪ Experience by Policy Detail
▪ Exposure, premium, and experience rating modifications
▪ Individual claims by injury type
▪ Purposes
▪ Classification relativities
▪ Experience Rating Plan
▪ Research
Statistical Plan for Workers Compensationand Employers Liability Insurance(Statistical Plan) Data
100
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Valuation of Statistical Plan Data
PolicyEffective
18 Months
1stReport
Valuation
2ndReport
Valuation
3rdReport
Valuation
4thReport
Valuation
5thReport
Valuation
30 Months42 Months
54 Months66 Months
101