WORKERS COMPENSATION: THE 2010 MODEL April 29, 2015 IASBO CONFERENCE.
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WORKERS COMPENSATION: THE 2010 MODEL April 29, 2015 IASBO CONFERENCE
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Transcript of WORKERS COMPENSATION: THE 2010 MODEL April 29, 2015 IASBO CONFERENCE.
WORKERS COMPENSATION:
THE 2010 MODELApril 29, 2015
IASBO CONFERENCE
MIKE NUGENT
●Worked for two large insurance brokers from 1981 – 1993
●Specialized in public entity insurance and pooling
●Created Nugent Consulting LLC in 1993
●Oversee, manage or consult to 30+ Illinois governmental agency self-insurance plans
●Manage 3 educational pools and 4 municipal pools
Diane Salomon
●Safety Director for the Secondary School Cooperative Risk Management Program (SSCRMP). (16 High Schools and 6 Alternative Schools)
●Primary responsibilities include; program implementation, incident investigation, facility inspections, claim analyses and safety recommendations to reduce work related injuries.
●Previously worked with Learning Care Group as the National Safety Specialist and Weber Stephen Products Company as a Safety Coordinator.
WC COVERAGE OPTIONS
●Pools
●Self-insurance
●Traditional Coverage
THE 2010 WC MODEL
●Front End Safety
●Nurse Triage
●Accident Investigation
●Dedicated Adjuster with Controlled Case Load
●Return to Work
FREQUENT MODEL
● Safety Audits / Inspections
● Safety Committees
● Policy Manuals
● Limited Accident Investigation
● Adjuster Case Load = 160 - 200
● Fax or email Form 45
● Initial Medical Triage by Supervisor
● Hyper PPO
● Limited RTW
NEW MODEL: FRONT END SAFETY
●Dedicated Safety Professional
●Accident Investigation
●Facility Inspections
●Training
●Safety Committees
●Resource
NURSE TRIAGE
● The Medcor Approach
● 1-800-NURSE
● Injured Employee calls the 800 number right after the injury
● The Nurse triages the claim over the phone
● Employee is sent for care to a designated medical provider or given self-care instructions
NURSE TRIAGE
●Calls are recorded and stored
●Translation in 200+ languages
●Triage report emailed minutes after the call
●Accident investigation is initiated minutes after the call
●Adjuster notified minutes after the call (No more form 45!)
NURSE TRIAGE RESULTS
●Provided an opportunity to commence accident investigation
●Provided a risk management tool
●Reduced lag time
●Improved adjuster / employee communication
●Reduced medical costs / per claim costs
●Employees have gone to designated provider 90% of the time
Claim Reporting- Average Lag DaysSecondary School Cooperative Risk Management Program
New Model: Dedicated Adjuster
●Hired a full time dedicated adjuster
●Capped case load at 60
●Contact with injured employees weekly
●Oversight of medical care
●Responsible for transition to RTW
New Model: RTW
●Previous resistance
●New Model / New Day
●Flexibility
●Everyone can work
Results
●SSCRMP Members WC claims volume decreased 4% from the three years after implementatin of the model, compared to three years prior.
●This reduction occurred even after the Nurse Triage system drew more claims into our system than before
●Total costs savings over the three-year period = $485,000 (after adjusting for medical inflation)
Additional Savings
●The number of auto accident cut in half, saving $700,000 over three years
●The number of student / visitor injury claims cut in half, saving $415,000 over three years
●Total Savings on non-WC claims = $1,115,000
Total Savings
$1,600,000
Q&A
●Q&A
