Report: California Workers’ Comp Medical Payment Trends Fell in 2018

NAPEO is right around the corner!  While in Austin, there’s certain to be quite a bit of discussion around claims trends throughout the country.  That said, I found the some interesting news out of California from the Insurance Journal regarding the continued decline of medical payments, number of claims and paid medical transactions.

See you in Austin!

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Medical payments in California’s workers’ compensation system continued to decline in 2018 as the medical payments per claim decreased, according to a report from the Workers’ Compensation Insurance Rating Bureau of California.

The WCIRB released its California Workers’ Compensation Aggregate Medical Payment Trends report comparing medical payment information from 2016 to 2018.

The report also includes an analysis on utilization and cost of opioid prescriptions over time and by region.

Other findings in the report include:

  • The medical payments for pharmaceuticals and to pharmaceutical providers declined sharply.
  • Physical therapy services experienced the largest increase in the share of medical payments driven by increases in both service utilization and paid per service.
  • Physical medicine and rehabilitation procedures continued to grow the fastest within all physician services and use of anticonvulsants increased more significantly than any other therapeutic groups.
  • Opioid prescriptions and costs declined significantly, mostly driven by fewer claims involving opioid prescriptions. In addition, average doses of opioids prescribed dropped sharply as did the concurrent use of opioids and sedatives.
  • Fresno, Bakersfield and Tulare areas had the highest share of claims involving opioid prescriptions, while the Silicon Valley area and the Los Angeles Basin had the lowest share.

Another WCIRB report issued this week showed a new drug formulary put into effect by the California Division of Workers’ Compensation over a year ago may be working as intended.

AM Best Assigns Credit Rating to Clear Spring Property and Casualty

Congrats to Clear Spring and the recent AM Best rating!

Press Release – AUGUST 14, 2019

AM Best Assigns Credit Ratings to Clear Spring P&C Co.; Downgrades Ratings of Lackawanna Casualty Co. and Other Subsidiaries


CONTACTS:
Jeffrey Stary
Financial Analyst
+1 908 439 2200, ext. 5689
jeffrey.stary@ambest.com

Robert Raber
Associate Director
+1 908 439 2200, ext. 5696
robert.raber@ambest.com

Christopher Sharkey
Manager, Public Relations
+1 908 439 2200, ext. 5159
christopher.sharkey@ambest.com

Jim Peavy
Director, Public Relations
+1 908 439 2200, ext. 5644
james.peavy@ambest.com


FOR IMMEDIATE RELEASE

OLDWICK – AUGUST 14, 2019
AM Best has assigned a Financial Strength Rating (FSR) of A- (Excellent) and a Long-Term Issuer Credit Rating (Long-Term ICR) of “a-” to Clear Spring Property and Casualty Company (Clear Spring). Concurrently, AM Best has removed from under review with negative implications and downgraded the FSR to A- (Excellent) from A (Excellent) and the Long-Term ICRs to “a-” from “a” of Lackawanna Casualty Company and its subsidiaries, Lackawanna American Insurance Company and Lackawanna National Insurance Company. The outlook assigned to these Credit Ratings (ratings) is stable. Clear Spring is domiciled in Dallas, TX, while the three Lackawanna companies are domiciled in Wilkes-Barre, PA. The companies are collectively referred to as Lackawanna Insurance Group (Lackawanna).

The ratings reflect Lackawanna’s balance sheet strength, which AM Best categorizes as strongest, as well as its adequate operating performance, limited business profile and appropriate enterprise risk management.

The ratings assigned to Clear Spring reflect the company’s role as a member of the group. Factors supporting this relationship include common ultimate ownership and management. Explicit support is provided through Clear Spring’s participation in the inter-company pooling agreement.

The rating downgrades reflect a revision in AM Best’s assessment of the group’s operating performance to adequate from strong. This rating action is in response to less favorable comparisons with peer companies assessed as having strong operating performances over the most recent five-year period in metrics such as loss and loss adjustment expense ratio and operating ratio. This places the group more in line with companies in the composite assessed as having adequate operating performances. The assessment also takes into consideration the execution risk associated with the blending of the distinct lines of business and geographic delineation of the member companies, which may affect prospective operating performance.

Negative rating actions would occur with a decline in the group’s risk-adjusted capitalization, operating performance well outside expected ranges, or business profile modifications that fail to gain traction.

This press release relates to Credit Ratings that have been published on AM Best’s website. For all rating information relating to the release and pertinent disclosures, including details of the office responsible for issuing each of the individual ratings referenced in this release, please see AM Best’sRecent Rating Activity web page. For additional information regarding the use and limitations of Credit Rating opinions, please view Understanding Best’s Credit Ratings. For information on the proper media use of Best’s Credit Ratings and AM Best press releases, please view Guide for Media – Proper Use of Best’s Credit Ratings and AM Best Rating Action Press Releases.

AM Best is a global rating agency and information provider with a unique focus on the insurance industry.

New House Bill Would Allow Insurance For Cannabis Sector

A bipartisan bill that would ensure legal marijuana and related businesses have access to insurance coverage has been introduced in the U.S. House of Representatives, just days after the bill was introduced in the Senate.

Rep. Nydia Velázquez, D-N.Y., and Rep. Steve Stivers, R-Ohio, have introduced H.R. 4074, the Clarifying Law Around Insurance Marijuana, or CLAIM, Act, which would help businesses operating in the rapidly growing cannabis sector obtain insurance products, according to a statement issued by the office of Rep. Velázquez on Monday.

“Due to discrepancies in federal and state law, insurers are understandably reluctant to provide coverage to legitimate, cannabis-based businesses,” Rep. Velázquez said in the statement. “Without casualty, property and title insurance coverage, the growth of this industry will be impeded if not blocked entirely.”

The CLAIM Act establishes a federal “safe harbor” to prevent federal criminal prosecution of insurers that transact with consumers and would prevent civil liability for agents, brokers and insurers that do business with the cannabis sector.

In addition to the insurance provisions, the House bill would require a Government Accountability Office study of hurdles facing women and minority entrepreneurs interested in entering the cannabis sector.

“For far too long, minority communities bore the brunt of our country’s backward marijuana policies,” Rep. Velázquez said. “As we normalize these products and this becomes a business, we must ensure minorities, women and other disadvantaged groups are able to enter this market and profit from this burgeoning industry.”

The CLAIM Act has been referred to the House Financial Services Committee.

https://www.businessinsurance.com/article/20190729/NEWS06/912329852/House-introduces-bill-to-allow-insurance-for-cannabis-sector

 

Beacon Aviation To Provide Workers’ Compensation Program Via Appulate

Excited about the partnership between our friends at Beacon Aviation and Appulate!

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Beacon Aviation To Provide Workers’ Compensation Program Via Appulate

MGA To Connect Program To Appulate Agent Network

Sarasota, FL – July 22, 2019 Beacon Aviation Insurance Services, Inc. is excited to announce that it will offer its Workers Compensation program via Appulate.

“Making the submission process easy for agents is a high priority” said John Cunningham, President at Beacon Aviation Insurance Services. “With Appulate’s automation, we are able to use technology to enhance the user experience and make it easier for agents to do business with us,” commented Cunningham.

Appulate offers independent insurance agents technology so that they can bridge data directly from their management systems to make the submission process to key programs easier. By working with Appulate, Beacon will bring its Workers’ Compensation program, that focuses on risks in the aviation industry to the nearly 30,000 independent agencies using Appulate’s platform nationwide.

“Agents using Appulate want to be able to more easily submit to key program administrators,” said Jeff Harris, President at Appulate, Inc. “Beacon has a unique program that serves the Aviation industry and we are pleased to partner with them on their offering” stated Harris.

To access this program, an agent simply needs to have an Appulate account. This is offered free of charge and can be setup within 5 minutes. Once the agent has an account, they will be able to bridge ACORD and other data from their management system to complete the Beacon Aviation online application.

About Beacon Aviation Insurance Services

Established in 2003, Beacon Aviation Insurance Services, Inc. (an Amynta Group Company) is a Workers’ Compensation Program Manager specializing in workers’ compensation insurance coverage for the general aviation industry. Based in Sarasota, Florida, we work with a nationwide network of partner agents and brokers to offer coverage in all non-monopolistic states except Alaska. Beacon “holds the pen” for AmTrust Insurance Underwriters.

Our experience and expertise in providing workers’ compensation coverage and risk-management solutions extends to a full range of general aviation businesses: Fixed Base Operators (FBOs), Maintenance Repair and Overhaul operations (MROs), Municipal Airports, Airline Services, Aviation Manufacturers and Suppliers, Charter Operators, Flight Schools, and Corporate/Industrial Aid.

We pride ourselves on being responsive to each client’s individual needs. That personal touch, combined with our extensive industry expertise, is why so many agents, brokers and policyholders choose to work with Beacon.

Visit Beacon Aviation at www.beaconais.com

About Appulate, Inc.

The digital age is rapidly changing the way agents quote business with their carriers. Long gone is the fax machine – replaced by mobility and algorithms. Today, agents (and the insureds they represent) demand instant gratification. If business can’t be conducted quickly, customers go elsewhere.

Appulate powers the digital transformation of insurance by bringing together the insured, agent, wholesale broker, MGA and carrier on a single “point of sale” platform designed to expedite the rate, quote and even bind process for property and casualty risks.

Carriers and MGAs use Appulate to not only digitize their products and programs, but further expose them to the more than 30,000 agencies using Appulate today.

Appulate is where Agents, MGAs & Carriers do business digitally!

Visit Appulate at www.Appulate.com.

Check out our upcoming webinar:

 

Beacon Aviation Workers’ Compensation Powered by Appulate

 

Scooter Riders Advised to Avoid Insurance Pothole

More on the scooter fad from Insurance Journal…specifically, what’s not typically covered when a rider causes an accident.

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We’ve all seen reports about head injuries, traffic accidents and even deaths that electric scooter riders have suffered as the popular new mobility option has pushed onto the streets in more than 100 cities worldwide.

Despite the dangers, riders are exposing themselves to liability and are most likely not insured for the damages they may cause.

A rider’s personal health insurance — if he or she has it — could help defray the cost of their own medical bills in case of an accident.

But it’s another matter entirely when a scooter rider hits and injures a pedestrian, damages someone’s property or causes a car accident. The rider may be held responsible, and most insurance policies will not cover those expenses.

“Under the standard insurance policy, there’s most likely a pretty significant gap in coverage,” said Lucian McMahon, senior research specialist for the Insurance Information Institute. “Even if the odds are low, it doesn’t mean that something bad might not happen, and owing people money or compensation for injuries that you caused them can get very, very expensive, perhaps even ruinously so.”

The two largest scooter companies in the U.S. — Bird and Lime — generally place the responsibility for accidents on riders by listing in their rental agreements that riders relieve the companies of liability. Customers must agree to those terms to ride.

Bird says riders are fully insured for anything that might happen as a result of a faulty Bird scooter. Lime says its insurance policy offers at least $1 million in liability coverage for each covered claim, but there’s no way to know whether a claim is covered until an investigation is done, and each claim is unique.

Despite the scooter companies’ liability insurance, experts say responsibility for damages is likely to fall on the riders’ shoulders, because of the terms and conditions users agree to when they download the app.

“These are such new modes of transportation that the courts have not weighed in on any of this,” said Bryant Greening, attorney and co-founder of LegalRideshare, which represents clients injured in ride-hailing or shared scooter accidents. “Generally speaking, these waivers of liability hold up in court, but we’re going to have to see what happens as more and more of these injury cases are brought and are litigated.”

Electric scooter riders might think their auto insurance would kick in to cover an electric scooter accident, but automobile insurance generally doesn’t cover vehicles with less than four wheels. And homeowner’s or renter’s insurance may cover an accident that occurs on a traditional bicycle, but it does not cover motorized bike or scooter trips.

“Once you motorized that scooter or that bike, then the equation changes,” said Bob Passmore, assistant vice president at the American Property Casualty Insurance Association. “More likely than not, most people’s home liability or their renters’ liability probably aren’t going to provide coverage for that.”

So what can scooter riders do to protect themselves? Experts suggest calling an insurance agent to ask how to get coverage. If you have a homeowner’s or renter’s insurance policy, you may be able to add an `”umbrella policy,” which can cover more scenarios and include higher limits for coverage than typical homeowner’s or renter’s policies.

For example, State Farm offers a personal liability umbrella policy that the company said may cover an electric scooter driver’s liability for damages they cause, but all claims are investigated based on their own merits. Allstate offers an umbrella policy to customers that have a qualifying auto or property insurance policy. The umbrella policy doesn’t specifically state that it covers electric scooters in promotional materials, but there is a “recreational vehicles” category.

Nationwide’s policies do not provide liability coverage for losses arising out of the use of shared electric scooters. The company says it supports shared mobility options and believes the devices should be governed by common-sense regulation that emphasizes safety and protects all road users. “When that is in place, insurance covering the operation of a shared mobility device should be provided directly to the consumer by the device provider,” Nationwide said in a statement.

“Read your policy and talk to your insurance agent,” Passmore said. “There’s certainly some issues that need to be worked out.”

Voom, an Israeli company which offers on-demand insurance for drone operators in the U.S., plans to roll out per-ride insurance that covers electric scooters and is targeting riders and providers as potential customers.

“My partner being a scooter owner, and me being a scooter sharing rider, we kind of realized, who is insuring those things?” said Ori Blumenthal, co-founder and CTO of Voom. “If you go to all the scooter sharing companies and you look at the terms and conditions, you actually take responsibility and liability for everything that may happen.”

Riders in the U.S. took 38.5 million trips on shared scooters last year, according to the National Association of City Transportation Officials. Within a few days of Chicago’s recent electric scooters launch, LegalRideshare got calls from injured riders asking for help.

If a rider causes a car crash, he or she could be badly injured and still be held financially responsible for damages to the car, Greening said. If the rider injures a pedestrian, the rider could be responsible for the pedestrian’s medical bills, lost wages and pain and suffering. Many shared electric scooter riders are riding scooters for the first time, increasing the chance of injury, Greening said.

“They don’t think to themselves, `boy if something goes wrong here I might be on the hook for thousands and thousands of dollars,”’ Greening said.

Avoid a Workers’ Comp Disaster With Smart Electric Scooter Limits for Employees

See below from our friends at XMI PEO regarding the recent electric scooter fad. Interesting times!

Move over, Uber. Electric scooters are the latest transportation fad popping up in cities of all sizes. Urban commuters across the country are zipping around on these devices, utilized by a smartphone app and rented by the minute.

While e-scooters offer an easy and sustainable way to get around, their fast popularity is already sparking concern for businesses whose employees are using them on company time. Whether an employee hops on a scooter to make a customer delivery, run an office errand, or meet with a client across town, riding these devices on the clock exposes companies to workers’ compensation risks that they may never see coming. And with more employees using scooters to commute to and from work, the lines of liability can get murky.

Scooter operators typically require users to sign waivers absolving the manufacturer of any responsibility should an accident happen. In case of a serious injury, however, these waivers are usually not worth the paper they’re printed on. Nonetheless, if an employee is injured on a scooter while conducting what’s considered to be company business, the employer could end up with a hefty workers’ comp claim. Worse yet, the business could get slapped with a tort lawsuit if an employee injures someone else or damages their property while riding a scooter.

Scooter accidents on the rise

How likely are these scenarios on a vehicle that goes less than 20 miles per hour? The chances are fairly high if you consider the spike in emergency room visits for injuries such as broken bones and concussions caused by scooter-related accidents. Few people who ride the scooters wear helmets or have much experience operating one. A recent study by UCLA found that only 4 percent of Los Angeles scooter users wear helmets. Combine that with hectic pedestrian and roadway traffic and distracted drivers, and the odds are ripe for a collision.

“Anytime you give someone a task that involves operating some kind of vehicle, something is bound to happen—it’s just a matter of time,” says Gordon Berger, a law partner with Atlanta-based FisherBroyles LLP, which advises XMI on labor and employment issues.

“Like any emerging technology that can be used as a means of transportation during work, employers have a responsibility to make sure employees understand what safe and practical use would be,” Berger says.

Employees and electric scooters

So, what’s the best way to handle employees using scooters during work hours? There are several routes you could take, but if you want to protect your company from being held liable for potential accidents, you need a clear-cut policy on what’s acceptable for their use.

First of all, decide if you want to give employees the option of using scooters. You could put a disclaimer in your employee handbook stating that you don’t recommend or approve their use during work hours or for business-related activities. That puts the onus on employees, who could face disciplinary action for violating the policy.

“Reinforcing the way you feel about your employees using these types of vehicles through company policies, payroll stuffers and email is the best way to protect yourself,” says Paul Hughes, CEO of Libertate Insurance, an Orlando-based property and casualty insurance provider. “You can’t be with them every minute of every day, but you can document how you expect them to act and enforce it as best you can.”

Proceed with caution—and scooter safety guidelines

If you want to give workers the freedom to use scooters, it’s best to set some safety parameters, such as requiring them to wear a helmet and learning how to operate one first. You may even want to restrict when and where they can use scooters or how fast they can drive them. It’s also wise to ban their use of cell phones, headphones or other devices while maneuvering scooters through busy streets.

“It’s possible to come up with a happy medium that allows employees to participate in this new technology, while limiting their use of it in ways that don’t seem sensible or safe,” Berger says.

https://xmigrowth.com/scooters-and-workers-comp/

The History of Father’s Day

I am fortunate enough to have 3 men I call dad. I won’t go into why but my love for the dads in my life prompted me to dig into the history of Father’s Day. Ironically, Fathers’ Day was started by a woman, Sonora Smart Dodd, who was perplexed as to why fathers weren’t celebrated to the same extent as mothers on an annual basis. In her opinion, her father who was a widower and raised 6 children on his own definitely deserved acknowledgement. And, so it began…this wonderful day that praises the many biological dads, step-dads, men (and women) who are raising their children to be, at the most basic of levels, good people.

From all of us at Libertate, here’s to you Dad!

Click here for more information on this wonderful day.

Extensis Named Company of the Year by CIO Applications Magazine

See the below/attached article circulated by NAPEO regarding Extensis’ most recent award. Congrats!

NAPEO member Extensis Group LLC has been named a company of the year by CIO Applications magazine. The publication noted how HR departs have evolved, and the immense value proposition that PEOs hold. Extensis was recognized for its technology offerings. CIO Applicationswrites, “Extensis caters to its clients through a fully cloud based human resource information system (HRIS) platform: HRCloud. The service suite comprises HR administration and consulting, workers’ compensation, and risk management, along with Fortune 500-level employee benefits.  Managers can oversee their employee workforce through the Manager Self-Service portal and worksite employees can view their PTO, personal deductions, and 401(k) contributions in Employee Self-Service.”