Chief Actuary Antonello to Be Next CEO of Employers Holdings

Excited to announce that former NCCI Chief Actuary, Katherine H. Antonello, will take the helm at Employers beginning next April. Here’s to hoping 2021 will bring this great carrier into the PEO space!

Source: Insurance Journal

Small business workers’ compensation insurance specialist Employers Holdings Inc. has named Katherine H. Antonello as its president and chief executive officer.

She will take over upon the retirement of Douglas D. Dirks on April 1, 2021. Dirks will be retiring after heading the company for more than 27 years.

Antonello joined EMPLOYERS in August 2019 as executive vice president and chief actuary of the company. Prior to joining EMPLOYERS, Antonello served as the chief actuary for the National Council on Compensation Insurance (NCCI) from 2013-2019.

Antonello has more than 25 years of workers’ compensation insurance experience having held leadership roles in actuarial, policy services, claims and internal audit functions. In addition to working at NCCI, she has worked at Lumbermen’s Underwriting Alliance and the consultant Milliman.

Katherine Antonello

Michael J. McSally, chairman of the board, said that in her “relatively short tenure” with the company, Antonello has demonstrated her “ability to be a visionary and think strategically” about the business.

“As a mono-line company, we have the size, talent and entrepreneurial spirit to excel at what we do best,” commented Antonello. “We understand comp. I look forward to continuing our digital transformation, focusing on exceptional service to injured workers and ease of doing business for our agents, partners and policyholders.”

Reno, Nevada-based Employers Holdings operates throughout the United States, with the exception of four states that are served exclusively by their state funds. It offers its coverages through Employers Insurance Company of Nevada, Employers Compensation Insurance Co., Employers Preferred Insurance Co., Employers Assurance Co. and Cerity Insurance Co. Not all companies do business in all jurisdictions.

California Workers’ Comp COVID-19 Claim Count Tops 50,000

Below is a quick COVID update from workerscompensation.com regarding COVID claims in California. Let’s hope this downward trend continues!

Oakland, CA (WorkersCompensation.com) – The California workers’ compensation COVID-19 monthly claim count may have peaked in July, but the latest tally by the California Workers’ Compensation Institute (CWCI) shows that as of November 2, there have been 50,592 COVID-19 claims reported to the state Division of Workers’ Compensation (DWC) so far this year – including 282 death claims. That translates to 1 out of every 9 California job injury claims reported for accident year (AY) 2020.

The latest figures show that after climbing rapidly over the first 7 months of this year and hitting a record 14,453 claims in July, the number of COVID-19 workers’ compensation claims reported to the DWC began to dwindle. The updated count shows 6,710 claims with August injury dates, 3,779 claims with September injury dates, and 2,016 claims with October injury dates. A significant number of claims from September and October could still be reported, but the initial claim counts from both these months were well below the early counts from June and July, so even accounting for the reporting lag associated with COVID-19 claims, those figures suggest a significant downtrend. Using claim development factors based on historical claim development from 2019 and the fluctuating development pattern for 2020 COVID-19 claims, CWCI now projects that there could ultimately be 15,786 COVID-19 claims with July injury dates, 6,910 claims with August injury dates, 4,535 claims with September injury dates, and 5,242 claims with October injury dates, which puts the projected number of COVID-19 claims for the first 10 months of AY 2020 at 57,833. Notably, denial rates for COVID-19 claims have stabilized within a narrow range, holding between 28.7 percent and 31.3 percent from April through August, while denial data on September and October claims is still too green for analysis as many of those claims remain under investigation. The distribution by industry shows that COVID-19 claims remain heavily concentrated among a small number of industry sectors, with more than three quarters of the claims from the first 10 months of this year involving workers in health care (37.1 percent); public safety/government (15.0 percent); manufacturing (8.3 percent); retail (7.9 percent); transportation (5.1 percent), and food service (4.4 percent).

The data on claims reported through October is included in the latest update to CWCI’s COVID-19 and Non-COVID-19 Interactive Claim Application, an online tool that integrates data from CWCI, the DWC, and the Bureau of Labor and Statistics to provide detailed information on California workers’ comp claims from comparable periods of 2019 and 2020. The new version features data on 1,047,448 claims from the first 10 months of AY 2019 and AY 2020, including the 50,592 COVID-19 claims reported for AY 2020. As of November 2, the DWC had received reports on 458,941 workers’ compensation claims with January through October 2020 injury dates, which even with the COVID-19 claims, was 22 percent less than the total reported for the corresponding period of 2019, or 12.5 percent less after factoring in the projected claim development for AY 2020. The decline in the overall claim count reflects the economic slowdown and declining employment, as well as the millions of Californians who continue to work from home.

CWCI updates its COVID-19/Non-COVID 19 data app with new data every two weeks and plans to expand its features as more data on claim type and systemwide costs become available. The application is available to the public here.

OIR Orders Larger Workers’ Compensation Insurance Rate Decrease for 2021

TALLAHASSEE, Fla. – Florida Insurance Commissioner David Altmaier has issued an Order​ to the National Council on Compensation Insurance (NCCI) requesting an amended rate filing to further reduce workers’ compensation rates for 2021.

The Order notifies NCCI that the rate filing submitted for a 5.7% rate decrease has been disapproved and, if amended by November 4, 2020, will be approved with the larger workers’ compensation rate decrease of 6.6%. Approval of the revised 6.6% rate decrease is contingent on the amended filing being submitted with changes as stipulated within the Order.

If approved by OIR, the revised rate decrease would become effective on January 1, 2021, for new and renewal business.

For more information about the NCCI public hearing and rate filing, visit the OIR NCCI Public Rate Hearing webpage.​ 

About the OIR

The Florida Office of Insurance Regulation (OIR) has primary responsibility for regulation, compliance, and enforcement of statutes related to the business of insurance and the monitoring of industry markets. For more information about OIR, please visit our website or follow us on Twitter @FLOIR_comm.

Workers’ Compensation Should See Profit in 2020 But Next Year Will Most Likely Be a Different Story

Source: Fitch Ratings

Despite the economic challenges from the coronavirus pandemic, the workers’ compensation insurance market is likely to report strong profitability in 2020 thanks to savings from lower claims frequency due that are currently outpacing pandemic-related losses, according to Fitch Ratings.

However, Fitch analysts warn, underwriting performance in 2021 and beyond will likely deteriorate, as claims activity normalizes with increased business activity and premium revenue continues to fall amid recent underwriting exposure reductions and competitive pricing forces.

According to Fitch, workers’ compensation insurance has been the most consistently profitable segment in U.S. commercial lines over the last five years, with a 91% average combined ratio from 2015-2019, Fitch notes. Loss reserves have also exhibited unusual strength with favorable prior-year development of 15% of calendar year earned premium in both 2018 and 2019.

While events remain highly fluid, year-to-date overall workers’ compensation results remain favorable. The direct loss ratio of 50% remained unchanged in the first half of this year versus the prior year first half.

Reports indicate that claims frequency is down significantly, tied likely to the slowdown in economic activity, with sharp reductions in employee time spent at the workspace. The California Workers’ Compensation Insurance Rating Bureau (WCIRB) reported second quarter claims frequency compared to the prior-year quarter was down by 10% for indemnity claims and 33% for medical only claims.

Pandemic-related long term or catastrophic claims have also been limited to date. However, uncertainty remains regarding longer term health implications for more severe virus cases, including the potential for major organ damage and other chronic conditions that would ultimately increase workers’ compensation costs.

Pandemic-related cases represent 7.4% of year-to-date paid claims, 99% of which settled for payments of less than $10,000, according to the Florida Division of Workers’ Compensation’s recent 2020 COVID-19 Report.

Due to prior profitability, workers’ compensation is the only major commercial lines segment not experiencing significant premium rate increases. Segment direct written premiums in the first half of this year fell by 9% versus the prior-year period. “These volume declines are likely to continue in the near term, with underwriting exposure reductions, reduced employer payrolls and effects from negative premium audits,” the report says.

Negative premium rate pressure may briefly pause amid current economic uncertainty but not meaningfully subside over the next few years. Future premium volume will also hinge on the pace of the economic recovery, with recognition that improvement in employment and wages will be uneven across sectors.

Fitch says the strength of the economic recovery will also influence claims frequency levels going forward. However, some of the broad socio-economic shifts in response to the pandemic may have a longer-term effect on workers’ compensation risk exposures and claims costs, Fitch adds.

Also, Fitch analysts say greater use of telemedicine in case management, more prevalent work from home arrangements and reduced employee travel activity will affect the severity and frequency of claims.

https://www.insurancejournal.com/news/national/2020/10/27/588273.htm

Summary of 2020 Employer Health Benefits Survey

Each year, the Kaiser Family Foundation conducts a survey to examine employer-sponsored health benefits trends. This document summarizes the main points of the 2020 survey and suggests how they could affect employers.

Health Insurance Premiums

In 2020, the average premium rose by 4% for both single coverage and family coverage. The average premiums were $7,470 and $21,342, respectively.

However, premiums for single coverage under high deductible health plans with a savings option (HDHP/SOs) were noticeably lower than the average single coverage premium. The family coverage average between HDHP/SOs and other plans was largely the same. HDHP/SOs’ annual premiums for single and family coverage were $6,890 and $20,359, respectively.

Worker Contributions

The average worker contribution toward the premium was 17% for single coverage and 27% for family coverage. Employees at organizations with a high percentage of lower-wage workers (where at least 35% make $25,000 or less annually) made above-average contributions toward family coverage—35% vs. 24% when compared to employees at firms with a smaller share of lower-wage workers.

In terms of dollar amounts, workers contributed $1,243 and $5,588 toward their premiums for single coverage and family coverage, respectively. Workers enrolled in HDHP/SOs contributed less on average, paying $1,061 for single coverage and $4,852 for family coverage.

Plan Enrollment

The following were the most common plan types in 2020:

  • Preferred provider organizations (PPOs)—47% of workers covered
  • HDHP/SOs—31% of workers covered
  • Health maintenance organizations (HMOs)—13% of workers covered
  • Point-of-service (POS) plans—8% of workers covered

HMO enrollment has gone up and down over the last several years (enrollment was up to 19% in 2019), so it’s unclear how this will trend in the near future.

Employee Cost Sharing

Most workers must pay a share of their health care costs, and the average deductible for all workers was $1,644 in 2020. The average annual deductible has increased by 25% over the past five years and nearly 80% over the past decade. The prevalence of HDHP/SOs has contributed to the increase of deductible amounts. The percentage of covered workers with a general deductible of $2,000 or greater has increased to 26% in the last five years.

Beyond deductibles, the vast majority of workers cover some portion of the costs from their health care services. For example, 65% of covered workers have coinsurance, and 13% have a copay for hospital admissions.

In addition, nearly all workers are covered by a plan with an out-of-pocket maximum (OOPM), but the costs vary considerably. Among covered workers with single coverage, 11% have an OOPM of less than $2,000, and 18% have an OOPM of $6,000 or more.

Availability of Employer-sponsored Coverage

Similar to the last few years, 56% of employers offer health benefits to at least some workers. Only 48% of very small employers (three to nine employees) offer coverage, while nearly every large employer (1,000 or more employees) offers coverage.

Health and Wellness Promotion Programs

Wellness programs help employees improve their lifestyles and avoid unhealthy habits. Fifty-three percent of small employers and 81% of large employers offer at least one wellness program in the areas of smoking cessation, weight management and lifestyle coaching. Of these large employers, 44% offer participation incentives like gift cards or merchandise.

Telemedicine

The large majority of employers with 50 or more workers have embraced telemedicine, with 85% offering health care services through this method. Within the last year, telemedicine offerings have increased significantly, especially among employers with between 50-199 workers.

Self-funding

Twenty-three percent of workers with small employers are enrolled in plans that are either partially or entirely self-funded, compared to 84% of workers with large employers. In the past few years, level-funded plans have become more popular. Level-funded plans are health plans provided by insurers that include a nominally self-funded option for small or mid-sized employers that incorporates stop-loss insurance with relatively low attachment points.

Conclusion

This year continues a period of a stable market, characterized by relatively low-cost growth for employer-sponsored coverage. While premium growth continues to exceed earnings and inflation increases, the differences are moderately small. Additionally, while there have been some changes in terms of employer-sponsored health benefits, no trends have gained significant traction.

However, it’s still unclear how the COVID-19 pandemic will affect employer health plans in 2021. Given the economic impact, employers may need to shift more costs to employees than they have in the past. Alternatively, employers may look to other funding models to provide competitive health benefits.

What’s more, 2020 is an election year, and a Supreme Court case regarding the Affordable Care Act is scheduled for around the same period. Both of these events could significantly impact employer health plans in unforeseen ways.

Looking forward, employers should begin to identify tools and resources they can use to offset higher premiums. As costs continue to rise and possible political changes ensue, employers and employees may begin to see increased market movement.

For more information on benefits offerings or on what you can do to control your health care costs, contact Libertate Insurance today.

Congrats Abram Finkelstein…this year’s recipient of NAPEO’s Michaeline A. Doyle Award!

As most know, NAPEO is hosting its annual conference virtually this week.  It is with great excitement we announce that our client and friend, Abram Finkelstein, received this year’s Michaeline A. Doyle Award.

The purpose of this award it to recognize an individual who has provided exemplary leadership and service in devoting his/her time to association or industry activities on a local or national basis, with little or no previous recognition for his/her efforts. The award aims to recognize the person whose business philosophy is to improve the industry while improving his/her own PEO.

This award is in memory of Michaeline A. Doyle who exemplified these characteristics in her relationships with our industry and association.

Again, congrats to Abram!  Well deserved!

Phishing Scam Targeting PEOs

See below from our friends at NAPEO…

 

 

 

 

Today, a PEO notified NAPEO that they and their clients were the victims of a novel phishing scam. Under this scheme, fake Google advertisements were created to mimick the PEO’s legitimate ads and appeared when any variation of the PEO’s name was searched. The phony ads then redirected anyone who clicked on them to a phony log-in page for the PEO’s payroll software. The unaware victims had their personal information captured, including usernames and passwords.

The PEO is working with Google to take down the fraudulent ads. They have also notified all victims and have secured any jeopardized accounts.

Please remain vigilant against these types of scams. You should also consider checking to see if any of your company’s Google ads are being mimicked to commit fraud. Additionally, you should consider recommending that all clients and employees enable two factor authentication, where available.

 

Recent COVID-19 Claims Examples and Changes

Check out the article below to see some examples of COVID-19 claims and how it is affecting employers, carriers and employees alike.
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Coronavirus/COVID-19 is affecting Florida workers’ compensation claims in a variety of ways, including litigation events (being required to appear telephonically for events or having to continue final hearings due to delays in being able to depose physicians) and the actual workers’ compensation claims themselves as discussed below.

On April 24, 2020, Judge Timothy Stanton of the Gainesville Office of Judges of Compensation Claims found in Gomez, Esteban v. Ridgeway Roof Truss/Zenith Insurance Company, OJCC Case No. 19-016953TSS (Final Compensation Order dated April 24, 2020)  that “based upon the COVID-19 pandemic and its associated risks and restrictions,” the employer’s/carrier’s selection of a physician an hour away from the claimant’s home whereby the claimant would be transported to the medical appointment in “close proximity to a stranger, in an enclosed vehicle for close to two hours for each medical visit that may expose him and his family to COVID-19 (was) unreasonable.” The employer/carrier was required to select and authorize a local physician to provide the claimant with medical treatment, whereby his wife could drive him to appointments, due to Florida being “engulfed in the Coronavirus (COVID-19) pandemic” and preventing the spread of this virus.

On May 14, 2020, Judge Robert Arthur of the Lakeland Office of Judges of Compensation Claims opined asserting that an injured employee’s failure to meet its prima facia burden to show entitlement to temporary partial disability benefits (i.e. in asserting there was a break in the causation chain due to COVID-19) is an affirmative defense that should be listed on the Uniform Pretrial Stipulation.  “The parties are required to set forth their claims and defenses in the Pretrial Stipulation. It is the employer’s/carrier’s burden to demonstrate a break in the causation chain. As the employer/carrier bears the burden to establish the break in the causal chain this is an affirmative defense that must be pled with specificity on the Pretrial Stipulation.” See Gamero-Hernandez, Teresa v. Beals/Sedgwick CMS, OJCC Case Nos. 17-023646RAA; 18-007955RAA (Final Compensation Order dated May 14, 2020) citing Knight v. Walgreens, 109 So. 3d 1224 (Fla. 1st DCA 2013); Perez v. Se. Freight Lines, Inc., 159 So. 3d 412 (Fla. 1st DCA 2015); Meehan v. Orange County Data & Appraisals, 272 So. 3d 458 (Fla. 1st DCA 2019)

On May 21, 2020, Judge Keef Owens of the Port St. Lucie Office of Judges of Compensation Claims denied a claimant’s motion for an advance of $2,000.00 as the claimant failed to demonstrate (1) a failure to return to employment at no substantial wage reduction; (2) a substantial loss of earning capacity; or (3) an actual or apparent physical impairment. Judge Owens stated, “An advance serves as a ‘stopgap to help a claimant avoid defaulting with creditors while awaiting the potential distribution of workers’ compensation benefits, when the reduction in income is caused by the injury.” In this case, the claimant was not working for the employer because she had been furloughed due to COVID-19.  As such, Judge Owens found that her “reduction of earnings is not a result of her work-related accident” and therefore no advance was due and owing to the claimant. See Paradise, Kyley v. Global Hospitality Management/MEMIC Indemnity Co., OJCC No. 20-004078KFO (Evidentiary Order on Claimant’s Motion for Advance dated May 21, 2020 (citations omitted.)

The decisions amongst the various Offices of Judges of Compensation Claims may vary on a case-by-case basis. In general, it appears that JCCs prefer employer’s/carrier’s to limit exposure by coordinating appointments that the claimant is able to drive to, without the need for providing means of transportation.  Any COVID-19 affirmative defenses need to be listed on the Uniform Pretrial Stipulation or same will be waived as a defense.  And when determining whether an advance may be due and owing to an injured employee, the employer/carrier should further investigate whether the claimant’s reduction in income is due to the industrial accident or rather furloughs due to COVID-19.

Remember that coronavirus/COVID-19 exposure claims are being treated as occupational injuries and/or exposure.  These claims have a higher burden of proof and require the claimant to use a clear and convincing burden of proof to prove causation in relation to Florida Statute Sections 440.01(1) and 440.151(1)(a) and (2).

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This article was written by Amanda Mitteer Bartley with Chartwell Law. Article link is below:

https://www.jdsupra.com/legalnews/various-effects-of-coronavirus-on-96202/