Analysis of the COVID-19 Pandemic’s Impact on the New York State Workers’ Compensation System

In late June the NYCRIB released a research brief on understanding and estimating the impact of COVID-19 claims.

Coronavirus New York state updates from May 2020 - ABC7 New York

Introduction

The COVID-19 pandemic has devastated our communities, brought personal tragedy to many, and wreaked havoc on our economy. New York State’s unique experience has been driven by the breadth of virus transmission throughout its downstate metropolitan region, New York City, which is the most densely populated American city with approximately 27,000 people per square mile. While managing a pandemic in a dense urban area presents a myriad of complexities, the New York State workers’ compensation system will undoubtedly be called upon to compensate workers infected with the COVID-19 disease in the course of employment.

The purpose of this study is to provide a framework for understanding and estimating the direct impact of COVID-19 claims on medical and indemnity costs in the State’s workers’ compensation system.1 While we also briefly discuss the pandemic’s indirect impact, a detailed analysis is beyond the scope of this research brief. We hope that the information provided in this study will facilitate meaningful and informed discussion, policymaking, and decisions, and we also recognize that while the pandemic continues, its ultimate impact will remain largely unknown. This is so because the number of people infected and the number of COVID-19 claims filed are a function of public orders that have not yet been issued, choices that have not yet been made, behaviors that have yet to manifest, and the timing of scientific discovery that will bring this tragic period to conclusion.

Nevertheless, serious and thoughtful study on the impact of the COVID-19 pandemic cannot wait until the pandemic concludes and all claims and data have been submitted. Accordingly, this research brief relies upon Rating Board data as well as external information, data, and estimates from the New York State Workers’ Compensation Board, the New York State Department of Labor, the Bureau of Labor Statistics, the Centers for Disease Control and Prevention, and published studies on medical treatment patterns and costs. In some instances, this research brief incorporates assumptions based upon conversations with workers’ compensation experts and anecdotal evidence collected by the Rating Board. As more information becomes known and additional data emerges, these assumptions will be refined for use in future research briefs and analyses.

You can find the complete brief here: NYCIRB Releases Research Brief on COVID-19 Impact on State’s Workers’ Comp System

Source: The New York Compensation Insurance Rating Board

COVID-19: Confirmed Cases & Deaths Per State

Featured

The Kaiser Family Foundation has created an interactive map that illustrates the most current confirmed cases and deaths of COVID-19. For a breakdown by state, click here.

 

The NCCI, Presumption and COVID19

The National Council of Compensation Insurance (“NCCI”) continues to further refine its cost estimates of COVID19 for the 38 states that it oversees for the purposes of rate and rule making for workers’ compensation.  The most notable states not included in this study are California, New York and New Jersey which collectively make up about 40% of the workers’ compensation premiums countrywide.

The term “presumption of compensability” speaks to whether a COVID19 case is deemed compensable solely by the nature of the afflicted’s joe duties, scope and where work is performed.  This is different in every state with new bills and laws being drafted and legislated every day.

The preemption legislation generally falls into three buckets:

  • Bills that establish compensability presumptions for first responders (fire, police, ambulance) and/or certain healthcare workers (nursing homes, hospitals, home health etc)
  • Bills that establish compensability presumptions for essential or frontline workers.  This expands presumption into most all client-facing roles still necessary (grocery, pharmacist, mass transit, TSA, meat-packing, banking etc.)
  • Bills that establish compensability presumptions for all employees in the state

Needless to say, understanding the expected costs to the workers’ compensation system of any given state and the appropriate risk load to charge as a result starts with who will and will not “automatically” be covered and thus drive cost.  As you will note below, there is a lot of activity in regard to this issue across the country.

You can access NCCI’s state-by-state compensability tracker here.

Additionally, the NCCI has built a free on-line COVID19 “Hypothetical Scenarios Tool” that really gets into the granular on expectation of costs by type of worker and symptom group as well as the expected risk load as a result thereof.  Here is where the NCCI’s middle of the road projection is as of their last study in April with the assumptions of all NCCI states and the total workforce presumed to have contracted COVID19 in an occupational setting.  The scenario assumptions with slide bars below can be adjusted manually, but these are the “middle ion the road” defaults.


Note in this scenario of the total workplace presumed to being exposed to COVID19 in all NCCI states, the expected additional risk load is +85%.

Where I found this model to be even more interesting is on a state by state basis.  Using same “total workforce” but now selecting just Florida.

A 69% v 85% risk load and a fatality claim average being $121,118 v $341,111.  Fatalities the most important risk and cost driver with “critical claims” coming in #2.  Now if we do the same for Texas…

The risk load almost triples the national average at 236% fueled by the cost of a fatality more than double the national average, or $723,912.

This is a very powerful tool that shows all of the variables in play in the forecasting of expected costs in NCCI states due to COVID19.  As this continues to be refined we will update you.

Have a great weekend and stay safe.

California Workers’ Compensation Impact Projections – COVID19

As our clients continue to grow their businesses during the COVID19 pandemic, it has never become more important to select the right client company exposures to take risk on and those to lay off on guaranteed cost policies.  Having an underwriting strategy for risk selection and understanding of proper pricing as a result of COVID19 is an issue that needs to be focused on in this dynamic environment.

As with any projection, as time goes by, the future is understood with greater certainty.  As I continue to monitor the “risk load” attributable to COVID19 on a State by State basis, it made me think of one of my literary heroes and a famous quote of his:

“A habit of basing convictions upon evidence, and of giving to them only that degree or certainty which the evidence warrants, would, if it became general, cure most of the ills from which the world suffers.”  – Bertrand Russell
Why?  Because we are still dealing with “evidence” on COVID19 that is uncertain.   How much we can warrant forecasted outcomes as a result is therefore uncertain.  Besides the fact we are dealing with a 1 in a 100 year pandemic with no script to work off from the past, the models forecasting number of events and costs are built off of social distancing and staying at home; these variables being complicated by the reopening of States on the rise and social demonstrations triggered by the Floyd case/police brutality.
That said, based on the evidence in California at present, the middle of the road estimate is the addition of $1.2B of system costs to the current system costs of $18.3B, or 7%.
The low end is 3.3% and high end 11%.  These costs emanate from the mid-range loss estimate of 31,100 COVID19 claims.  Please note that this projection is based off the Governor’s order of presumption only lasting through July 1, 2020.  Of these expected claims, it is anticipated the costs will be as follows:
Claim Type               %               Expected Costs per Claim
Mild                           82                          $2,100
Severe                      10                           $74,800
Critical                        3                           $191,100
Death                         5                            $280,500
While I found this projection on the surface to be light, Mr. Stypla and I than contemplated the facts that California was one of the first to close and has been very strict in “stay at home” protocols.  As a result, their fatalities per 100,000 people are far less than other populous states:
Cases/ Fatalities/ 100,000
California – 347/12/100,000
New York – 1,951/157/100,000
Texas – 270/6/100,000
Florida – 307/13/100,000
New Jersey – 1,855/139/100,000
Illinois – 1,020/48/100,000
Michigan – 651/60/100,000
Wisconsin – 366/11/100,000
Ohio – 335/21/100,000
Mass. – 1,507/108/100,000
As you can see, there is a wide range of events by State with California being on the lower end of the spectrum.  So the take away is based on evidence today, California appears to be outperforming against initial forecasts and the country as a whole.  Hopefully the numbers will stand, but to belabor it, these are very fluid forecasts based on evidence available as of today.

Commercial Lines Prices Rose +6% During Q1

According to a survey conducted by Willis Towers Watson, Property and Casualty premiums increased by over 6% in aggregate during Q1 which marks the 2nd quarter in a row for such an increase.   As has been the trend for years, Workers’ Compensation was the only line to experience consistent rate reductions during the same time period. However, many presume there is a hard market ahead for comp as well. Time will tell.

———-

U.S. commercial insurance prices climbed more than 6 percent in aggregate during the 2020 first quarter compared to the year, Willis Towers Watson’s pricing survey for the sector.

Price increases surpassed 6 percent in aggregate for the second quarter in a row, Willis Towers Watson said.

Once again, nearly all commercial lines saw price hikes. Some saw double-digit increases: Directors and Officers liability, excess/umbrella, commercial auto and property.

For most other lines, however, Willis Towers Watson said price changes trended higher at a similar rate to the previous quarter.

Price increases were more muted for small commercial accounts and higher across mid-market accounts, with large accounts nearing double digits, Willis Towers Watson said.

Workers’ compensation continued to be a notable exception with many carriers reporting rate reductions, Alejandra Nolibos, senior director, Insurance Consulting and Technology for Willis Towers Watson, said in prepared remarks.

As well, Nolibos said that the statistics don’t yet reflect reactions to short and midterm impacts of COVID-19, “among them changes in task and employment mix and the economic situation.” He said that continued analysis of emerging data will track those effects for future premium trends.

Willis Towers Watson’s CLIPS survey is a retrospective look at historical changes in commercial property/casualty insurance (P&C) prices and claim cost inflation.

Source: Willis Towers Watson

https://www.insurancejournal.com/news/national/2020/06/09/571470.htm

 

California COVID Call to Cost Billions for Workers’ Compensation System

As expected, the largest workers’ compensation market in the country has rendered the opinion that it is presumed that anyone that is employed outside of their house has contracted the virus at work.  Prior to this order or COVID for that matter the total cost of loss in the California system was predicted to be $18.1 B.  The median risk load as a result if you include “First Responders” is $11.2 B, or 61%.  If you exclude “First Responders”, the additional cost expected is $5.2 B, or a risk load or 28%.

It will be interesting how insurance carriers and those on large deductibles react to this.

FOR IMMEDIATE RELEASE: Contact: Governor’s Press Office
Wednesday, May 6, 2020 (916) 445-4571

Governor Newsom Announces Workers’ Compensation Benefits for Workers who Contract COVID-19 During Stay at Home Order

Benefit will be available for diagnosed workers working outside their homes

 

Presumption will be workers contracted the virus at work; employers will have chance to rebut

 

Governor also signed executive order waiving penalties on property taxes for residents and small businesses experiencing economic hardship based on COVID-19; order also extends deadline for filing property tax statements

 

SACRAMENTO – As California prepares to enter Stage 2 of the gradual reopening of the state this Friday, Governor Gavin Newsom today announced that workers who contract COVID-19 while on the job may be eligible to receive workers’ compensation. The Governor signed an executive order that creates a time-limited rebuttable presumption for accessing workers’ compensation benefits applicable to Californians who must work outside of their homes during the stay at home order.

 

“We are removing a burden for workers on the front lines, who risk their own health and safety to deliver critical services to our fellow Californians, so that they can access benefits, and be able to focus on their recovery,” said Governor Newsom. “Workers’ compensation is a critical piece to reopening the state and it will help workers get the care they need to get healthy, and in turn, protect public health.”

 

Those eligible will have the rebuttable presumption if they tested positive for COVID-19 or were diagnosed with COVID-19 and confirmed by a positive test within 14 days of performing a labor or service at a place of work after the stay at home order was issued on March 19, 2020. The presumption will stay in place for 60 days after issuance of the executive order.

 

The Governor also signed an executive order that waives penalties for property taxes paid after April 10 for taxpayers who demonstrate they have experienced financial hardship due to the COVID-19 pandemic through May 6, 2021. This will apply to residential properties and small businesses. Additionally, the executive order will extend the deadline for certain businesses to file Business Personal Property Statements from tomorrow to May 31, 2020, to avoid penalties.

 

“The COVID-19 pandemic has impacted the lives and livelihoods of many, and as we look toward opening our local communities and economies, we want to make sure that those that have been most impacted have the ability to get back on their feet,” said Governor Newsom.

 

Since declaring a state of emergency due to COVID-19 on March 4, 2020, Governor Newsom has taken several actions to benefit workers on the front lines, includingpaid sick leave benefits for food sector workers that are subject to a quarantine or isolation order; critical child support services for essential workers and vulnerable populations; additional weekly unemployment benefits; and needed assistance in the form of loans for small businesses and job opportunities in critical industries for workers that have been displaced by the pandemic.

 

Regulators and Lawmakers Introducing Workers’ Comp to COVID-19

By Jim Sams, April 20, 2020

Sympathetic state lawmakers and regulators in states both red and blue promise to make COVID-19 a major cost driver for workers’ compensation insurers.

The governors of Kentucky, Arkansas, North Dakota and Florida and state regulators in Illinois, Washington, Michigan and Missouri have issued executive orders or amended rules to expand eligibility for workers’ compensation.

Most of those decrees ease the path for benefits only for healthcare workers and first responders, but an emergency order by the Illinois Workers’ Compensation Commission creates a presumption that work is the cause of COVID-19 if contracted by any “frontline worker” identified in Gov. J.B. Pritzker’s March 20 stay-at-home order. That includes workers at grocery stores, laundries, banks and hardware stores, among other businesses.

Kentucky Gov. Beshear issued a similarly broad executive order that created a COVID-19 presumption for workers in grocery stores, child-care centers, domestic violence shelters and rape crisis centers, in addition to first responders and healthcare workers.

In the meantime state legislators are also pushing to expand benefits for COVID-19. Earlier this month, Alaska Gov. Mike Dunleavy (R), Wisconsin Gov. Tony Evers (D) and Minnesota Gov. Tim Walz (D) signed into law bills that create a COVID-19 presumptions for first responders and some healthcare workers.

Bills to create presumptions for COVID-19 have been introduced in the New York, New Jersey, Pennsylvania, Ohio and Utah state legislatures.

Steamroller

Philadelphia defense attorney Cliff Goldstein said he saw the avalanche of presumption bills coming as soon as heard the first reports of the disease spreading into the United States.

“I don’t think there’s any way to stop that steamroller,” he said.

Data from the California Division of Workers’ Compensation bears him out. As of Thursday, 1,527 claims coded for COVID-19 on claims notices had been filed, according to agency spokeswoman Erika Monterroza.

Goldstein is not the only defense attorney predicting a flood of COVID claims.

“There will likely be many workman compensation claims because of the ease of filing, there is no requirement to prove negligence, and for many people their greatest contact with others, and hence the greatest chance of contracting the virus, is at work,” David Boies, managing partner of Boies Schiller Flexner LLP in New York, told Bloomberg News.

Goldstein said presumption legislation promises to be a boon for claimants’ attorneys, who will take a percentage of any permanent disability benefits awarded.

“You are just dangling meat in front of hungry lions,” he said.

Goldstein said his office — Chartwell Law in Valley Forge — has already received a handful of claims, some of them death claims. He said employers should resist any kind-hearted urge to quickly approve such claims based on the employee’s job category. Instead, each claim must be individually investigated, he said.

COVID-19 claims that require admission to an intensive care unit will likely run into the six figures for medical costs alone, he said. What’s more, employers will be taking full responsibility for whatever complications arise from a coronavirus infection far into the future.

Goldstein said Congress passed a pair of relief bills in March that should make it easier for employers to delay acceptance of a claim. The legislation requires employers with fewer than 500 employees to grant up to 80 hours of sick leave to workers sickened by the new coronavirus, which will be reimbursed with tax credits. Gov. Gavin Newsom issued an executive order Thursday that requires the same benefit from employers with more than 500 workers.

For workers who lose their jobs because of coronavirus, the federal emergency law also allows up to 16 weeks of unemployment insurance benefits at rates ranging from $875 to $1,500 per week, depending on the state, Goldstein said.

Vulnerable Occupations

Claimants’ attorney Julius Young in Oakland, Calif. said those benefits won’t make workers whole. Usually workers lose their health insurance if they lose their job, which makes workers’ comp a vital benefit for employees who were made sick because of their exposure to the public while at work. Also, some workers may be permanently disabled by COVID-19.

He said presumption bills make sense for workers who can’t avoid constant contact with the public.

“A lot of these people in vulnerable occupations shouldn’t have to go through this roulette-like maze wondering whether they are going to be covered,” Young said.

Young said the federal benefits will help in the short-term. He said state regulators should start thinking about whether and how any federal benefits paid can be offset from workers’ compensation awards.

Medical research indicates that there is a real possibility of permanent disability from COVID-19.

According to Science Magazine, the lack of oxygen and widespread inflammation caused by COVID-19 can damage kidneys, liver, heart, brain and other organs. Studies show that severe pneumonia caused by other diseases sometimes lead to scarring that causes long-term breathing problems. Pneumonia also increases the risk of future illnesses, including heart attack, stroke and kidney disease.

In one study of 138 patients hospitalized in Wuhan, China due to pneumonia from COVID-19, 20 percent suffered acute respiratory distress syndrome.

A separate study published by the New England Journal of Medicine in 2011 Regulators and Lawmakers Introducing Workers’ Comp to COVID-19found that of 109 survivors of ARDS, 51% suffered physician-diagnosed depression, anxiety or both. Perhaps more relevant to workers’ comp, that study found that just 77 percent of the 83 patients who survived throughout the study period had returned to work five years after being treated. The study found that only 39% of patients were able to walk the distance expected for their age group in six minutes five years later, suggesting a high degree of physical impairment.

As of yet, none of the major workers’ compensation rating organizations has released any projections on the potential impact of COVID-19 on workers’ comp loss costs.

The National Council of Compensation hopes to release next week an analysis of potential claim costs under a variety of scenarios, said Executive Director Jeff Eddinger. For example, one scenario project costs if a large percentage of workers who contract COVID-19 file claims and 100 percent are found to be compensable. He said the analysis will make projections for a variety of infection and claim-acceptance rates.

Eddinger said NCCI does not yet have any data on how many claims have been filed. He said insurers don’t report their losses until six months after the policy period expires. But he said there is some data available. For example, the Centers for Disease Control and Prevention reported that between 10 percent to 20 percent of COVID-19 cases were healthcare workers.

The California Workers’ Compensation is working on similar projections, said President Alex Swedlow.

 

Want to learn more about how COVID-19 affects your company? Give us a call at 305-495-5173, or email us at sreynolds@libertateins.com.

California Orders Payback of Insurance Premiums

In an unprecedented move, California Insurance Commissioner Ricardo Lara has ordered insurers that support “workers’ compensation, private passenger auto, commercial auto, commercial multi-peril, commercial liability, medical malpractice and any other insurance line where the risk of loss has fallen substantially as a result of the COVID-19 pandemic.”  It should be noted that no policies can be cancelled and at the same time all premiums are to be returned for March, April and potentially May.

Wow.

How the market will now correct itself in the largest insurance market in the US?  Will other states follow suit?

Detail from our friends at the Insurance Journal…

Tuesday, April 14, 2020

Insurance Commissioner Orders Companies to Pay Back Premiums Due to COVID-19 Fallout

California Insurance Commissioner Ricardo Lara on Monday ordered workers’ compensation carriers and insurers in at least five additional lines to pay back premiums because of the economic fallout of the COVID-19 pandemic.

Ricardo Lara

Commissioner Ricardo Lara

Premiums for March and April must be returned, with May premiums also on the table if the state’s stay-at-home order continues, according to Lara’s declaration.

Other insurance lines that must pay back premiums under Lara’s order include private passenger auto, commercial auto, commercial multi-peril, commercial liability, medical malpractice and “any other insurance line where the risk of loss has fallen substantially as a result of the COVID-19 pandemic.”

“With Californians driving fewer miles and many businesses closed due to the COVID-19 emergency, consumers need relief from premiums that no longer reflect their present-day risk of accident or loss,” Lara said in a statement. “Today’s mandatory action will put money back in people’s pockets when they need it most.”

The news also arrived on the eve of a Workers’ Compensation Insurance Rating Bureau meeting, where Classification and Rating Committee members are scheduled to vote on three proposed regulatory changes to send to Lara in response to the COVID-19 pandemic.

Dave Bellusci, executive vice president and chief actuary for WCIRB, wrote in an email that issues related to premium returns were “not within the WCIRB’s role, which focuses on advisory pure premium rates, experience modifications, payroll reporting. etc.”

Lara’s order requires insurers to provide premium credits, reductions, returns or “other appropriate premium adjustment” by August 2020. The department has requested a minimum grace period of 60 days for policyholders to pay premiums so that policies are not canceled for nonpayment, according to the news release.

The Department of Insurance did not respond to requests for comment on how the order would be carried out with regard to workers’ compensation premiums or whether employers and their insurers still were exposed by having employees work from home.

David A. Sampson, president and CEO of the American Property Casualty Insurance Association, said Monday that insurance companies were finding ways to help customers before Lara made his announcement.

Those arrangements include refunds and discounts for drivers who are traveling fewer miles, waiving late fees and pausing coverage cancellation, Sampson said.

“Over the last two weeks, insurers have announced billions of dollars in premium rate relief to their policyholders,” Sampson said in a statement. “Insurance is a data-driven industry. Rates are continuously adjusted based on losses and claims costs. If regulators allow insurers flexibility, private competitive markets will work to the benefit of consumers.”

The COVID-19 outbreak’s impact on driving patterns has already forced companies to respond and adjust, Sampson said. He added that some line policies, such as those found in workers’ compensation, are audited every year and allow for premiums to be adjusted.

“Now is not the time for arbitrary calls for rate decisions,” Sampson said. “We urge all stakeholders to support flexibility in the marketplace. California has the most complex regulatory structure in the nation. The department should be providing guidance to companies that are trying to implement premium reductions within the confines of Proposition 103.”

California voters passed Prop. 103 in 1988. It requires approval from the Department of Insurance before carriers implement rates for most property and casualty lines. The initiative does not apply to workers’ compensation.

Aside from actions already taken by auto insurance companies, other lines including workers’ compensation are likely to self-adjust in response to the COVID-19 crisis without government intervention, said Robert Hartwig, director of Risk and Uncertainty Management Center at the University of South Carolina’s Darla Moore School of Business.

“In terms of workers’ comp, premiums paid will be largely self-equilibrating irrespective of proclamations from insurance departments,” Hartwig wrote in an email. “Workers’ comp is an audited line, meaning insurers routinely examine policyholder (employer) payroll exposure to ensure that the premium paid matches up with the exposure and risk assumed by insurers. Given that payrolls for many/most employers in the U.S. will fall below expectations for renewals prior to March 1, insurers will wind up refunding some premiums and/or simply collect less in premium over the next several quarters.”

Each insurance line differs by risk, Hartwig said, and a broad-brush approach by an outside party might not be the best solution.

“One wild card is how fast all of this will bounce back,” he wrote. “Insurers will need to be judicious in any rebates/discounts offered, offering them periodically only as justified based actuarial determinations — not in response to proclamations by regulators and legislators.”

In addition to ordering the premium return, Lara also ordered carriers to file a report of all actions taken as well as contemplated future actions to refund premiums. The report must include monthly and overall totals for the percentage of refunds applied, aggregate premiums refunded, average percentage of refunds and the number of policyholders receiving a refund.