Get To Know Your Insurance Pools

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Get To Know Your Insurance Pools

• By
• Brad Wilson, Marketing
• Insurance Benefits, Inc.
• Gary Drewes, Marketing
• Hagan Benefits, Inc.
• Dan Mostek, Loss Control
• Safety Benefits, Inc.

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Why do you NEED Work Comp?
SDCL 62
Its the LAW

• Workers Compensation is regulated by the
  Department of Labor

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Who is Covered???

• Employees

• Elected Appointed Officials

• Volunteers
• SDCL 62-1-5.1 states that
• Volunteers must be listed in the entitys
  official minutes

4
When Does It Apply?

• Work-related injuries/illnesses
• Doesnt include mental injury arising from
  emotional, mental or nonphysical stress
• Employment or employment related activities must
  be a major contributing cause
• Determined by SD DOL

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When Does A Claim Need To Be Reported?

• Employee has 3 days to notify Employer
• Employer has 7 days to notify Work Comp Carrier
• Insurer has 10 days to notify the Department of
  Labor
• This is according to South Dakota Codified Laws
  
• 62-6-1 and 62-7-10 and 62-4-37
• PLEASE REPORT ALL INCIDENTS

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Statutory Reasons to Decline a Claim! Statute
62-4-37
Intoxication
Illegal use of Drugs
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Hope this looks like an accident!
Self-inflicted Injury
WILLFUL Misconduct (Horseplay)
Refusal to Use Safety Equipment
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Benefits of Workers Compensation

• Medical (no deductible)
• Disability (2/3 of Salary)
• 2010-2011 Max. 630
• Min. 315

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Benefits - Continued

• Rehabilitation i.e.
• Retraining or Education
• Death Benefits - 10,000
• funeral expenses

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How much does Work Comp Cost??

• The pricing is developed from
• YOUR payroll!
• Each job description has a separate
• rate. Example Highway code is
• 5506 and the rate is 6.46 per 100
• of payroll

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What is anExperience Modifier
A mechanism to measure YOUR claims experience
compared to all other insureds.
Frequency Severity
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Control Costs with yourExperience Modifier

• Experience Modifiers begin at a 1.00
• Based on YOUR past 3 years of claims
• experience your pricing will go up
• with frequent or severe claims
• or down with fewer claims

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Cost of Bad Claims Experience
Class Description Payroll
Rate Contribution Codes 5506 Streets
Road 100,000 6.46 6,460 7720 Law
Enforcement 100,000 3.31 3,310 8810
Clerical 100,000 0.38 380 Total
Contribution 10,150 Experience
Modifier (BAD EXPERIENCE) 1.30 MODIFIED
CONTRIBUTION 13,195
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Benefit of Good Claims Experience
Class Description Payroll
Rate Contribution Codes 5506 Streets
Roads 100,000 6.46 6,460 7720 Law
Enforcement 100,000 3.31 3,310 8810
Clerical 100,000 0.38 380 Total
Contribution 10,150 Experience Modifier
(GOOD EXPERIENCE) 0.70 MODIFIED CONTRIBUTION
7,105
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Payroll Audits
Contributions or Premiums are Calculated on an
estimated Payroll amount. At the end of the
year, an audit Is performed.
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Other Important Points
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Job Classifications???

• Employees Payroll is classified by the
• employees job duties NOT by Department
• Jail Employees Code 7720
• Clerical Code 8810 Incl. Dispatchers, Hwy
  Dept Secretary Commissioners
• Assessor, Building Inspectors Code 9410
• Highway Workers Code 5506
• Miscellaneous Volunteers Code 9015a
• Volunteer vs. Paid Firefighter/EMTs

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What Determines an Independent Contractors?

• Control Must have flexibility in performing job
  function
• Responsibility of costs to perform the job
  supplies, equipment
• NOT paid by payroll an expensed item
• Written Contract
• Discuss these Contracts with your States
  Attorney.

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INDEPENDENT CONTRACTORS
Request Certificates of Insurance
If you DO NOT have those in your File, the cost
of the Contract must be Added to YOUR Workers
Compensation Premium in addition injuries can
be assessed to your WC.

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SDCL 62-1-5.1 Volunteers serving state or
political subdivision without pay Computing or
imputing wage Certain persons not deemed
volunteers

• Any volunteer worker rendering services
  in or for any agency, department, institution, or
  instrumentality of the state or of any of its
  political subdivisions, including counties,
  townships, school districts, or municipalities,
  whose services have been duly recommended to the
  officer or appointed thereto by such officers or
  governing body, shall for purposes of this title
  be deemed an employee of the state or the
  political subdivision, as the case may be. The
  appointment shall be entered into the official
  records or minutes of the entity.

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Federal - Child Labor Laws
Children under 16 CANNOT RUN
MOWERS Children under 18 CANNOT RUN POWER
DRIVEN EQUIP SUCH AS POWER SAWS CANNOT DRIVE
VEHICLES OVER 6,000 LB SUCH AS DUMP
TRUCKS CANNOT BE AN UNSUPERVISED LIFEGAURD
UNLESS RED CROSS CERTIFIED NEVER HANDLE
CHEMICALS
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Return to Work

• Reasonable accommodations
• Part-time work

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Importance ofReturn to Work Programs
Return the employee to pre-injury income
Expedites recovery self-esteem
Improves Morale injured Employees Co-workers!
Reduces Claim Costs thus Saves the Employer
money
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Indirect vs. Direct Costs

• For every 1 spent by workers compensation
• an additional 4 to 6 (not covered by
  insurance) is a COST TO YOU!
• Examples
• Time to file claims
• Overtime paid to get the job done
• Time to train replacement workers
• Morale issues with other employees

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NewInjury Reporting Hotline

• Easy first point of contact for injured worker
• Nurse will triage the injury
• Reduces the time lag for reporting the injury
• Gives the employer or medical provider a contact
  number for authorizations
• Increases communication between everyone involved
  in the claims process
• This will ultimately reduce the overall cost of
  claims
• 85 of claims cost are caused by 15 of claims

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SDML Workers Compensation FundPremium
(Contribution) Comparison toStandard Market
SDML Std Mkt Renewal Credits
Yes No Loss Control Credits
Yes No Equity Credits Yes No
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SDML WC Fund Comparison Continued
SDML Std Mkt Rates Policy Fee NONE
Yes Taxes NONE Yes Loss Control FREE NONE
Less
More
Approximate Savings with SDML WC 20
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Members of the SDML Work Comp Fund

• 368 Members
• 65 of the 66 Counties
• 44 Conservation Districts

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SDML Work Comp Fund Board of Trustees

• Dennis Falken
• Brookings County
• Alvin Fjeldheim
• Campbell County
• Bob Wilcox
• SD Assoc of County Commissioners
• Francis Toscana, Chm
• Lead-Deadwood Sanitary District

• Jodi Friedel
• City of Spearfish
• Karl Alberts
• City of Aberdeen
• Mike Grosek
• City of Webster
• Stanton Fox
• City of Watertown
• Yvonne Taylor
• SDML

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POOL ADMINISTRATORS
Hagan Benefits, Inc. Gary Drewes, Marketing
Ladene Bachtell, Underwriter Christa Lee,
Underwriter Jeff Pederson, Administrator 877-273-
1712
Insurance Benefits, Inc. Karen Ripperda,
Administrator Brad Wilson, Marketing 800-233-9073
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What is a Pool?
Risk-Sharing!!

• A group of similar exposures formed to share
  losses.
• Authorized by the Joint Power Act.
• Owned, by the members Governmental Entities of
  the State of South Dakota

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South Dakota Public Assurance Alliance

• Gary Drewes, Marketing
• Ladene Bachtell, Underwriting
• Christa Lee, Underwriting
• Jeff Pederson, Administration

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Who is Covered??
County Employees
Elected Appointed Officials
Volunteers
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What is Covered???
Counties
Cities/Towns
Special Districts i.e.Townships/
Conservation Districts
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SDPAA Lines of Coverage
General Liability
Public Officials Liability
Law Enforcement Liability
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Auto Liability
Auto Physical Damage
Property Coverage
Boiler Machinery
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SDPAA Specialized Features

• Employment Practices Liability Included
• Civil Rights Violations - Included
• Volunteers are Included as Employees
• Blanket Property Limits
• Replacement Cost

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How much does the SDPAA Pool Cost??
The pricing is developed
from YOUR budget, exposures, equipment
property! Liability rates have not changed
since 1987 thus a stable market!!
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Does your Liability and Property Claims
Experience Matter?
Contributions can be reduced with Good Claims
Experience
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PROFESSIONAL CLAIMS HANDLING
Claims Management
Jeff Jares, Claims Administrator
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Member/Claim Involvement
Adjuster Member Discuss Settlement
The Best Interest of the Member is Considered
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FREE!!
Safety Loss Control
Doug Kirkus, Loss Control Administrator
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Property Surveys

• Buildings valued correctly
• New Buildings covered
• Old Buildings deleted

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What are YOUR Benefits of a POOLING CONCEPT!

• Stabilized Rates
• No taxes and fees
• Profits belong to the Members
• Retention nearly 100

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SDPAA Board of Directors

• Dennis Olson, Chm.,
• City of Brandon
• Tracy Turback,
• City of Sioux Falls
• Mike Hall,
• City of Sioux Falls
• Jim Borszich,
• City of Huron
• Jeff Heinemeyer,
• City of Madison
• Jerry Krambeck,
• City of Spearfish

• Ted Eggebraaten, Brookings County
• Terry Weisenberg, Lawrence County
• Mike Wiese, Brown County

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ENDORSES SDML WC Fund and the SDPAA
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LOSS CONTROL SERVICES

• Dan Mostek
• Safety Benefits, Inc.
• [phone]

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Introduction

• Doug Kirkus has been involved with providing
  safety and loss control services for the Pools
  since 1995
• Today we have 7 staff working with Pool members
• Doug Kirkus - Dan Carlson
• Dan Mostek - Janet Sporrer
• Todd Everson - Sue Kirkus
• Kelly Everson

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Employment Practices Hotline

• SDPAA entities currently carrying Government
  Officials Liability coverage can use service
• Questions that concern employment practices will
  be taken
• Hiring, discipline, termination
• Questions concerning personnel policy and
  employee manuals
• SDPAA has contracted with 2 law firms with
  expertise in employment law

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Services Overview

• Member is entitled to 1 hour of free legal
  service for each SEPARATE inquiry
• If more than 1 hour is needed, the Member may
  extend the use of the service at their own
  expense
• When a call is accepted, Member entity becomes a
  client of firm for purpose of call and
  attorney/client privilege is activated
• Only information about call that is necessary for
  billing purposes will be provided to SDPAA

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How Does Service Work

• Contact SBI at [phone]
• You will be asked a series of questions
• Who is calling
• Your location
• Exact nature of the call
• Once approved, attorney from one of approved law
  firms will return call and consult caller about
  inquiry
• Lisa Marso East River
• Don Knudsen West River

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Voter Redistricting Hotline

• Works the same but deals with redistricting
  issues
• Counties have to complete redistricting by
  February of 2012
• SDPAA members are entitled to 2 hours of legal
  advice for each situation
• Sara Frankenstein of Rapid City one of the
  Midwests leading legal experts
• Counties that have larger minority populations
  and Commissioners that are elected by Districts
  are really going to be watched by ACLU
• To activate contact our office at [phone]

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Law Enforcement Policy Project

• PATC developed model policies and procedures in
  12 high risk critical areas of law enforcement
  specifically for South Dakota
• Have added several new policies since the initial
  project
• SDPAA funding updates for 3 years
• Entities receive 5 loss control credit on Police
  Professional Liability coverage for signing
  participation agreement
• PATC provides free monthly training webinars for
  SDPAA members
• Free video training downloads will be able within
  the next 30 days

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Jail Policy Project

• PATC has developed 31 model policies and
  procedures specifically for SD jails in several
  high risk areas
• Draft manual is completed and is now being
  reviewed
• Train-the-trainer classes sometime in May or June
• These will be available free to all jails covered
  by the SPAA

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On-Site Surveys

• By contract we visit each member once every 3
  years
• Visit members with highest loss ratios more often
• Designed to assist members with safety and loss
  control
• Make written recommendations designed to make the
  workplace as safe as possible for employees and
  reduce your chances of being sued
• Loss Control Credits are given for cooperation
  and responding to our recommendations

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Property Valuations

• 2008 - Completed on-site valuations for all SDPAA
  members with Property Coverage
• Process of revisiting everyone started in 2009
  and will complete in 2012
• Important to do self-inspections of facilities
• Report any new additions or acquisitions to Hagan
  Benefits

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All Day Safety Training - MSHA

• Offer 35 classes that began on January 5th
• 7 hours of training
• These classes qualify towards 8 hours of MSHA
  Annual Refresher training requirements
• Most County Highway Departments have to comply
  with MSHA
• MSHA compliance officers are busy
• 2 SD counties fined last summer

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Other On-Site Training Classes

• DDC
• EVOC Police, Fire, Ambulance
• Harassment Prevention for Employees and
  Supervisors
• Back Injury Prevention
• Jail Suicide Prevention
• Forklift Safety
• Accident Investigation for Supervisors
• Bloodborne Pathogens
• Safety Committees
• Self-Inspections of Facilities

• PPE
• Lockout/Tagout
• Confined Space Entry
• Coaching the CDL Operator
• Ergonomics
• Playground Equipment Inspections
• Trenching/Excavation Safety
• Non-Violent Crisis Intervention
• Public Officials Liability
• Improving Performance Appraisals
• Customer Service

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ATV Safety Training

• New hands-on class being offered this year
• Free to Pool members
• Participants will be certified through the ATV
  Safety Institute
• Encourage all ATV operators to attend this
  training especially County Weed and Search and
  Rescue employees

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Take Time for Safety

• 37 different training topics
• Includes Trainer Outline, Handout, Quiz, Answer
  Sheet, Attendee Roster and Training Certificate
• Have added 8 new topics this year
• Available on CD or subscription service

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DVD-Video Library

• Can be accessed through Pool websites and ordered
  on-line
• www.sdmlwcfund.com
• www.sdpaa.org
• Have 100s of titles available
• Add new titles each year

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On-Line Training

• Access through Pool websites
• www.sdpaa.org
• www.sdmlwcfund.com
• 22 general courses
• 4 supervisory level courses
• Free to Members
• Easy to navigate

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Safety Awards

• Can qualify for 3 different levels
• Bronze, Silver and Gold
• Not competing against any other entity
• Just have to meet criteria for each level
• Platinum Level
• Combined Loss Ratio - lt 60
• Presented at annual Safety Award Luncheon
  sponsored by the SDPAA and SDML WC Fund
• News release sent to local newspapers
• 2010
• Bronze 7 Silver 7 Gold 35 Platinum - 20

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Annual Safety Conference

• Sponsored by the 2 Pools, Insurance Benefits,
  Claims Associates and Safety Benefits
• Different safety and loss control topics are
  covered
• 2011 Conference is at Cedar Shores Oacoma on
  November 16th 17th

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Essential Physical Job Functions

• You dont want to hire someone that is physically
  unable to do the job or has a pre-existing
  condition
• Cannot legally ask an applicant how is your
  health? or have you had previous work comp
  claims?
• Can ask them if they can perform the essential
  physical functions of the job

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SDML WC Fund

• Has hired occupational health experts to develop
  these and they have been validated
• Members can obtain a copy from us
• How can you tell if the applicant is being
  truthful?
• Pre-Employment/Post-Offer Physical
• Only has to be performed on the person you are
  offering the job to and job offer can legally be
  withdrawn if cant physically do the job
• Cheapest investment that you will ever make
• Also valuable in protecting the County when
  bringing back an injured employee or an employee
  who has health issues

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QUESTIONS??
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Dan Mostek
Safety
Benefits, Inc.