Industry News

How To Lower Your Experience MOD by Understanding Your Primary Threshold

Author, Drew Garcia, NALP Program Director, Rancho Mesa Insurance Services, Inc. 

The Experience Modifier (i.e., experience MOD, MOD, XMOD, experience modification rating, EMR) weighs heavy on the calculation of your workers' compensation premium. With a MOD rating of 1.00 signifying unity  (i.e., the average for your industry), any MOD above 1.00 is considered adverse. Thus, any MOD below 1.00 is considered better than average. Higher MODs will debit the premium, resulting in higher workers' compensation premiums, while lower MODs will credit the premium, resulting in lower workers' compensation premiums.

Author, Drew Garcia, NALP Program Director, Rancho Mesa Insurance Services, Inc. 

AdobeStock_118639202.jpeg

The Experience Modifier (i.e., experience MOD, MOD, XMOD, experience modification rating, EMR) weighs heavy on the calculation of your workers' compensation premium. With a MOD rating of 1.00 signifying unity  (i.e., the average for your industry), any MOD above 1.00 is considered adverse. Thus, any MOD below 1.00 is considered better than average. Higher MODs will debit the premium, resulting in higher workers' compensation premiums, while lower MODs will credit the premium, resulting in lower workers' compensation premiums.

How do I decrease my MOD to lower my workers compensation premium?

A few factors can be addressed to reduce the workers' compensation premium. The most important is the primary threshold. Each individual employer has their own primary threshold that is determined by the class of business they operate and the amount of field payroll they accrue over a three year period. The primary threshold is the point at which any claim maximizes its negative impact on the MOD. You must be sensitive to this number because any open claim with paid amounts under the threshold, provides an opportunity to save points to the MOD. Once a claim exceeds paid amounts over your threshold, it no longer can negatively impact your MOD. However, you would still want to monitor and manage these claims to ensure your injured employee is being provided attentive care and to maintain knowledge of your loss experience. 

Example

You’re a landscaping company and your primary threshold is $33,000. The most any claim can affect your MOD is $33,000 and the most points that any claim can add to your MOD is 13.
You have a claim open for $40,000 with paid amounts of $10,000 and reserved amounts of $30,000.

This claim will go into the calculation at $40,000 (Paid + Reserved) but because the total amount succeeds the primary threshold of $33,000, it will only show up on the rating sheet totaling $33,000 of primary loss and contribute 13 points to your MOD.

It would behoove you to analyze and monitor this open claim, because it has paid out amounts well below your primary threshold of $33,000.

If this same claim closes for a total paid amount of $22,000, the closed claim would go into your MOD at $22,000 with 8 points contributing to the MOD.

The difference between a $40,000 claim and a $22,000 claim is 5 points to your MOD, or, 5% to your premium!

Knowing your primary threshold is the most important piece of information when managing your XMOD. Fortunately, Rancho Mesa can help you manage your experience MOD by tracking your primary threshold and maintaining the other critical elements that go into establishing a sustainable low experience MOD.

For more information about lowering your experience MOD or a detailed analysis of your current MOD please reach out to Rancho Mesa.

Below is an example worksheet for Landscapers to determine the primary threshold.

Primary Threshold for Landscape Industry

Annual Landscape Payroll 2018 Primary Threshold Max Points to MOD Lowest MOD
$100,000 $5,500 53 .84
$250,000 $10,000 38 .75
$500,000 $15,500 30 .65
$1,000,000 $22,000 21 .56
$1,500,000 $26,000 17 .51
$2,000,000 $30,000 14 .47
$2,500,000 $32,000 12 .45
$3,000,000 $35,000 11 .42
$5,000,000 $41,000 8 .36
$10,000,000 $40,000 5 .30

Read More
Construction, Landscape Alyssa Burley Construction, Landscape Alyssa Burley

Why All Trade Contractors Must Consider Pollution Liability

Authors Sam Clayton, ARM, CRIS, Vice President, Construction Group and Daniel Frazee, ARM, CRIS, Executive Vice President, Rancho Mesa Insurance Services, Inc.

Contractor’s Pollution Liability (CPL), once viewed as expensive and unnecessary, has now become an integral part of every trade and environmental contractor’s insurance program. The industry is seeing requirements for this coverage from a combination of building owners, developers and general contractors for projects of all sizes.

Authors Sam Clayton, ARM, CRIS, Vice President, Construction Group and Daniel Frazee, ARM, CRIS, Executive Vice President, Rancho Mesa Insurance Services, Inc.

AdobeStock_75520836.jpeg

Contractor’s Pollution Liability (CPL), once viewed as expensive and unnecessary, has now become an integral part of every trade and environmental contractor’s insurance program. The industry is seeing requirements for this coverage from a combination of building owners, developers and general contractors for projects of all sizes.

Protecting contractors from pollution exposure by transferring this risk to a CPL policy supports a best practice approach. Contractors' pollution liability insurance provides coverage for third party bodily injury, property damage and pollution clean-up costs as a result of pollution conditions for which the contractor may be responsible. A pollution condition can include the discharge of pollutants brought to the job site, a release of pre-existing pollutants at the site or other pollution conditions due to the performance of the contractor’s or a lower tier subcontractor’s operations. In addition to the potential loss of reputation, often overlooked expenses that can negatively impact a profit & loss statement are the costs incurred to defend a company involved in a pollution claim.

Contractors who choose not to purchase Contractor’s Pollution Liability Insurance generally fall into two categories. Many believe that their operations do not have a pollution exposure. And countless others assume that their Commercial General Liability (CGL) policies offer protection in the event a pollution claim arises. Neither of these assumptions is accurate. Pollution coverage is not commonly found in CGL policies by virtue of the Total Pollution Exclusion. This form excludes pollution coverage for any bodily injury, property damage and/or the clean-up costs. Examples of pollution incidents apply to many different types of trade contractors, in addition to traditional environmental contractors. A handful of those are listed below:

  1. An HVAC system is installed improperly which, over time, causes moisture and ultimately mold to spread throughout a residential building, causing bodily injury and property damage
  2. A painting contractor accidentally disposes paint thinner through a public drain causing polluted water to a local community
  3. Dirt being excavated from one area of a job site to another is contaminated with arsenic and lead. The chemicals are then spread to a larger area which is later found by a soils expert
  4. Construction equipment on a project site has hydraulic fuel lines cut by vandals, causing fuel to leak out and contaminate the soil
  5. A contractor punctures an underground storage tank during excavation, causing the product to spill into the soil and groundwater.
  6. A gas line ruptures during excavation causing a gas leak into a neighboring building that leads to an explosion

The common thread seen above describes how contractors are causing some type of “contamination” on a job site. And, contamination is the operative word in all pollution exclusions. With such a broad definition extending to so many types of construction, beginning your search now for CPL options is just simply good business.

And, with a multitude of insurance companies aggressively pricing CPL policies, securing competitive quotes to compliment your current insurance program can fill significant gaps at more reasonable costs than you think. 

Take time to consult with your broker and learn more about how pollution liability impacts your firm.

For more information, contact Sam Clayton at (619) 937-0167 or Daniel Frazee at (619) 937-0172.

Read More

3 Practical Reasons for Timely Claims Reporting

Author, Jim Malone, Claims Advocate, Rancho Mesa Insurance Services, Inc.

When a work-related accident occurs, as a business owner or manager, it is our nature to want to analyze the situation in order to learn how to avoid it in the future. However, the reporting of the incident is equally as important. With the recent requirement to report first aid claims, timely reporting for all claims is recognized as being critical for a number of reasons. 

Author, Jim Malone, Claims Advocate, Rancho Mesa Insurance Services, Inc.

pexels-photo-280253_1000pxls.jpg

When a work-related accident occurs, as a business owner or manager, it is our nature to want to analyze the situation in order to learn how to avoid it in the future. However, the reporting of the incident is equally as important. With the recent requirement to report first aid claims, timely reporting for all claims is recognized as being critical for a number of reasons. 

Employee Morale

First and foremost, timely reporting allows for immediate care of any injuries that may have occurred as a result of the incident. It promotes prompt referral for medical evaluation, documentation of the bodily areas affected, and provides recommendations for treatment. 

Promptly reporting an injury shows the injured employee, and their coworkers, that the company cares about them. When an employee knows the employer cares, they are less likely to litigate the claim, which can significantly reduce the overall cost to the employer.  

Elimination of Hazards

Timely reporting can trigger the immediate assessment of the scene and cause of the accident. The initial focus is to document the area and determine if there is still an injurious exposure or condition present that may need to be addressed to prevent further incidents or injuries. Timely reporting also allows for prompt investigation of the accident and the scene of the accident, identify witnesses, secure faulty tools or equipment for safety and subrogation purposes, and to convey a sense of responsibility and concern for the employee that their safety is of extreme importance.

Prompt investigations into the cause of a near miss, accidents, and injuries can lead to an understanding of the factors that lead up to the incident. Thus, the employer has the opportunity to make changes in processes and improvements in safety in order to prevent future near miss events or accidents from occurring.

Cost Savings

Timely reporting can directly affect the overall costs of a claim. Decreased medical costs are realized when injuries are promptly assessed, allowing for treatment to start immediately. Injured employees tend to recover quickly when treatment is provided right away. Swift recoveries usually result in shorter periods of temporary total and/or temporary partial disability, fewer diagnostic studies, physical therapy visits, injections, surgeries, permanent physical limitations, work restrictions or permanent disability percentages, and lower future medical care needs. This translates into lower financial resources allocated to these claims.

The timely reporting of a claim promotes positive morale among employees; helps remove potential future hazards from the workplace and can significantly reduce overall the cost of incidents.

 
For more information about claims reporting, contact Rancho Mesa Insurance Services, Inc. at (619) 937-0164.

Read More
Construction, Landscape, OSHA Alyssa Burley Construction, Landscape, OSHA Alyssa Burley

Simple Steps to Developing a Personal Protective Equipment Program

Author, Jeremy Hoolihan, Account Executive, Rancho Mesa Insurance Services, Inc.

In the workplace, employees can be exposed to potentially harmful hazards. Identifying these hazards and using precautionary measures such as personal protective equipment (PPE) can mean the difference between a safe jobsite and an injury.

Author, Jeremy Hoolihan, Account Executive, Rancho Mesa Insurance Services, Inc.

AdobeStock_102438225.jpeg

In the workplace, employees can be exposed to potentially harmful hazards. Identifying these hazards and using precautionary measures such as personal protective equipment (PPE) can mean the difference between a safe jobsite and an injury.

PPE “is equipment worn to minimize exposure to a variety of hazards,” according to the Occupational Safety and Health Administration’s (OSHA) booklet on the subject. Examples of PPE include gloves, foot and eye protection, earplugs, hard hats, respirators and full body suites.

Implementing a PPE program can greatly reduce the chances of workplace injuries and increase a business’s productivity.

A PPE Program consists of three main components:

  1. An assessment of the workplace hazards and procedures, and determining what PPE will be used to protect employees.
  2. Employee training.
  3. Documentation of hazard assessment and employee training.

Conducting a Hazard Assessment

The OSHA Personal Protective Equipment Standard (29 CFR 1910.132-138) requires that employers ensure appropriate PPE is “provided, used, and maintained in a sanitary and reliable condition whenever it is necessary” to protect workers from hazards. Employers are required to assess the workplace to determine if hazards that require the use of personal protective equipment are present or are likely to be present. The following information will aid in the hazard assessment process:

  1. Develop a Hazard Assessment Checklist (a sample is available in the Risk Management Center) to identify exposures in the workplace that could injure a specific body part such as eyes, face, hand, arms, feet, legs, body, head, or hearing.  Once you have identified the potential exposures, include the required PPE to minimize or eliminate the exposure.
  2. Conduct a walk-through survey of the workplace and complete the information on the Hazard Assessment Checklist. The purpose of the survey is to identify sources of hazards to workers such as chemical exposures, harmful dust, sharp objects, electrical hazards, etc.  
  3. Select suitable PPE.  Should an employer determine that PPE is necessary, they are then required to ensure that it is available and used. It is not enough to select PPE and witness its use, however.  Employers must also make sure that the PPE is suitable for protection from the identified hazards, is properly fitted, and is not defective or damaged in any way.

Employee Training

Before doing work which requires PPE, employees must be trained to know the following:

  1. When PPE is necessary.
  2. The type of PPE that is necessary.
  3. How the PPE is properly worn.
  4. PPE's limitations.
  5. How to properly care, maintain, and disposal of the PPE.

Written Verification of Hazard Assessments and Employee Training

Employers are responsible for ensuring that employees are trained in the use of PPE and must provide written certification to that effect. Employers must also certify in writing that the employees understand the training.  Also, in general, employers must provide required PPE at no cost to employees. 

A large majority of workplace injuries are preventable through the implementation of a PPE Program.  It is the employer’s responsibility to keep their employees adequately protected at all times. After all, it is certainly difficult to imagine a firefighter performing his or her duties without a helmet, boots, gloves and other necessary protective equipment.

Rancho Mesa Insurance Services has expertise in risk management for the construction industry.  We can provide you with assistance in developing a PPE Program, as well as other risk management and insurance needs. Please contact me with any questions at (619) 937-0174 or jhoolihan@ranchomesa.com.
 

Read More
Construction, Human Services, Landscape, OSHA Alyssa Burley Construction, Human Services, Landscape, OSHA Alyssa Burley

Reminder: 2017 OSHA Summary of Work-Related Injuries and Illness Must Be Posted

Author, Alyssa Burley, Client Services Coordinator, Rancho Mesa Insurance Services, Inc.

According to a recent memo, the State of California Department of Industrial Relations would like to remind employers that they are required to physically post their 2017 annual summaries of work-related injuries from February 1, 2018 through April 30, 2018. 

Author, Alyssa Burley, Client Services Coordinator, Rancho Mesa Insurance Services, Inc.

OSHA 300A.jpg

According to a recent memo, the State of California Department of Industrial Relations would like to remind employers that they are required to physically post their 2017 annual summaries of work-related injuries from February 1, 2018 through April 30, 2018. 

OSHA’s Summary of Work-Related Injuries and Illness, also known as Form 300A, must be completed and posted for employees to view.

If you are tracking work-related injuries in the Rancho Mesa Risk Management Center, the Form 300A can be generated from the system. From the Incident Track screen, click on "Reports," then "OSHA Reports," select "OSHA 300A Summary," the "2017." Complete any missing information and "Download."

To manually complete the Form 300A, review the instructions found on the Cal/OSHA or OSHA websites.

If you are unsure if you are required to maintain OSHA logs, visit the OSHA website.

 

Read More
Construction, Human Services, Landscape Alyssa Burley Construction, Human Services, Landscape Alyssa Burley

Why Would a Contractor Purchase Employment Practices Liability Insurance?

Author, Kevin Howard, CRIS, Account Executive, Construction Gorup, Rancho Mesa Insurance Services, Inc.

Insurance is often considered a necessary evil by business owners. It can represent a significant line item on a profit & loss statement rivaling the cost in some cases of payroll, material costs and rent. With deductibles that can range from $15,000-$25,000 per claim, why then would a business spend dollars on an insurance policy that is not required by either state law or part of any General Contractor’s insurance specifications?

Author, Kevin Howard, CRIS, Account Executive, Construction Group, Rancho Mesa Insurance Services, Inc.

AdobeStock_77248161.jpeg

Insurance is often considered a necessary evil by business owners. It can represent a significant line item on a profit & loss statement rivaling the cost in some cases of payroll, material costs and rent. With deductibles that can range from $15,000-$25,000 per claim, why then would a business spend dollars on an insurance policy that is not required by either state law or part of any general contractor’s insurance specifications?

What does an EPLI policy cover?

Employment Practices Liability Insurance (EPLI) policies typically extend coverage to the following:

  • Wrongful termination of an employee who alleges violation of their contract;

  • Sexual harassment claims by one employee against another;

  • Wage related claims by employees who allege denial of overtime pay or tips, or working “off the books." Note: Most carriers offer a defense only sub limit for this type of claim;

  • Claims of unequal or unfair pay between employees performing the same job and having similar skills, education, seniority and responsibility;

  • Discrimination claims based on age, race, gender or sexual orientation;

  • Third Party. Example: Your employee out in the field of work upsets another subcontractor’s employee, a customer at their home, a student at a school enough to where they file a lawsuit against you.

Why do businesses resist purchasing EPLI?

Declining to purchase EPLI can stem from businesses feeling that they are not large enough for this type of claim to occur.  Many owners have close relationships with their employees and never believe any of the above scenarios could occur within their organization.  And yet, many more can assume that a General Liability policy would cover these types of potential claims when, in fact, most have specific EPLI exclusions. This type of thinking could result in losses that have severe financial consequences for your company. Let’s take a quick look at three common EPLI exposures facing the construction industry.

Common EPLI Claims in the Construction Industry

Rapid growth and layoffs are unique aspects of the construction industry that can cause the elimination of a specific position and/or termination.  With these ebbs and flows, contractors unintentionally open themselves up to wrongful termination cases which can carry into discrimination charges, as well.  It can also be common to see employees bring post-employment wage & hour claims, which center around improper overtime, breaks, etc.   Lastly, contractors' work very often involves interaction and exposure to the public.  This interaction can lead to comments, inferences, or specific actions that non-employees find offensive.  Claims brought by these third parties are difficult to prove when the employer is unable to witness the events first-hand.  

Light Bulb Moment

In these and other potential claim scenarios, employers without EPLI must outlay their own funds to find legal representation and fight the charges.  Legal costs add up quickly regardless of the documentation an employer has kept on file and the conviction they have that an employee’s claim is frivolous.  Defending yourself in today’s environment can become cost ineffective very quickly.  Light bulb moments can occur when EPLI limits are unavailable because coverage is not in force and an owner is staring at a “balance sheet loss,” resulting in a six figure settlement.

Consult Your Broker for EPLI Options

At Rancho Mesa, as it relates to coverage for our clients, we often say "you would rather be looking at it than for it”. That is, you want to be looking at a policy that will respond to coverage than for one at the time of a loss.  Take time to explore the nuances of employment practices liability insurance with a knowledgeable broker.  Allow an expert to educate you on the real exposure to your company, ask to spreadsheet different policy forms, deductibles and limits in an effort to balance the annual premium with the potential impact of a large loss.

For more information about Employment Practices Liability Insurance, contact Rancho Mesa Insurance at (619) 937-0164.

Read More
Construction, Workers' Compensation Alyssa Burley Construction, Workers' Compensation Alyssa Burley

Experience Modification Factors and the Pre-Qualification Process

Author Sam Clayton, Vice President, Construction Group, Rancho Mesa Insurance Services, Inc.

As we enter 2018, government agencies, project owners and general contractors often require subcontractors to enter their pre-qualification process.  Many of these entities will look closely at your Experience Modification Rate (EMR).

Author Sam Clayton, Vice President, Construction Group, Rancho Mesa Insurance Services, Inc.

AdobeStock_159485274.jpeg

As we enter 2018, government agencies, project owners and general contractors often require subcontractors to enter their pre-qualification process.  Many of these entities will look closely at your Experience Modification Rate (EMR).  

EMR is a numeric representation of a company’s payroll and claims history, compared to businesses in the same industry or standard industry classification.  EMRs create a common baseline for businesses while allowing for a surcharge when employers' claims are worse than expected and credit when employers' claims are better than the industry average.  More specifically, companies with an EMR rate of 1.00 are considered to have an average loss experience.  Factors greater than 1.00 are considered worse than average, while less than 1.00 are considered better than average.  

Pre-Qualification Process

In the highly competitive world of construction bidding, it has become more common that contractors can be precluded from the pre-qualification process due solely to above average EMRs.  This represents an oversight as many companies have strong, well-developed safety programs, yet their EMR is holding them back.  Some examples of this are:

  1. EMRs are lagging factors. They only factor the last three policy periods, not including the current policy period.  
  2. EMRs can include claims that may have been unavoidable and do not represent a lack of safety (i.e. an employee is rear ended by an uninsured motorist).
  3. Large severity claims from smaller sized companies can impact the EMR much more negatively than a similar sized claims at a larger firm.
  4. The effectiveness of claims handling may vary from one insurance company to another, thus impacting certain employers when cases remain open with high reserves.

Rather than placing such a critical importance on the EMR Rate, owners and contractors designing the pre-qualification document should include frequency indicators like incident and DART Rate (i.e., days away, restricted or transferred) forms.  These measuring tools incorporate current year totals and can provide up to 5 years of historical data.  Incident Rate calculations indicate how many employees per 100 have been injured under OSHA rules within the specific time period.  The DART rate looks at the amount of time an injured employee is away from his or her regular job.  Lastly, contractors attempting to become pre-qualified should have the ability to provide a detailed explanation should their EMR exceed 100.  This can include loss data, a summary of the company’s Illness and Injury Prevention Plan (IIPP) and code of safe practices, and more information on what exactly the company is doing to reduce future exposure to loss.

Given the importance of the pre-qualification process and the potential for contractors to be precluded from new opportunities to bid work, we’ve developed a “Best Practices” approach to assist companies in managing their EMR.  

Managing Your EMR with Best Practices

The Best Practices approach to high EMRs includes a total claim physical, claims advocacy, and implementation of the Risk Management Center

Total Claim Physical
The total claim physical accurately identifies your company's strengths and weaknesses, and then scores the company against others in the industry. It includes an audit of the EMR, analysis of claim frequency and severity, claim trends and determine root causes, provide quarterly claims reviews, and conduct pre-unit stat meetings.

Claims Advocacy
Utilizing a claims advocate can decrease existing claim costs, reduce excessive reserves, and expedite claim closures, which can reduce the EMR.

Risk Management Center
The Risk Management Center provides access to safety training materials and tracking, analysis of incidents and OSHA reporting, monthly risk management workshops and webinars.

For more information on managing your EMR before the pre-qualification process, contact Rancho Mesa Insurance Services at (619) 937-0164. 

Read More
Construction, OSHA Alyssa Burley Construction, OSHA Alyssa Burley

Building an Effective Fall Protection Program

Author, Daniel Frazee, Executive Vice President, Rancho Mesa Insurance Services, Inc.

In a Census summarizing fatal occupational injuries from 2016, those originating from falls continued a steady upward trend that began in 2011 and increased another 6% in 2016.  More specifically, falls increased more than 25% for roofers, painters, carpenters, tree trimmers & pruners.  Since 2013, fall protection citations have been #1 or #2 on OSHA’s most cited violations.  Now, more than ever, it is essential for employers with personnel who work at heights to provide comprehensive fall protection.

Author, Daniel Frazee, Executive Vice President, Rancho Mesa Insurance Services, Inc.

AdobeStock_164071795.jpeg

In a Census, summarizing fatal occupational injuries from 2016, those originating from falls continued a steady upward trend that began in 2011 and increased another 6% in 2016.  More specifically, falls increased more than 25% for roofers, painters, carpenters, tree trimmers & pruners.  Since 2013, fall protection citations have been #1 or #2 on OSHA’s most cited violations.  Now, more than ever, it is essential for employers with personnel who work at heights to provide comprehensive fall protection.

Job Hazard Analysis

While developing any type of new safety program, experts encourage breaking the process into steps.  These steps must be designed for all construction sites where exposure to height exists.  And the plan must be prepared by a competent (qualified) person, defined as someone with extensive knowledge and training on fall protection systems.  The initial step requires a job hazard analysis to be performed at the location in advance of work commencing.  The analysis can include determining the average & maximum height at which work will be performed, identifying the number of employees using the area, observing potential hazards that might compromise the work, and modifying work to reduce exposure.  According to the American National Standards Institute (ANSI), “the most desirable form of protection is elimination of the need to work from height” (Z359.2, section 5.1). 

Types of Fall-Arrest Systems

Assuming hazards cannot be eliminated and the need to work from height still exists, employers can implement both passive and active fall-arrest systems.  Passive systems can include examples such as guardrails or ladder cages while the more technical active fall-restraint systems can use specialized lanyards and anchors to eliminate fall exposure.  These require individualized training that is crucial for proper use and effectiveness.

Proper Implementation & Calculating Fall Clearance

Once you have identified the appropriate system for the jobsite, the implementation is critical to the success of the program.  Using the more complex active fall-arrest system as an example, employers can track their progress with four steps:

  • Anchorage-the secure point of attachment to the fall arrest system.  The structure must be capable of supporting at least 5,000 pounds/worker or meet OSHA’s criteria of a 2:1 safety factor.
  • Body Support-the connection point to the anchorage, commonly seen with a full body harness that distributes the forces of a fall over the chest, shoulders, pelvis & thighs.
  • Connectors-examples include lanyards and self-retracting lifelines, devices that connect or link the harness to the anchorage.
  • Descent & Rescue-all good fall protection programs must have a plan for rescue or retrieval of a fallen worker.  Employees need to be raised or lowered to a safe location when needed.

As employers build out their fall-arrest system, calculating fall clearance and swing fall hazards represent key components to a successful program.  In part, this can be achieved by determining sufficient clearance below the worker to stop the fall before he/she hits the ground or another object.  It should include an awareness of the anchorage location, the connecting system, deceleration distance, the height of the suspended worker, etc.

Training, Training, Training

Formal, written training programs only become effective tools when employers combine classroom knowledge with practical, hands-on experience.  Competent persons need to continually educate workers on industry regulations, proper equipment selection/use and ongoing maintenance standards.  This must be emphasized on a consistent basis so that workers understand the importance of fall protection as it relates to their own safety and that of the company.

Improving Your Risk Profile

Without argument, the most important reason for introducing a Fall Protection program is the safety and well-being of your employees.  Getting workers home safely at the end of every work day remains every employer’s ultimate goal.  A second goal for consideration is that of improving your company’s risk profile to the insurance marketplace.  If your construction firm performs work in excess of 2 stories, underwriters expect to see details on your Fall Protection program.   While just one aspect of a Best Practices renewal strategy, providing a copy of your program with training examples and site specific layouts can give insurance company underwriters the comfort level they need to deliver more competitive quote proposals. Allowing your insurance broker these reference points can help them engage more options which can lead to better terms and pricing, and lower overall insurance costs for your company.

As your company builds out safety modules and looks to refresh or develop new a Fall Protection program, look to Rancho Mesa Insurance and their Risk Management Center (RMC) for assistance.  The RMC contains endless content, program templates and resources for our construction partners.  Additionally, the Agency’s monthly offerings of industry specific trainings and webinars provides the education our clients need to stay ahead of their competition.

For more information about fall protection, contact Rancho Mesa Insurance Services, Inc. at (619) 937-0164.

Read More
Construction, Human Services, Landscape, News Alyssa Burley Construction, Human Services, Landscape, News Alyssa Burley

Highlights of the New Tax Reform Law

Article provided by, Kevin Brown, Managing Partner, RBTK, LLP.

The new tax reform law, commonly called the “Tax Cuts and Jobs Act” (TCJA), is the biggest federal tax law overhaul in 31 years, and it includes both good and bad news for taxpayers. 

Below are highlights of some of the most significant changes affecting individual and business taxpayers. (Except where noted, these changes are effective for tax years beginning after December 31, 2017.)

Article provided by, Kevin Brown, Managing Partner, RBTK, LLP.

AdobeStock_174737179.jpeg

The new tax reform law, commonly called the “Tax Cuts and Jobs Act” (TCJA), is the biggest federal tax law overhaul in 31 years, and it includes both good and bad news for taxpayers. 

Below are highlights of some of the most significant changes affecting individual and business taxpayers. (Except where noted, these changes are effective for tax years beginning after December 31, 2017.)

Individuals

  • Drops of individual income tax rates ranging from 0 to 4 percentage points (depending on the bracket) to 10%, 12%, 22%, 24%, 32%, 35% and 37% — through 2025

  • Near doubling of the standard deduction — through 2025

  • Elimination of personal exemptions — through 2025

  • Doubling of the child tax credit to $2,000 — through 2025

  • Elimination of the individual mandate under the Affordable Care Act — effective for months beginning after December 31, 2018

  • Reduction of the adjusted gross income (AGI) threshold for the medical expense deduction to 7.5% for regular and AMT purposes — for 2017 and 2018

  • New $10,000 limit on the deduction for state and local taxes (on a combined basis for property and income taxes; $5,000 for separate filers) — through 2025

  • Reduction of the mortgage debt limit for the home mortgage interest deduction to $750,000 ($375,000 for separate filers), with certain exceptions — through 2025

  • Elimination of the deduction for interest on home equity debt — through 2025

  • Elimination of miscellaneous itemized deductions subject to the 2% — through 2025

  • Elimination of the AGI-based reduction of certain itemized deductions — through 2025

  • Expansion of tax-free Section 529 plan distributions to include those used to pay qualifying elementary and secondary school expenses, up to $10,000 per student per tax year

  • AMT exemption increase — through 2025

  • Doubling of the gift and estate tax exemptions to $10 million (expected to be $11.2 million for 2018 with inflation indexing) — through 2025

Businesses

  • Replacement of graduated corporate tax rates ranging from 15% to 35% with a flat corporate rate of 21%

  • Repeal of the 20% corporate AMT

  • New 20% qualified business income deduction for owners of flow-through entities (such as partnerships, limited liability companies and S corporations) and sole proprietorships — through 2025

  • Doubling of bonus depreciation to 100% — effective for assets acquired and placed in service after September 27, 2017, and before January 1, 2023

  • Doubling of the Section 179 expensing limit to $1 million

  • New disallowance of deductions for net interest expense in excess of 30% of the business’s adjusted taxable income (exceptions apply)

  • New limits on net operating loss (NOL) deductions

  • Elimination of the Section 199 deduction, also commonly referred to as the domestic production activities deduction or manufacturers’ deduction — effective for tax years beginning after December 31, 2017, for noncorporate taxpayers and for tax years beginning after December 31, 2018, for C corporation taxpayers

  • New rule limiting like-kind exchanges to real property that is not held primarily for sale

  • New tax credit for employer-paid family and medical leave — through 2019

  • New limitations on excessive employee compensation

  • New limitations on deductions for employee fringe benefits, such as entertainment and, in certain circumstances, meals and transportation

More to Consider

This is just a brief overview of some of the most significant TCJA provisions. There are additional rules and limits that apply, and the law includes many additional provisions. Contact your tax advisor to learn more about how these and other tax law changes will affect you in 2018 and beyond.

Source

Read More
Construction, Human Services, Landscape, News, OSHA Alyssa Burley Construction, Human Services, Landscape, News, OSHA Alyssa Burley

OSHA Accepting Electronic Form 300A Data Submissions Through End of Year

Author, Alyssa Burley, Client Services Coordinator, Rancho Mesa Insurance Services, Inc.

In a recent news release from the U.S. Department of Labor (DOL), the Occupational Safety and Health Administration (OSHA) will be accepting electronically submitted 2016 OSHA Form 300A data through midnight on December 31, 2017.  The previous deadline had been December 15, 2017.  

Author, Alyssa Burley, Client Services Coordinator, Rancho Mesa Insurance Services, Inc.

OSHA Login Screen.jpg

In a recent news release from the U.S. Department of Labor (DOL), the Occupational Safety and Health Administration (OSHA) will be accepting electronically submitted 2016 OSHA Form 300A data through midnight on December 31, 2017.  The previous deadline had been December 15, 2017.  

According to a statement released by the DOL, as of January 1, 2018, the Injury Tracking System "will no longer accept the 2016 data."

Employers in California, Maryland, Minnesota, South Carolina, Utah, Washington and Wyoming are currently not required to submit their OSHA reports electronically.  However, it is likely it will be a requirement in the future.

Update: 5/3/18 For updated information on State requirements, read "Federal OSHA Asserts Electronic Data Reporting Requirement Applies to Employers across All States."

For additional information about the OSHA electronic reporting, read "Risk Management Center Streamlines Electronic OSHA Reporting," "DHS Alerts OSHA of Possible Electronic Reporting Security Breach," "OSHA Launched Electronic Reporting System."

 

Read More

California Workers Compensation 2018 Annual Officer Payrolls Minimums and Maximums, Assessment Rates, and Dual Wage Thresholds Announced by WCIRB

ICW Group Insurance Company, the largest group of privately held insurance companies domiciled in California, recently released an announcement that outlines the details and is attached for your review.

ICW Group Insurance Company, the largest group of privately held insurance companies domiciled in California, recently released an announcement that outlines the details of California Workers Compensation 2018 Annual Officer Payrolls Minimums and Maximums, Assessment Rates, and Dual Wage Thresholds.  The document is available for your review.

For any questions concerning the changes, please contact your Rancho Mesa service team.

"2018 Annual Officer Payrolls, CA Assessemnt Rates & Duel Wage Threshold." Insurance Company of the West. 

"2018 Annual Officer Payrolls, CA Assessemnt Rates & Duel Wage Threshold." Insurance Company of the West. 

Read More
Construction, Human Services, Landscape Alyssa Burley Construction, Human Services, Landscape Alyssa Burley

3 Steps to Developing Your 2018 Safety Training Calendar

Author, Alyssa Burley, Client Services Coordinator, Rancho Mesa Insurance Services, Inc.

The end of the year is the perfect time to evaluate your company’s overall safety program. One important element in a successful safety program is the weekly safety meetings (aka training shorts, tailgate talks, or toolbox talks). 

Author, Alyssa Burley, Client Services Coordinator, Rancho Mesa Insurance Services, Inc.

Example of a construction training short calendar.

The end of the year is the perfect time to evaluate your company’s overall safety program. One important element in a successful safety program is the weekly safety meetings (aka training shorts, tailgate talks, or toolbox talks). 

Rancho Mesa’s Risk Management Library provides the content employers need to educate their employees on how to be safe in the workplace.

The library includes hundreds of English and Spanish training shorts designed to educate employees on various safety topics in a quick and concise manner.  Each training short typically includes 1-2 pages of easy to follow content and a sign-in sheet.

Rancho Mesa recommends choosing 52 topics that are relevant to your industry. This will serve as your training short calendar for 2018.
    

Step 1:  Review the Training Shorts Library

To access the training shorts within the library, login to the Risk Management Center, click “Resources,” then click “Risk Management Library. Click on “Training Shorts,” then click “Safety.”

Review the list to determine which topics are appropriate for your industry.

Step 2: Save the Training Topics

It is recommended that you save your selected Training Shorts to your “My Content” folder.  This will make it easily to find them later.

From the list of training shorts, check the box to the left of the title(s) you would like to save to the “My Content” folder.  Then, click “Add to My Content” in the upper right corner.  Choose the subfolder to save the training shorts. Now, you can refer back to the list of topics, later. 

Step 3: Schedule the Trainings

Now, that you have picked your 52 training topics from the library, we recommend putting them on a calendar.  Pick a day during the week when you’ll have your safety meeting and include the topic for each week. Training may also be scheduled within the Risk Management Center.

For recommendations for your training calendar, contact Rancho Mesa Insurance Services, Inc. at (619) 937-0164.

Read More
Construction, Human Services, Landscape, News, OSHA Alyssa Burley Construction, Human Services, Landscape, News, OSHA Alyssa Burley

OSHA Pushes Back Electronic Reporting Deadline

Author, Alyssa Burley, Client Services Coordinator, Rancho Mesa Insurance Services, Inc.

In a recent news release from the U.S. Department of Labor (DOL), the Occupational Safety and Health Administration (OSHA) announced it has extended its electronic reporting deadline from December 1, 2017 to December 15, 2017.  

Author, Alyssa Burley, Client Services Coordinator, Rancho Mesa Insurance Services, Inc.

OSHA Login Screen.jpg

In a recent news release from the U.S. Department of Labor (DOL), the Occupational Safety and Health Administration (OSHA) announced it has extended its electronic reporting deadline from December 1, 2017 to December 15, 2017.  

The extension was made "to allow affected employers additional time to become familiar with the new electronic reporting system launched on August 1, 2017," according to the statement issed by the DOL's OSHA.

Employers in California, Maryland, Minnesota, South Carolina, Utah, Washington and Wyoming are currently not required to submit their OSHA reports electronically.  However, it is likely it will be a requirement in the future.

Update: 5/3/18 For updated information on State requirements, read "Federal OSHA Asserts Electronic Data Reporting Requirement Applies to Employers across All States."

For additional information about the OSHA electronic reporting, read "Risk Management Center Streamlines Electronic OSHA Reporting," "DHS Alerts OSHA of Possible Electronic Reporting Security Breach," "OSHA Launched Electronic Reporting System."

 

Read More
Construction, Surety Alyssa Burley Construction, Surety Alyssa Burley

Small Performance Bonds No Longer Require CPA Financial Statements

Author, Matt Gaynor, Director of Surety, Rancho Mesa Insurance Services, Inc.

In the past, many Surety Bond carriers required financial statements from a Certified Public Account (CPA), bank lines of credit, tax returns, etc. for contractor bond programs, whether the client required one bond a year or a large bond program. This is no longer the case.

Author, Matt Gaynor, Director of Surety, Rancho Mesa Insurance Services, Inc.

AdobeStock_103758914.jpeg

In the past, many Surety Bond carriers required financial statements from a Certified Public Account (CPA), bank lines of credit, tax returns, etc. for contractor bond programs, whether the client required one bond a year or a large bond program. This is no longer the case.

Several “A” rated carriers now provide “personal credit based scoring” to approve single bonds of $350,000 up to $500,000. There is no need for company financial statements. Instead, the contractor completes a “fast track” application, which requests personal financial information about the owner(s). The bond company will run the personal credit of the owner(s). If the owner(s) personal credit is decent, the bond will be approved. A response is provided within 48 hours of submission. 

The program responds to requests for bid bonds, performance and payment bonds, and letters of bondability. Several carriers provide a “pre-qualification” feature so you can determine if you will qualify for the bond before you bid or negotiate a project that will require a bond. This pre-qualification feature is helpful for owners that are aware they have low credit scores.

So, if you are considering a project that requires a bond and you are not a big fan of collecting a lot of paperwork for one project – don’t fret.  We may have a solution to help you win that job!

Contact Rancho Mesa Insurance Services, Inc. at (619) 937-0164.

Read More

OSHA Announces Top 10 Cited Violations for FY 2017

Author, Sam Clayton, Vice President, Construction Group, Rancho Mesa Insurance Services, Inc.
 
The Occupational Safety and Health Administration (OSHA) released its preliminary top 10 citation list for fiscal year 2017 at the annual National Safety Council (NSC) Congress and Expo, held in late September 2017.

Author, Sam Clayton, Vice President, Construction Group, Rancho Mesa Insurance Services, Inc.

sign-slippery-wet-caution.jpg

The Occupational Safety and Health Administration (OSHA) released its preliminary top 10 citation list for fiscal year 2017 at the annual National Safety Council (NSC) Congress and Expo, held in late September 2017.

“One thing I’ve said before in the past on this is, this list doesn’t change too much from year to year,” said Patrick Kapust, deputy director of OSHA’s Directorate of Enforcement and Programs, during the expo presentation. “These things are readily fixable. I encourage folks to use this list and look at your own workplace.”

OSHA compiled the list using data collected from incidents occurring from October 2016 through September 2017.

  1. Fall Protection in Construction: 6,072 violations.
    Frequently violated requirements include unprotected edges and open sides in residential construction and failure to provide fall protection on low-slope roofs
  2. Hazard Communication: 4,176 violations.  
    Not having a hazard communication program topped the violations, followed by not having or providing access to safety data sheets
  3. Scaffolding: 3,288 violations.  
    Frequent violations include improper access to surfaces and lack of guardrails
  4. Respiratory Protection: 3,097 violations.  
    Failure to establish a respiratory protections program topped these violations, followed by failure to provide medical evaluations
  5. Lockout/Tagout: 2,877 violations.  
    Frequent violations were inadequate worker training and inspections not completed.
  6. Ladders in Construction: 2,241 violations.  
    Frequent violations include improper use of ladders, damaged ladders and using the top step.
  7. Powered Industrial Trucks: 2,162 violations.  
    Violations include inadequate worker training and refresher training.
  8. Machine Guarding: 1,933 violations.  
    Exposure points of operation topped these violations.
  9. Fall Protection-training requirements: 1,523 violations. 
    Common violations include failure to train workers in identifying fall hazards and proper use of fall protection equipment.
  10. Electrical-wiring methods: 1,405 violations.  
    Violations of this standard were found in most general industry sectors, including food and beverage, retail and manufacturing

Training materials for each of the items on the OSHA list are available within the Risk Management Center.  Contact Rancho Mesa Insurance Services, Inc. at (619) 937-0164, for more information.
 

Read More

3 Steps to Protect Your Employees from San Diego’s Recent Hepatitis A Outbreak

Author, Alyssa Burley, Client Services Coordinator, Rancho Mesa Insurance Services, Inc.

Whether you work in the human services sector like healthcare, community outreach, or schools, or you are in the construction industry working in areas like downtown San Diego, your employees may come in contact with the Hepatitis A virus. 

Author, Alyssa Burley, Client Services Coordinator, Rancho Mesa Insurance Services, Inc.

AdobeStock_60961167.jpeg

Whether you work in the human services sector like healthcare, community outreach, or schools, or you are in the construction industry working in areas like downtown San Diego, your employees may come in contact with the Hepatitis A virus (HAV). 

As cities throughout San Diego County actively work to stop the spread of the recent Hepatitis A outbreak, some employers are asking how they can protect their employees who may be exposed to the virus.

According to the Center for Disease Control (CDC), the Hepatitis A virus is spread by “person-to-person transmission through the fecal-oral route (i.e., ingestion of something that has been contaminated with the feces of an infected person) is the primary means of HAV transmission in the United States.”

While the local and national media have primarily focused on the concentration of homeless and drug users who have contracted the virus, about 20% of the recent reported cases are not included in that population, according to the “Hepatitis A Outbreak in San Diego, CA” interview by Dennis Stein, linked to on the County of San Diego’s website. However, about half of the 20%, can trace their infection back to working with at risk populations. Thus, the Hepatitis A outbreak should be everyone’s concern, not just those included in the homeless population and drug users.

The “Hepatitis A vaccination is the best way to prevent the disease,” wrote Wilma J. Wooten, Public Health Officer and Director for the County of San Diego Public Health Services, in a letter to emergency responders, businesses, homeless providers and substance abuse treatment providers.  While vaccination is an option to prevent infection, good hygiene is also highly effective.  

Follow the steps below to help prevent the spread of the Hepatitis A virus to your employees:  

1. Wash Hands
First and foremost, instruct employees to frequently wash their hands with soap and warm water after using the restroom, before eating, and after touching handrails, door handles, tools, and other surfaces that are frequently used by others. 

Handwashing is “integral to Hepatitis A prevention, given that the virus is transmitted through the fecal–oral route,” according to the CDC’s website.

2. Sanitize
It may be necessary to regularly sanitize your facility or equipment. “Maintain routine and consistent cleaning of bathrooms for employees and the public, using a chlorine-based disinfectant (bleach) with a ratio of 1 and 2/3 cup of bleach to one gallon of water. Due to the high bleach concentration of this mix, rinse surfaces with water after 1 minute of contact time and wear gloves while cleaning,” suggests Wooten.

3. Educate
Awareness and education about the Hepatitis A outbreak is key to preventing the spread of the virus.  Based on knowing the facts about how the virus is spread, employees may decide to wear disposable gloves, wash hands more frequently, or change the way they perform their job duties to prevent exposure.
 
The Risk Management Center provides a variety of training materials to Rancho Mesa clients on Hepatitis A and other bloodborne pathogens.  Through online courses, training shorts, videos and other training materials, help educate your employees before there is an infection.

The County of San Diego also provides Hepatitis A information in the form of guidelines, cards, posters, videos and more.

Contact Rancho Mesa Insurance Services at (619) 937-0164 for more information.

Read More
News, Construction, Workers' Compensation Alyssa Burley News, Construction, Workers' Compensation Alyssa Burley

Workers' Compensation Dual Wage Thresholds Increases for Construction Classes in 2018

Author David J. Garcia, C.R.I.S., A.A.I., President Rancho Mesa Insurance Services, Inc.

In an effort to keep you informed, so that you can begin to plan your 2018 budget, we wanted to let you know of a potential change in the dual wage classes, for many but not all, the dual wage construction class codes.

Author David J. Garcia, C.R.I.S., A.A.I., President Rancho Mesa Insurance Services, Inc.

Updated September 15, 2017

The Workers’ Compensation Insurance Rating Bureau has confirmed the following increases for the 2018 dual wage construction classifications.  
California - Tools.png

Originally published on May 12, 2017.

In an effort to keep you informed, so that you can begin to plan your 2018 budget, we wanted to let you know of a potential change in the dual wage classes, for many but not all, the dual wage construction class codes.

The Workers’ Compensation Insurance Rating Bureau is proposing increases in the wage threshold for ten different construction industry dual wage classifications and is likely to recommend an increase in an eleventh, by the time it releases its 2018 regulatory filing, next month. The proposed increases range from $1.00 to $2.00 per hour, to keep the thresholds in line with wage inflation. See the chart below for the actual changes.

Dual Wage Thresholds

Classification Current Threshold Recommended Threshold Threshold Difference Last Changed
5027/5028 Masonry $27 $27 $0 2013
5190/5140 Electrical Wiring $30 $32 $2 2014
5183/5187 Plumbing $26 $26 $0 2014
5185-5186 Automatic Sprinkler Installation $27 $27 $0 2009
5201-5205 Concrete or Cement Work $24 $25 $1 2009
5403/5432 Carpentry $30 $32 $2 2016
5446/5447 Wallboard Application $33 $34 $1 2016
5467/5470 Glaizers $31 $31/further study $1 2016
5474/5482 Painting/Waterproofing $24 $26 $2 2009
5484/5485 Plastering or Stucco Work $27 $29 $2 2014
5538/5542 Sheet Metal Work $27 $27 $2 2009
5552/5553 Roofing $23 $25 $2 2009
5632/5633 Steel Framing $30 $31 $1 2016
6218/6220 Excavation/Grading/Land Leveling $30 $31 $1 2014
6307/6308 Sewer Construction $30 $31 $2 2014
6315/6316 Water/Gas Mains $30 $31 $2 2014
Table Source: WCIRB.com.

Rancho Mesa will keep you informed should the proposed 2018 change go into effect.  If you have any questions, please give us a call at (619) 937-0164.

Your Rancho Mesa Team - RM365 Advantage

Read More

3 Topics to Discuss with Vendors, Independent Contractors, and Partner Agencies Prior to Working Together

Author, Chase Hixson, Account Executive, Human Services, Rancho Mesa Insurance Services, Inc.

Recently, a non-profit client of mine asked the question: What are the steps I should take with vendors, contracted professionals and partner agencies to make sure my organization is protected should a claim arise as a result of their work?  This is a common exposure to many of our clients, and there are several steps that can be taken to protect your business.

IMG_4428_opt_1000pxls.jpg

Recently, a non-profit client of mine asked the question: What are the steps I should take with vendors, contracted professionals and partner agencies to make sure my organization is protected should a claim arise as a result of their work?  This is a common exposure to many of our clients, and there are several steps that can be taken to protect your business.

1. Verify the Proper Insurance is in Place
Any person/organization that you consider working with should be fully insured and able to provide you with a Certificate of Insurance, which lists the coverages, carriers and limits of insurance they have in place.  Without their own insurance in place, your company is now assuming full responsibility for anything that may occur as a result of their negligence. Depending on the nature and scope of the work being performed, different types of insurance will be required.  An insurance professional can help you determine the specific coverage needed.

Example: A charter school has hired a local animal shelter to bring animals to their students and teach about conservation.   One of the animals bites a student.  If the animal shelter does not have the proper insurance, the charter school’s insurance will be liable for any action taken against the school.

2. Name Your Business as Additional Insured
In addition to verifying that the correct coverages and limits are in place, you should also require they name your company as an additional insured on their policy.  By doing this, your organization will now be indemnified under their policy for claims arising as a result of their work, in which you are named. 

Example: In the example where a charter school has hired a local animal shelter to bring animals to their students and one of the animals bites a student, by requiring the animal shelter to name the charter school as an additional insured, the school is covered under the animal shelter’s insurance.

3. Provide a Waiver of Subrogation
A waiver of subrogation means an insured (and their insurance company) are waiving their right to subrogate against another party, should their employee suffer an injury on your premises.  Most independent contractors aren’t required to carry insurance, so this wouldn’t apply to them.  However, if employees of another company are performing work on your premises, it is wise to have them waive their right to subrogate against your workers’ compensation carrier. 

Example: A charter school has hired a local animal shelter to bring animals to their students and teach about conservation.   While presenting, an employee of the shelter trips and injures their knee.  A waiver of subrogation would void the animal shelter’s workers’ compensation provider from seeking subrogation against the charter school’s workers’ compensation policy. The employee will still be treated, but you won’t suffer the penalty for it.

I strongly recommend reviewing your processes regarding vendor, independent contractors and partner agencies to see what is currently in place.  Far too often steps are skipped and businesses are unaware of the liability they are assuming.  If you have any question about a specific circumstance, please don’t hesitate to give Rancho Mesa a call at (619) 937-0164, we are happy to assist.
 

Read More

5 Steps to Avoiding Workers’ Compensation Claim Litigation

Author, Jeremy Hoolihan, CRIS, Janitorial Group Leader, Rancho Mesa Insurance Services, Inc.

Workers’ Compensation claims can cost a company time, money, employee productivity, and morale. Litigation is one of the most costly results of a workers’ compensation claim. Once an employee hires an attorney, the time and money it takes for the claim to close drastically increases.

Author, Jeremy Hoolihan, CRIS, Janitorial Group Leader, Rancho Mesa Insurance Services, Inc.

AdobeStock_93395941.jpeg

Workers’ Compensation claims can cost a company time, money, employee productivity, and morale. Litigation is one of the most costly results of a workers’ compensation claim. Once an employee hires an attorney, the time and money it takes for the claim to close drastically increases.

There are several reasons why an employee will find the need to hire an attorney. Practicing a sound Risk Management Program can dramatically reduce the likelihood of litigation. Here are some ways you can prevent most workers’ compensation claims from ever reaching that point:

  1. Acknowledge why employees hire attorneys. The employee/employer relationship is a critical factor in determining if a workers’ compensation claim results in litigation. Employees who feel threatened in some way are more likely to hire an attorney. A few key reasons are:
       a. The employee is concerned they will be fired because of the injury and/or ownership or management doesn’t truly feel the injury was work related.
       b. The employee feels they will face retaliation for reporting the claim.
       c. There is a lack of understanding of the workers’ compensation claim process. For those employees that are faced with a workers’ compensation injury, it can be a very stressful time.
       d. There is a fear the claim will be denied or they will be treated unfairly. Attorneys can prey on vulnerable injured employees. Radio and television ads imply injured employees need their assistance in order to get proper treatment and/or a huge settlement they deserve.
     
  2. Keep lines of communication open with your employee. Reassure the employee that he or she will have a job when they are able to return to work. In addition, show some compassion and stay in regular contact with the individual. An employee is far more likely to hire an attorney if they are concerned about losing their job or no longer of value to the company.
     
  3. Consider the ramifications before firing an injured employee. Termination of an employee after they have been injured on the job can put the company at risk of a lawsuit (Section 132 claim). In addition, terminating an injured worker could cost the company more in wage loss benefits; an injured employee will continue to draw from the workers’ compensation policy if they are unable to return to work, regardless if the company continues to employ them or not. Often, employees are released to modified duty (Return To Work Program). If an employer can accommodate the work restrictions, the employee’s temporary benefits are reduced or eliminated. This can significantly reduce the total cost of the claim.
     
  4. Act before a problem employee becomes injured.  Once an injury has been reported, it becomes extremely risky to discipline or terminate a problem employee.  Address and deal with the employee immediately and be consistent with your documentation.
     
  5. Train your supervisors!!!! It is vital that supervisors are trained in reporting and handling claims. They are your first line of defense in preventing claim litigation. Businesses should have a formalized Accident Investigation Program in place. Rancho Mesa provides a Supervisor’s Report of Accident or Near Miss form and a Witness’ Accident Statement form to assist in the investigation process.  In addition to all the formal documentation, there are other key strategies a supervisor can use: 
       a. Do not accuse the injured employee of fraud, even if you know fraud is involved. Supervisors should simply document the facts.  If there is suspicion of fraud, make sure you document any supporting evidence in the report and inform the adjuster.  
       b. Do not negotiate the injured worker’s treatment or return to work schedule.  Leave that determination to the claims adjuster.
       c. Keep in touch.  Instruct the supervisor to check on the injured worker from time to time.  Show some compassion and build trust. Assure the employee that their job is secure.

While there is no surefire way to eliminate litigated claims, by following these five steps you should see results.  With the average litigated claim costing 30% more than a non-litigated claim, the savings over time could be significant.  To discuss implementing this strategy within your company’s Risk Management Program, please contact Rancho Mesa Insurance Services, Inc. at (619) 937-0164.

Read More

Assembly Bill 72 Passes to Limit Unexpected Medical Costs to Californians

Effective July 1, 2017, Assembly Bill 72 (Bonta) went into effect by protecting Californians from unexpected medical bills when visiting in-network facilities (i.e., hospitals, labs, and imaging centers). No longer can providers who aren’t contracted with a patient’s health plan step into the operating room, for instance, and charge the patient more than the patient would have expected to pay an in-network provider. Furthermore, the patient can only be billed for his or her in-network cost-share, meaning in-network benefits apply to all providers seen, and services rendered, in an in-network facility.

AdobeStock_54747603.jpeg

Effective July 1, 2017, Assembly Bill 72 (Bonta) went into effect by protecting Californians from unexpected medical bills when visiting in-network facilities (i.e., hospitals, labs, and imaging centers).  No longer can providers who aren’t contracted with a patient’s health plan step into the operating room, for instance, and charge the patient more than the patient would have expected to pay an in-network provider. Furthermore, the patient can only be billed for his or her in-network cost-share, meaning in-network benefits apply to all providers seen, and services rendered, in an in-network facility.

Over the course of my career, I’ve had to help many clients understand and appeal surprise charges from out-of-network doctors, anesthesiologists, etc., who’ve charged patients separately from the in-network facility, and I have experienced this myself when receiving care.  With many/most Preferred Provider Organization (PPO) plans, there is a separate deductible that a member has to satisfy for care received from out-of-network providers, after which, there is less coverage than in-network providers, and the member can be “balance-billed” between what the insurance company pays and what out-of-network providers charge.  AB 72 goes a long way toward eliminating such surprise charges.

As always, it’s important to review the Explanations Of Benefits (EOB’s) you receive from your insurance company, to make sure that your benefits have been applied correctly, according to your plan.  This is a smart piece of legislation that will help prevent unsuspecting patients in California from getting charged more from out-of-network providers, at least not without prior written consent.

For more information, contact Rancho Mesa at (619) 937-0164.

Read More