Bondability Letters – Surety Prequalification for Owners and General Contractors

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

In the normal process of bidding a construction project, our contractor clients are required to post a 10% bid bond to guarantee that they will execute and deliver a signed contract along with 100% performance and payment bonds, if they are awarded the referenced project. While this is a requirement for public projects, bid bonds have also become more prevalent for certain private projects. By approving the required bid bond, the surety company provides their stamp of approval that they have reviewed the bidding documents and are willing to support the contractor for the specific project.

On certain occasions, the owners and general contractors will require a less formal surety prequalification in the form of a letter of bondability. Although the owner/general contractor requesting the letter does not have the 10% guarantee provided by a bid bond, the letter of bondability can be issued rather quickly to let the owner know that a bond program is in place for the bidding contractor. If this contractor is deemed to be the low and responsible bidder by the general contractor, they know in advance that the contractor has been through a third-party prequalification by the surety company.

This document is normally issued by the bonding agent and contains the following:

• Name of the current surety carrier, A.M. Best Rating, treasury listing, and length of relationship.

• Approved single and aggregate program bonding amounts.

The other key wording contained in a typical bondability letter that differs from a bid bond is as follows:

“The issuance of surety credit is a matter between the principal (contractor) and surety… We assume no liability to you or any other third party if for any reason we do not execute said bonds.”

This wording is important because unlike a bid bond, the surety company does not have an obligation to provide final bonds if their principal is awarded a contract. While this rarely happens, the bond company will need to review additional information (i.e., contractual or financial) before they agree to provide performance and payment bonds in support of a project. For example, the contract or bond form may contain onerous wording that the surety company is not willing to support.

For more information on letters of bondability and how they affect your business, please contact me at 619-937-0165 or mgaynor@ranchomesa.com.

Builder’s Risk Reporter Form Policy: The Ultimate Time Saver

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

Builder’s risk policies protect construction materials while they are being stored on a jobsite or have been installed during the course of a project, prior to the completion of the work. These policies are often required by the project owners or developers and provide protection from day one up until the last speck of paint is dry when the project is completed. They are considered the glue of a general contractor’s insurance program because they can provide critical protection if there is an insurance loss that otherwise could derail an entire project.

There are two methods of purchasing builder’s risk policies.

Purchasing Individual Builder’s Risk Policies

Imagine, as a general contractor, you are eager to bid a project. You identify the need for a builder’s risk policy while reading through the prequalification documents. You then need to take steps in order to secure this policy or to make sure that the proper pricing is included in your bid. Even with a faster than average timeline, the process can take days for the actual policy to be underwritten, quoted, communicated, agreed upon, bound and then certificates issued. Add the variable of needing several policies per year and/or bidding Job Order Contracts (JOC) through local municipalities, and the workload involved can be significant.

The process of interacting with your insurance broker in order to secure a builder’s risk policy that satisfies the needs of each project, and also the vendors that require the policy, can be time consuming and involves multiple steps.  

Builder’s Risk Reporter Form Policy

Another approach, often overlooked, would be to secure a “builders risk reporter form” policy that offers:

• Annual blanket basis

• A “pay as reported” basis

The annual blanket basis would provide coverage for any size of project you would perform, annually, and that can be written on a blanket basis for projects that have not even been open for bid. A lot of time can be saved for companies accustomed to procuring one builder’s risk policy at a time.

A “pay as reported” basis builder’s risk reporter form allows policies to be purchased as they are reported to the carrier, which is ideal for any entity who needs multiple policies or that have multiple projects going on at once. Reporter forms can be set up on monthly, quarterly or on an annual reporting basis.

Items Needed to Generate a Builder’s Risk Reporting Policy Proposal

In order setup a Builder’s Risk Reporter form, you will need the following:

• A list of past projects with project name, size, type and length included (i.e. the last 10 projects is the minimum, but more info can create a more favorable response from underwriting),

• An executed and signed supplemental application, and

• A favorable loss history.

A builder’s risk reporter form can save a ton of time and energy. And as we know, time is the only resource we cannot gain back.

If you have questions about setting up a builder’s risk policy, contact me at (619) 438-6874 khoward@ranchomesa.com.

A Hardening Employment Practices Marketplace Likely to Impact Many Businesses

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

The Employment Practices Liability Insurance (EPLI) marketplace has faced a number of factors that are contributing to skyrocketing premiums and deductibles. Many insurance companies are facing the choice of whether to remain in the marketplace or exit altogether. Those willing to remain are then faced with having to consider the following changes:

• Increase their premiums to offset increased claim activity

• Increase their deductibles

• Consider adding exclusions of previously covered exposures

• Consider only renewing existing clients’ policies

• Pulling out of certain business segments such as retail, hospitality, leisure, and transportation which is currently being impacted the most from COVID-19.

Below are some of the main factors causing the hardening EPLI marketplace. As you will see, they vary significantly but combined they have created a perfect storm.

COVID-19

These are unprecedented times with businesses being forced to shut down for months due to COVID-19, employees having to work remotely and our economy seemingly coming to a standstill. Couple this with a significant increase in layoffs, severance packages, furloughs, and unemployment, and we have seen a significant increase in claims filed. By January 2021, the plaintiff’s bar had filed over 1,200 COVID-19 related employment lawsuits. These types of lawsuits have continued to grow each month since the pandemic began.

We have also seen the unemployment rate spike from 3.5% in March of 2020 to 14.7% in April 2020. Currently the unemployment rate has settled to about 8% but this still represents a double digit increase from2019.

EPLI claims often follow large changes in workforce, including reductions, promotions and demotions. Three areas of particular growing concern include:

• Sexual Harassment

• Privacy

• Retaliation

Sexual Harassment

The heightened awareness and increased public intolerance for harassment developed in part from the #MeToo movement has given a voice to people that are now not only speaking out but filing lawsuits against their employer for sexual harassment. This national attention has also altered the legal environment surrounding these types of claims, often leading to much higher settlements outcomes..  Industry wide, the total monetary benefits awarded to sexual harassment victims has increased 68% from 2016 to 2019 according to the U.S. Equal Employment Opportunity Commission.

Privacy

In addition to discrimination and sexual harassment claims, insurance carriers also anticipate privacy-related claims. As businesses begin to reopen, there are new policies and procedures in place that require a Human Resources department to question employees about their personal health, their health history, and their family’s health history. The nationwide Health Insurance Portability and Accountability Act (HIPAA) and other state-specific laws like the Illinois Biometric Information Privacy Act (BIPA) regulates how companies collect, store, use, and share biometric information. With temperature-taking requirements and a certification form filled out, there is a concern that some employees may feel their privacy has been invaded. 

Retaliation

There is also a growing concern that there will be more retaliation type claims relating to an employee’s use of social media. With COVID-19 in mind, employees are already expressing their concerns via social media about their employers’ lack of safety measures or personal protective equipment (PPE). It’s reasonable to consider that if these employees are terminated that they may feel they were retaliated against because of their posts.

Retaliation could also be a result of employees exercising their rights under Family Medical Leave Act (FMLA) or other benefits such as workers compensation or paid sick leave.

US Supreme Court LGBTQ Decision

The Supreme Court ruled in June 2020 that Title VII of the 1964 Civil Rights Act protects employees from discrimination based on sexual orientation and gender identification. 

Previously only 28 States awarded such protections. Now that these protections are law in all 50 states, we will likely see additional claims alleging employment discrimination based on gender identity and sexual orientation.

In conclusion, running a business remains a challenge under normal circumstances. Add in the many side effects of the pandemic and it can feel overwhelming. EPLI-related claims can result in catastrophic financial impacts to a company’s balance sheet. The cost of defending your business alone can potentially put a company out of business. While EPLI premiums continue to rise, so does your exposure to a myriad of claims that fall under this coverage umbrella. Having EPLI in place can mean the difference between absorbing fair and reasonable claim costs or forcing an uninsured business to close their doors. To learn more about EPLI coverage and ways to construct a policy that meets your needs, please reach out to me at 619-937-0174 or jhoolihan@ranchomesa.com.   

Profitable Bids Should Include Often Overlooked Insurance Costs

Author, Casey Craig, Account Executive, Rancho Mesa Insurance Services, Inc.

We will take a look at factors that go into your bid and ways to ensure you are hitting your target profit margin.

There are many factors that go into creating a profitable bid on a construction project. They include:

• The scope of the work

• The location of the project

• Material costs

• Labor costs

For most construction companies, their estimators are well versed in all of the areas mentioned earlier and yet despite their best efforts, an unforeseen circumstance may occur and drive up the cost of a project, resulting in reduced profitability or a loss on the project.

One area that is often overlooked, but controllable, is the impact insurance has on the profitability of the project. The question to ask is how prepared are you and your staff to address the following questions:

Do you have the required insurance, coverages, limits, and terms in place to meet the contractual requirements of the project? If not, what will be the cost to add those requirements?

Will the project overlap your insurance renewal? If so, what changes in your Experience Modification Rate (EMR) can you anticipate and what will be the dollar impact?

What changes in your General Liability and Excess Insurance rates can you expect? 

Working with your insurance advisor on the above is a necessary step is helping to create a better opportunity for profitable jobs. At Rancho Mesa, we follow strict Best Practices and have prescheduled meetings with our insureds throughout the policy term, but additionally conduct a focused pre-renewal meeting 120 days prior to policy expiration.

Those meetings allow us to:

• Keep our clients aware of changes in the insurance marketplace that may impact their business.

• Project their EMR for the coming year and discuss how this might influence your bidding process.

• Review industry workers’ compensation trends in both Pure Premium Rates and Expected Loss Rates and their impact on workers compensation costs.

So, work with your insurance advisor and uncover those overlooked insurance costs to minimize risk and maximize profitability. To understand these factors in more detail or to look at our new KPI Dashboard that puts this information at your fingertips you can reach me at 619-486-6900 or ccraig@ranchomesa.com.

Can Employers Mandate a COVID-19 Vaccination Policy?

Author, Sam Brown, Vice President of the Human Services Group, Rancho Mesa Insurance Services, Inc.

As COVID-19 vaccinations become more available and the positive results of our efforts are realized, employers may ask how this impacts the workforce and a full-scale return to the workplace. More specifically, they may ask if an employer can mandate a COVID-19 vaccination policy.

The laws are complex, so please do not rely on this article as legal advice. Please consult your labor law attorney before deciding how to proceed.

The short answer is yes, employers can mandate a COVID-19 vaccination for employees, when it makes sense. 

The 1905 court case Jacobson v. Massachusetts forms the U.S. Equal Employment Opportunity Commission’s (EEOC) basis for guidance. Following a deadly smallpox outbreak in New England in 1901, the Supreme Court ruled that the government may impose “reasonable regulations” to protect the “safety of the general public.” The EEOC makes clear that employers may implement similar demands.

According to the EEOC, an employer can implement a mandatory vaccination policy if there is a job-related need for it or if non-vaccination threatens the health of other employees, customers or themselves. The EEOC’s guidelines date back to the 2009 outbreak of H1N1, and was updated in March 2020.

A mandatory COVID-19 vaccination policy would commonly be used in a health care environment or in emergency services where the likelihood of exposure may be higher based on the nature of the work, opposed to the average office environment that is following the Centers for Disease Control COVID-19 guidelines along with implementing a COVID-19 Prevention Plan.

Employers should take caution when deciding whether or not to implement such a policy and whether it makes sense for their industry and organization. According to OSHA’s January 2021 Guidance on Mitigating and Preventing the Spread of COVID-19 in the Workplace, employers should not distinguish between workers who are vaccinated and those who are not. All employee should follow the same safety precautions regardless of vaccination status. 

Essential workers in sectors like construction and landscaping, community-based organizations and financial services to name few, can operate under the provided guidance without requiring their employees to get the COVID-19 vaccine in order to resume normal business operations.

Some employers are waiting to impose a mandatory vaccination policy, choosing instead to offer employees incentives for getting vaccinated. These incentives may include a vacation day, a few hours of regular pay, or a cash bonus. To avoid discrimination, an employer may offer the incentive to all employees if the company’s work force meets a vaccination goal. Whatever path you decide, make sure to include the policy in your employee handbook or COVID-19 Prevention Plan.

Considering a recent Kaiser Family Foundation survey, 27% of Americans are “vaccine hesitant.” So, the employer will need to decide if a COVID-19 vaccination policy is right for their organization.  Questions regarding mandatory vaccinations will continue to present a challenge to employers.

For specific questions about your company’s vaccine policy, consult our RM365 HRAdvantage™ portal’s live HR experts.

The Heart of Rancho Mesa

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

If you are reading this article, listening to our podcasts, and taking advantage of the meaningful risk management content we share weekly, you and your business likely find some degree of value in what is produced. While much of this content originates from our Media Communications Group, they, with other Rancho Mesa family members join together as the backbone of our operation. Our Certicians®, Account Coordinators, Benefit Analysts, Claim Advocates, Associate and Account Managers, and Sales Executives are the beating heart of our company. That core focuses on three main principles that guide our values, shape our decisions, and directly influence our daily interaction with clients and one another. They include Developing Solutions, Protecting Clients, and Building Trust.

Developing Solutions

A solution is defined as the act, method or process of solving a problem. Our clients face daily challenges and problems as they manage their organizations and continually look for competitive advantages. They rely on us to provide complete solutions but those can look far different across our many departments. Here are a few examples:

• One of our Sales Executives might recommend higher limits of coverage or adjusting deductibles to meet new exposures.

• Our Workers’ Compensation Claim Advocate might deliver a quarterly status to a company’s Safety Committee and make recommendations on return-to-work options. 

• It might also include an Account Manager reviewing contractual requirements for a client bidding a new job.

• And lastly, an Account Manager in our Benefits department might help to resolve a sensitive claim issue with a member. 

• These actions are just a few of the many day-to-day priorities that are centered entirely on serving our customers. We remain fearless in our approach to problem solving!

Protecting Clients

Risk comes in all shapes and sizes. Protecting our clients with insurance is one vehicle we may use to transfer some or all of that risk to a third-party. But, that process can only be effective when our team actively listens to clients and prospective clients through regular interaction at policy audits, pre-renewal meetings, claim reviews, stewardship reports, and renewal meetings. 

A key part of that protection are the resources we offer internally that help mitigate risk and reduce overall exposure to claims across all lines of coverage. Those resources include our:

• Risk Management Center Platform,

• RM365 HRAdvantage™ Portal,

• RM365 Advantage Safety Star™ Training Program,

• Weekly Educational Newsletter and Podcasts, 

• Workshops and Webinars.

Our clients can use these tools for risk management trainings, HR issues and concerns, safety certifications, and consistent risk management education and guidance.

These examples represent a very small sample of what is available from our organization. Building a risk management program that centers on controlling losses by implementing the proper protocols and best practice techniques is ultimately our vision for protecting clients.

Building Trust

We cannot develop solutions and properly protect our clients without building customer relationships based on a deep level of mutual trust. And, we view a distinct difference between establishing trust and maintaining it over the course of our partnership. While we are proud that our customer retention ranks in the top percentile across the nation, we recognize that trust is the key component to our success. And so, our work is never done. We continually expect more from ourselves, our team members, and our carrier partners to maintain, and ultimately, exceed customer expectations. It is simply how we were built and what we stand for. We see No Limit to what we can do.

To learn more about Rancho Mesa Insurance, subscribe to our weekly newsletter and podcast.

Funds Control May Secure Project Bond

Author, Andy Roberts, Account Executive, Surety, Rancho Mesa Insurance Services, Inc.

As surety brokers, we initiate bond programs for our construction clients. Single and aggregate limits are determined in large part by their financials and experience. Often, there are jobs that exceed the single limit we have in place, or are larger than any job that our client had previously completed. When it is a job that makes sense for the contractor, it is our job to work with the bond company and find a solution so the contractor can bid the job or take on the contract. One available solution is a process referred to as funds control.

Funds control is a service that bond companies use to ensure funds involved in the project will be used for appropriate work-related expenses. This arrangement involves a third party company engaged to handle the disbursement of the funds to the different sub-contractors and suppliers on that specific project. In order for this to be set up, the contractor is required to execute two documents, a Disbursement Agreement and an Irrevocable Direction of Funds. 

The Disbursement Agreement addresses the specific terms agreed upon by the contractor and the third party company and also details the responsibilities of both the contractor and the funds control company. The second document, the Irrevocable Direction of Funds, is a one-page document that requires the project owner, or the general contractor, to send all payments directly to funds control. Once the funds are received, they are placed into a project specific bank account that is set up in the contractor’s name. The payments are then disbursed to the sub-contractors and suppliers based on the pay applications that the contractor submit to funds control. And, while this adds some additional steps and work to the process, there are benefits to funds control and good reasons why the bond company will require it on certain projects. 

For the bond company, with a third party taking control of the distribution of funds, there is a much lower risk of financial mismanagement, and subcontractors, suppliers and vendors can expect to be paid for the work that they do, which leads to a lower risk of payment bond claims being filed against the contractor’s bond. 

While adding funds control to a project adds some additional work and steps to the job, it can be a valuable alternative route and one that contractors should gain familiarity. In many cases, funds control can be the solution that helps get a surety underwriter comfortable with supporting a bond for a particular job that otherwise would not be approved.

For more information or for any questions regarding your surety needs, please contact me at (619) 937-0166 or aroberts@ranchomesa.com.

Four Factors that Shape your Risk Profile

Author, Drew Garcia, Vice President, Landscape Group, Rancho Mesa Insurance Services, Inc.

How do you differentiate your company from your local competitors? Product, customer service, delivery, etc. The same can be said for your risk profile and insurance costs. Why are my insurance rates high when my competitors are low? Here are four factors that influence your risk profile and impact pricing:      

FREQUENCY OF CLAIMS

The frequency is the number of workers’ compensation claims you average.

Calculation – # of claims / basis

Evaluate – How often are you having workers’ compensation claims and how does that compare to other landscape companies in your region or state?  If frequency is high, a line can be drawn to conclude that your high frequency will lead to more lost time or severe injuries.

Action – If you are having a frequency issue, you need to assess:

• Injury Type (back, hand, wrist, knee…)

• Root Cause (lifting, punctures, slips…)

• Implement corrective actions to help mitigate the risks associated with your claims. 
  
  Take it to the next level and evaluate “near misses.”  Treat a “near miss” as if it were a claim and strategize a corrective action to prevent it from happening in the future. 

Use our Risk Management Center to assign a training to the foremen or supervisor and injured employee to help prevent this from occurring in the future.

Indemnity (Lost Time) Claims

Indemnity is the number of  lost time claims your company experiences.

Calculation – # of lost time claims / basis

Evaluate – How often are you having indemnity claims that result in lost time and how does that compare to other landscape companies in your region or State? 

Action – If you are having an Indemnity issue, you need to assess:

• Injury Type (back, hand, wrist, knee…)

• Root Cause (lifting, punctures, slips…)

• Implement corrective actions to help mitigate the risks associated with your claims. 
  
  Establish a “return-to-work” program which allows your injured employees an opportunity to come back to work on limited duty. 
  

  Improve accident investigation, documentation, and claim reporting protocols to equal best practices.

Experience Rating

Your experience rating is a combination of your loss data and total payroll when compared to your industry typically over a three year period.  Your experience rating will either credit or debit your workers’ compensation premium accordingly.

Calculation – Project your Experience Modification (XMOD) 6 months early at your Unit Stat filing.

Evaluate – Determine the impact changes in your Expected Loss Rate (ELR) and Primary Threshold will have on your next XMOD.

Action – Controlling your frequency of claims and number of indemnity claims will lower your Experience Modification. 

Operations

Heavier operations would include hardscape construction, tree trimming, and snow removal in which generally heavier machinery and product is used, thus a higher exposure to injury.  Compare these types of landscape operations to a lighter exposure such as landscape maintenance, mowing, edging and pruning. 

Calculation – Determine the percentages of your operations that fall into the various landscape work areas.

Evaluate – Identify the exposures that are unique to each area of your operations.

Action – Implement safety programs catered to your exposures that will mitigate risk and help protect your employees.  Although your operations might be heavier, you have the ability to implement tactics to reduce or prevent the claims from happening, thereby subjectively and objectively making your risk profile more appealing. 

We have seen 100% landscape construction firms achieve industry low experience XMODs and the markets most aggressive rates.   Don’t wait for the injury to occur; be proactive and stop the claim before it transpires. 

Your risk profile has already been created whether you know it or not.  The opportunity for you to own it and improve it is always available.

With one click of the mouse, you can see how you stack up against your competitors through our Key Performance Indicator (KPI) dashboard, today.

Contact me to get a customized KPI dashboard at (619) 937-0200 or drewgarcia@ranchomesa.com.

Total Cost of Risk

 Author, Rory Anderson, Account Executive, Rancho Mesa Insurance Services, Inc.

The total cost of risk is the sum of the measurable expenses that are associated with managing risk within any organization. Every successful business has a process for tracking and measuring performance to improve results. It is important for business owners to keep a pulse on key performance indicators. But, how are you measuring risk related costs? Some people may think that insurance premiums are the only cost associated with risk, but we need to look at the bigger picture.

In fact, insurance premiums only make up one fifth of an organizations total cost of risk. If you are only considering insurance premiums as a way of quantifying your company’s risk related costs, you are missing costs that you have control over. All risk-related costs can be observed and monitored. Also, there are certain strategies that, once implemented, will reduce those costs if executed correctly. That’s what total cost of risk is all about. There are five components that make up an organization’s total cost of risk: insurance premiums, retained losses, internal risk management costs, outside vendor fees, and indirect claim costs.

Insurance Premiums

An insurance premium is the payment that a company agrees to pay in order to have insurance. It is the most obvious component that makes up the total cost of risk and represents an important piece of the puzzle.

Retained Losses

There are two types of retained losses, active and passive. An active loss is simply when you have a deductible. If you have a deductible, you made a decision on the front end to take on (or retain) some of the risk, and pay a specified out of pocket amount for situations involving claims. On the other hand, a passive loss is any loss that is unexpected and not accounted for anywhere else. It could be a loss that is not covered by insurance and therefore must be covered out of pocket by the organization. Retained losses, active or passive, must be included when factoring total cost of risk.

Internal Risk Management Costs

Consider internal risk management costs as well. Maybe you have a full-time safety director. What is their salary? What about the person who is responsible for keeping track of the workers’ compensation claims, or the HR person who is in charge of managing and updating the employee handbook every time a new state law is passed? Calculate the internal hours that are spent looking at safety and risk management, and assign a dollar amount. These are costs that typically can be overlooked.

Outside Vendor Fees

You cannot forget to allocate any potential outsourced costs into the total cost of risk. Maybe you hired an outside firm to complete anti-harassment or First Aid/CPR training for your employees. Did you bring in outside safety consultants? These costs add up and need to be considered, as well.

Indirect Claim Costs

The last factor that makes up the total cost of risk are indirect costs associated with claims. These are secondary costs that are linked to claims. For example, with workers’ compensation insurance, the direct costs such as medical costs, indemnity payments, and legal services are just the tip of the iceberg. Some examples of indirect costs that are not covered by insurance are OSHA fines, accident investigation, implementation of corrective measures, hiring replacement workers, loss of productivity, etc.

Total cost of risk is critical for organizations to understand for several reasons. First, it helps you make educated and informed risk management decisions. You may want to invest into new equipment or bring in additional safety training from the outside. If you don’t know the total cost of risk and the ultimate impact in terms of upfront expense and projected return, how can you make the best decision?

Understanding your organization’s total cost of risk also helps you benchmark your progress towards your financial goals and objectives. It’s a quantifiable, controllable number that can be identified and reduced. It’s a metric that must be used to evaluate the overall success of your risk management process. When an organization is looking at their total cost of risk, they are focusing on the entire risk management function, which ultimately can lead to stronger safety programs and a reduction in frequency and severity of claims.

For questions about how your company can account for its total cost of risk, contact me at (619) 486-6437 or randerson@ranchomesa.com.

Construction Industry Faces Challenges Heading into 2021

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

As a result of COVID-19’s impact on the overall economy, the construction industry will likely see some strong head winds not only operationally, but also from a risk management and insurance standpoint in 2021.

Construction contractors are likely to feel the effects of economic uncertainty, insurance premium increases and labor storages moving forward. Specifically, when planning for 2021, contactors should consider:

• Economic Uncertainty

  • Funds may not be available as city, state and federal budgets are reduced.

  • Projects may be delayed or canceled.

  • Your back log of projects may be reduced.

  • Surety companies may implement tighter requirements.

• Insurance Impacts

  • The commercial insurance market may harden causing increased premiums.

  • Insurance carriers may have a limited capacity as they have been affected by the pandemic and natural disasters.

  • New exclusions may be added as policies are renewed.

• Labor Force Decreases

  • Employment Practices Liability (EPL) Exposure may increase as new and/or inexperienced employees are hired.

As we move into 2021 and begin to face these challenges, we’ve developed the following steps and actions you can take to help minimize these concerns:

• Economic Uncertainty

  • Audit your existing backlog and determine which projects may experience delays or cancellations.

  • Review and audit your existing surety program to make sure you have adequate capacity to meet your present and future surety needs.  Rancho Mesa’s Surety department has a best practices audit program to assess your needs.  Complete an interest form and our team will be able to assist you.

• Insurance Impacts

  • Meet with your insurance advisor and start the renewal process 90-120 days prior to your renewal.

  • With your insurance advisor, review all new coverage changes, conditions, and exclusions that will impact your risk management program.

  • Accurately project your rating basis (field payroll/sales) that will affect your workers’ compensation, general liability and excess insurance premiums.

• Labor Force Decreases

  • Use best practices during any labor reductions to limit EPL exposures like wrongful termination, discrimination, etc.

Through Rancho Mesa’s RM365 HRAdvantage™ Portal, clients have access to a library of resources and 50 human resources consultants to answer your questions and provide you information in making those decisions.

To discuss your 2021 risk management plans, contact me at (619) 937-0167 or sclayton@ranchomesa.com.

2021 Insurance Game Plan

Author, Dave Garcia, President, Rancho Mesa Insurance Services, Inc.

As we come to the end of 2020, the most challenging year most of us have ever experienced, where COVID-19, wild fires and other natural disasters took their toll emotionally, physically, mentally and financially on all of us, we can only hope for a brighter 2021.

The insurance industry did not escape the impact of COVID-19 and the natural disasters, either. Insurance companies, along with their reinsurance companies, suffered catastrophic losses as a result. As with many industries, there will be lagging actions that will take place in 2021 to help these companies in their efforts to recover.

While there really isn’t a line of insurance that wasn’t impacted, the lines of insurance that suffered the greatest losses and impacts include:

• Property

• General Liability

• Excess/Umbrella

• Workers’ Compensation

• EPLI

• Cyber Liability

• Surety

• Employee Benefits

For this article, I will limit my discussion to the property and casualty lines and leave surety and employee benefits to another day.

To offset these losses, I anticipate any number of steps insurance companies will take as we move into 2021. But, let me just touch on those that I think will have the greatest impact and need for attention to business owners in 2021. 

Let’s review these and I will try and give you a small sampling of the implications for each action.

• Non-renewing policies

  • Carriers in many cases will not offer renewal terms.

• Reducing coverage limits and terms

  • Increasing deductibles, lowering aggregate limits particularly in the excess/umbrella marketplace.

• Add new exclusions

  • Businesses will start to see “communicable disease” exclusions added to various lines of insurance.

• Increase underwriting information needed

  • A higher emphasis on information particularly as it relates to a business’s policies and procedures to mitigate COVID-19.

• Raise premiums

  • This is the ultimate consequence and one we are all anticipating to see beginning in early 2021.

To many businesses, this will seem daunting and hopeless - one more hurdle to overcome to keep their businesses going. However, there are proactive steps you can take to mitigate these circumstances and have a strong year despite the adversity.

I’m a firm believer in being pro-active and not re-active. Following are steps you can take to meet this challenge head on:

• Meet with your insurance advisor 90-120 days from your renewal date.

• Understand the specific challenges you will be facing.

• Create a strategy on how to approach the insurance marketplace to ensure the most cost effective and comprehensive risk management program.

• Review and enhance your existing safety program. Rancho Mesa offers our RM365 Advantage Safety Star™ certification program. This is a comprehensive web-enabled training course designed to enable your employees from supervisory to front-line workers to be trained and certified in safety best practices. The insurance marketplace already places a high value on these types of safety trainings and certifications, so this will help your company’s productivity through fewer claims but also position you in a more favorable position in the marketplace.

• Benchmark your company’s safety performance to your industry and see which areas you are outperforming your peers and areas that need your attention. Rancho Mesa offers a benchmarking report we call StatTrac™ to our clients or to other companies who want to see where they stack up.

To close, let me reassure you there is light at the end of the tunnel for 2021. Be proactive; start 90-120 day out from your renewal; don’t let insurance issues sneak up on you; attack them head on and I believe you can make 2021 a great year for you and your company.

If you have any questions or want any help in devising a plan and you are a construction company, please reach out to Sam Clayton, our Construction Group Leader at sclayton@ranchomesa.com. If you are in the human services industry, schools, non-profit, healthcare, assisted living, etc., please reach out to Sam Brown, our Human Services Group Leader. And finally, we can be reached at (619) 937-0164 or at our website, www.ranchomesa.com.

I really believe there is no limit to what you can do – best of luck in 2021.

Preparing the Home Care Industry for 2021

This past year has brought significant changes to many industries as they navigated the effects of COVID-19. Below is an overview of the effects to the home care industry and what employers can do to be better positioned in the marketplace.

Impact to the insurance industry as a whole

Even prior to COVID-19, several key events occurred which began impacting pricing:

• 2018 California Wildfires – over $12 billion in losses severely impacted the reinsurance marketplace causing a ripple effect to insurers, many of which weren’t even in the property insurance marketplace.

• AB 218 – This law was signed last year which eliminated many of the statutes of limitation for people to file child abuse claims. Though this related to those who work with children, the same carriers who insure  the home care industry also work with industries serving children. Claims have risen 500% since January 2020.

• Social Inflation – Recent trends have shown an increase in litigation, claims costs and plaintiff friendly legal decisions.

What impacts will COVID bring?

• SB 1159 – The presumption that COVID claims will be compensable under workers’ compensation is severely impacting the costs towards California insurers. Recent estimates suggest over $2 billion has been paid to date.

• Healthcare companies hit hardest – The vast majority of the claims are coming from the healthcare industry. With the heighten risk, we’ve seen carriers exit the marketplace and a hardening of the market for those remaining.  

What can Employers do?

• Make sure all your documentation is in order. This includes:

  • Written COVID-19 Prevention Plan Template

  • If you have had any incidents – proper documentation regarding what was done in response to the incident and if any changes were made moving forward to keep incidents from happening again.

  • Post all CDC, state and local health department required information and postings.

• Make sure you are being properly represented to the marketplace. Most insurance carriers are improperly categorizing home care companies as healthcare risks. The exposures to a home care companies are far less risky than that of a hospital or health center. However, without proper discussion between your broker and underwriter, you will be categorized as a health risk. Make sure your broker is communicating the true exposure of where your employees work and what they do and the exposures they are truly facing to help you get the best pricing.

To discuss your situation and prepare for 2021, contact Rancho Mesa Insurance Services at (619) 937-0164.

4 Key Factors in Developing a Motor Vehicle Report Program

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

Auto liability is often one of the most substantial risks a business will have. Driver selection is one of the most important evaluations a business can do to prevent accidents. It’s been proven that drivers with a history of moving violations and accidents pose a higher risk for organizations. Best practices for reducing this risk allow only safe drivers to operate a company vehicle. In order to manage this process, a business should develop a Motor Vehicle Records (MVR) Program as part of their Fleet Safety Program to ensure safe employees are driving company vehicles. There are four key factors in developing an MVR Program

1. Obtaining the MVR.

2. Evaluating the MVR.

3. Applying the MVR.

4. Documenting the MVR.

Obtaining the MVR

Obtaining the MVR is the first step of determining whether a driver meets acceptability standards. Best practices recommend that all employees who drive on company time, whether that is driving a company vehicle or their own, should have their MVR requested and evaluated at least on an annual basis. Some companies choose to obtain the MVR of those employees who drive regularly and not those that drive on an incidental basis. It’s best to consult your attorney but many believe at least verification that a license is valid should be established for incidental drivers.

Evaluating the MVR

Now, the employer has obtained the MVR and it needs to be evaluated. Many insurance companies evaluate a MVR based on three criteria:

1. The age of the driver. The minimum age for a driver varies by insurance company. Generally speaking, the minimum age to be eligible to drive on a commercial auto policy is 21-23 years old. It is strongly recommended that your MVR Program adheres to a minimum age requirement because there is a much higher percentage of accidents by young inexperienced drivers.

2. The length of time driver has maintained a valid license. Driver experience is another factor that should be strongly considered while evaluating a MVR. Most insurance companies are looking for at least three years of driving experience. With younger generations obtaining their licenses later and later, you may run into issues of drivers not meeting the minimum experience requirement. There may also be drivers that have been licensed in other states, which would show little experience in the state where they are now licensed. It may be necessary to verify a driver’s previous license status in another state.

3. The number of violations and infractions the driver has on their license. This could be the single most important factor in establishing driver eligibility. Drivers who have a history of moving violations and accidents pose a higher risk to an organization. When evaluating a MVR report, it’s important to establish consistent requirements that are agreed upon by the organization and insurance company. A common acceptable MVR includes:

a. No more than two minor moving violations and one preventable accident in a three-year period. A minor moving violation includes speeding (i.e., 1-14 mph over posted limit), improper lane change, failure to yield, failure to obey traffic signal or sign, and an accident.

b. No more than two zero-point infractions such as cell phone ticket, seat belt ticket, and texting in the last three years.

c. No major violations in the past five years such as a DUI, leaving the scene of an accident, excessive speeds over 20 mph over limit, reckless driving, felony involving the use of a vehicle, and license suspension or revocation resulting from accidents or moving violations.

Applying the MVR     

Once the MVR has been evaluated, it’s time to determine which drivers are eligible and which are not. This can certainly pose a problem when implementing a new MVR Program with existing employees and drivers. A company may have to evaluate whether an employee’s driving responsibilities are suspended, if they need to be re-assigned to a non-driving position, or in certain circumstances might have to be terminated (such as a delivery driver). It’s also possible to consider a transitional period for those that are now considered ineligible. It is also important to consult the HR Department and company attorney when making these transitions.

Documenting the MVR

Proper documentation of a company’s MVR process should be consistent and contained in each employee’s file. The employee’s file should have any applications, the MVR, warnings or corrective actions taken, annual MVR reports, and any signed release forms.

A formal MVR Program is a vital piece to a successful Fleet Safety Program. It creates a barrier of minimum requirements that can often weed out potential unsafe drivers and future liability. If you need assistance in developing a Fleet Safety and MVR Program, please feel free to reach out to me at (619) 937-0174 or jhoolhan@ranchomesa.com. 

A Tree Care Company’s Guide to the Annual Workers’ Compensation Audit

Author, Rory Anderson, Account Executive, Tree Care Group, Rancho Mesa Insurance Services, Inc.

The premium for your workers’ compensation policy is based on the type of work you do, and the amount of payroll incurred. By maintaining proper payroll records, segregating the wages earned by your employees, you may reduce the cost of your workers’ compensation insurance. The final audit is the process that calculates the last premium due. It compares the estimated payrolls to actual wages paid during the policy year. The audit may result in a refund or additional premium due. Workers’ compensation audits also determine if the classification codes quoted at inception accurately reflect the scope of work performed during the policy period. Insurance carriers charge more premium for higher risk operations, like tree trimming.

In my last article, we looked at how it may be possible for a tree care company to use the 0042 landscape classification code at specific times, if they are trimming hedges or trees from the ground. We noted, however, that when any of the tree care company’s operations are off the ground, at any elevation, that payroll would be classified in 0106 tree trimming. Also, any type of work that is associated with the tree trimming (e.g., clean-up, chipping, stump grinding, etc.) would also be included as 0106.

The basis of premium is the payroll earned during the policy period. Payroll includes regular wages, salaries, overtime, bonuses, vacation pay, sick pay, commissions, cash payments, and other substitutes for money. Summarizing and segregating wages allows for the possible reduction of exposures and lower premium charges. Consider the following for potential adjustments at final audit:

• If employees are engaged in both landscape construction/maintenance work, and tree trimming, you can segregate wages between operations and utilize both classifications. Earnings can be split by classification if time cards are maintained showing hours worked by activity, and payroll reports summarize hours and wages earned for each class. Segregation is based on records of actual hours worked; you cannot split earnings by percentages or projected bid calculations.

The wages for miscellaneous employees can be split by class if timecards segregate earnings by type of work performed. If no segregation is maintained, payroll will be assigned to the highest rated class. 

• Premium overtime is excludable if records document the hours and remuneration earned for regular hours and overtime hours. This includes earnings paid over and above the straight time earnings. If overtime is paid at one and one-half times the regular rate of pay, 1/3 of the total overtime pay can be excluded.  If double time is paid, ½ of the overtime pay is excludable.

• California allows the exclusion of deductions which are part of a Section 125 Cafeteria Plan.  This might include medical, dental, and vision premiums. If these deductions are summarized by employee and by classification, they can be excluded from the workers comp wages.

• Severance pay and tips are excludable. Maintain severance agreement letters documenting final payment agreements. 

• Depending on the type of entity insured, the earnings of sole proprietors, partners, and corporate officers may be excludable. Talk with your agent regarding qualifications and endorsements which can be issued as adjustments to your policy.

Workers’ compensation exposures may include costs for additional earnings paid outside of payroll. This could include bonuses, flat auto allowances, cash payments, casual labor, and subcontractors who could be considered employees. If subcontractors are hired, be sure to use licensed contractors who operate their own business. Always obtain and keep copies of the certificates of insurance from subcontractors to confirm independent coverage. 

To prepare for final audit, maintain proper payroll records segregating and summarizing wages earned by your employees. The Auditor will:

• Advise you on which reports to prepare for final audit. This typically includes payroll records and summaries, quarterly payroll tax reports, general ledger, cash disbursements, and/or 1099 reports.

• Assist you in identifying cost saving measures. They will help to recognize and explain how to take advantage of all potential credits, such as premium overtime, severance, Cafeteria 125 plan deductions, etc.

• Ask for a description of the business, and the job duties of employees to verify classification assignments.

• Review all findings and suggestions, and address any additional questions you may have.

For questions about your annual audit, contact me at (619) 486-6437 or randerson@ranchomesa.com

Get Your Bond Account in Shape for 2021 – A Surety Company Perspective

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

As we wind down the 2020 year, it is important for our contractor clients and prospects to start planning how the 12/31/2020 fiscal year end financial statement will look. The bond companies will use this information to set your 2021 Bond Credit Line for approval of your projects.

I recently sat down with two industry executives from Argonaut Surety, Steve Parnas, Vice President and Contract Practice Leader, and James Bluzard, Vice President and Chief Underwriting Officer-Contract to discuss the required financial information to ensure our contractors maximize their available bond credit going into 2021. Listen to the entire podcast Episode 56 “How to Get Your Surety Bond Account in Shape for 2021” on your favorite app.

Below are a few excerpts from our recent Podcast:

Rancho Mesa Matt Gaynor: “Although you track our contractor’s financial numbers throughout the year - how important is the 12/31 year-end financial statement?”

Arogonaut James Bluzard: “The 12/31 statement is typically a CPA-prepared statement viewed as the most important statement from the surety underwriter perspective since it is coming from an independent third party. Given the uncertain economic times we are in, and with COVID out there, getting that statement out and into your underwriters hands earlier rather than later will be really important to let the underwriters see how 2020 closed and also to get a forecast regarding 2021, as well.”

Rancho Mesa Matt Gaynor: “Within the CPA document, what are some of the specific items and schedules you are looking to analyze?”

Argonaut Steve Parnas: “We actually start our analysis at the back of the document looking at the work in progress and completed job schedules, which gives us insight into the performance of the past year along with how they are positioned going forward. Also, looking at the receivable and payable schedules to see how they are collecting their money and paying their bills.”  

To get a better understanding of how the bond carriers will analyze your underwriting documents during these uncertain times, please contact me at (619) 937-0165 or mgaynor@ranchomesa.com.

CAL/OSHA Adopts Written COVID-19 Prevention Plan

Author, Emily Marasso, Media Communications Assistant, Rancho Mesa Insurances Services, Inc.

On November 19, 2020, California’s Occupational Safety and Health Administration (Cal/OSHA) Standards Board adopted temporary emergency standards to protect workers from COVID-19. These standards are expected to go into effect November 30, 2020, upon approval from the Office of Administrative Law.

Now, what does this mean for California employers? It means employers must have a written COVID-19 Prevention Plan. This written plan must include and address specific key points outlined by Cal/OSHA. These standards require employers to establish a system for communicating information about prevention, positive cases to employees, how cases will be identified and evaluated, a process for investigation and responding to cases, correction of hazards, training, physical distancing requirements, face covering, site-specific controls, reporting/recordkeeping and access, preventing the spread of the virus to other employees and a defined return-to-work criteria after a COVID-19 recovery.

Rancho Mesa Insurance has developed a COVID-19 Prevention Plan template for its clients to assist in the implementation and compliance of the new standards. Updated versions may become available as the standards are approved by the end of the month.

In addition, Rancho Mesa’s Risk Management Center offers additional tools employers can utilize to make sure they are in compliance with the new standards. Track daily COVID-19 symptoms in the Audit Track screen and deploy free online COVID-19 training for all employees from any mobile device. Our library of COVID-19 resources continues to grow and is available for our clients to access from the Risk Management Center and the RM365 HRAdvantage Portal™.   

For information on how to access these resources, please reach out to your Client Services contact.

Download COVID-19 Prevention Plan Template

Download COVID-19 Prevention Plan Template

COVID-19 Workers Comp Surcharge Coming to California

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

Adding frustration to the growing concerns for businesses dealing with COVID-19, the Workers’ Compensation Insurance Rating Bureau (WCIRB) has recommended California employers pay a COVID-19 surcharge on their 2021 workers’ compensation policies. 

If approved, this new COVID-19 surcharge will vary by industry and have a minimum of $0.01 and hit a maximum of $0.24 per $100.00 of payroll. The industries with less of a COVID-19 exposure can expect a lower surcharge. While industries with a higher exposure can expect a greater increase. The additional surcharge my not seem like a lot, but multiplied by a company’s payroll, it can be significant to a company’s bottom line. Additionally, this surcharge will apply to all California employers, regardless if they had any COVID-19 illnesses.

The Workers’ Compensation Insurance Rating Bureau (WCIRB) approved the surcharge after growing concerns that the number of COVID-19-related workers’ compensation claims will continue to increase. It’s been estimated this year that 11% of all workers’ compensation claims in California have been COVID-19 related. The surcharge will help the insurance carriers mitigate the growing cost of the claims that could not have been anticipated when rates were calculated for 2020 policies. Even though COVID-19 claims will not be included in California’s companies’ Experience Modification Rates (i.e., XMOD, EMR), carriers will look to a number of variables in order to adequately price for an individual company’s premium. Those will include:

1. Overall claims experience

2. COVID-19 claims experience

3. The COVID-19 protocols and practices that are in place

Rancho Mesa, California union employer groups, as well as several carriers including the State Compensation Insurance Fund (State Fund), oppose the surcharge idea. Our feeling, as well as many of the others, is that most carriers are now underwriting specifically for COVID-19 by evaluating the businesses’ COVID-19 claim history and safe guards. Thus, there is no need for an additional surcharge.

In the next few weeks, we will release a follow up article that will highlight the best practices employers can implement now to minimize the COVID-19 impact to their organization and 2021 workers’ compensation renewal pricing.

For questions about workers’ compensation and the COVID-19 surcharge, contact me at (619) 937-0167 or sclayton@ranchomesa.com.

AB 685 Creates New Notice and Reporting Requirements

Author, Sam Brown, Vice President of the Human Services Group, Rancho Mesa Insurance Services Inc.

On September 17th, 2020 Governor Gavin Newsom signed into law Senate Bill 1159 (SB 1159) and Assembly Bill 685 (AB 685), both COVID-19 related bills.

Both pieces of legislation will impact how employers respond to incidents of COVID-19 infections. This article will help business owners and officers understand AB 685’s heightened occupational health and safety rules. Employers also need to understand how AB 685 grants California’s Occupational Safety and Health Administration (Cal/OSHA) greater enforcement powers.

Posting Requirements

AB 685 requires California employers to provide the following four notices within one business day of being informed of a potential COVID-19 exposure:

1. Provide a written notice to all employees, and to the employers of subcontracted employees, who were at the same worksite within the infectious period, notifying the employee that they may have been exposed to COVID-19. It must be reasonable to assume the employees will receive the notice within one day, whether that is through email, text, or written notification.

2. If the employee population includes represented employees, then the employer must also send notice to the exclusive representative of the affected bargaining unit.

3. The employer must also provide notice of any COVID-19 related benefits or leave rights under federal, state, and local laws, or in accordance with employer policy. The employer must also notify employees of their protections against retaliation and discrimination. 

4. The employer must notify all employers, the employers of subcontracted employees, and any exclusive representative, of the employer’s plan to complete a disinfection and safety plan in accordance with federal Centers for Disease Control guidelines.

Employers are required to maintain records of these notices for at least three years. Failure to comply with the notice requirements may result in a civil penalty.

If an employer learns of an “outbreak” as defined by the California Department of Public Health (“CDPH”), the employer must also notify the appropriate public health agency within 48 hours with the names, occupation, and worksite of any “qualifying individuals” related to the “outbreak.”

Two exceptions to the notice and reporting requirements:

1. Health facilities as defined in Section 1250 of the Health and Safety Code, are not required to report an “outbreak” within 48 hours.

2. The notice requirements do not apply to exposures by employees whose regular duties include COVID-19 testing and screening, or care to individuals who have or who are suspected to have COVID-19, unless the “qualifying individual” is also an employee at the same worksite.

Authorized Shutdown

Under AB 685, if Cal/OSHA determines that a workplace or operation within a workplace exposes employees to a risk of COVID-19 infection, creating an imminent hazard to employees, Cal/OSHA is authorized to prohibit entry to the workplace or the performance of operation in question.

If your organization would benefit from guidance on these new employer requirements, please contact Rancho Mesa Insurance at (619) 937-0175.  

Sources:

https://www.lcwlegal.com/news/governor-newsom-signs-sb-1159-and-ab-685-into-law-impacting-covid-19-related-workers-compensation-coverage-and-creating-new-notice-and-reporting-requirements-related-to-covid-19-workplace-exposures

https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200AB685

Safe Cloud Computing for Contractors

Author, Drew Garcia, Vice President, Landscape Group, Rancho Mesa Insurance Services, Inc.

Even prior to the COVID-19 pandemic, many construction companies were utilizing some form of cloud-based systems to effectively streamline business operations and increase accessibility of information. While hosting sensitive data in the cloud has many benefits like shared access to data, applications and storage, there are some risks contractors should take into account before relinquishing their data to the cloud.

A leading provid//er of Cyber Liability insurance, CNA references three key risks companies utilizing cloud technology need to be aware of in an recent article, “Cloud computing 101: Getting clear about the cloud.” CNA explains data protection, data loss/disruption and inappropriate access are risks business take on in exchange for the benefits of cloud computing.

Data Protection

Protecting data is essential for any organization. Customers’ personal and payment information may be stolen by hackers once the data is stored in the cloud or even while in transit. So, your data in the cloud must be secured through encryption to prevent the data from being usable if stolen. As the cloud customer, the company should manage the encryption keys to ensure only authorized users can decrypt the data.

Data Loss / Disruption

You may be thinking about moving your data to the cloud as a way to protect it from electrical outages, fire, flood and other natural disasters. However, your cloud hosting provider can be left inoperable due to similar calamities. Before hosting your data in the cloud, review your host’s back-up and redundancies to ensure there will be a copy of your data available if something should happen to the host’s servers. Have a plan in place to help navigate your most critical information in the event something like this occurs. 

Inappropriate Access

When storing data in the cloud, it is imperative the company ensures stringent and complex user authentication. This may mean passwords are changed frequently or two-factor authentication is deployed to ensure hackers can’t find their way to your data. When you manage a large user-base, the risk rises. Ensure former employees no longer have access to your data by changing security rights or disabling their account. Complex user authentication can be an effective deterrent to keep those who should not have access to your information from finding their way into your network.

Assuming your information is safe and secure in the cloud is misleading. Be proactive in protecting your information and round out your risk management program with a strong cyber liability program that can fulfill your cloud based risk needs.

For more information about the CyberOne™ program, contact Rancho Mesa.

Article edited 4/19/2021.

SB 1159 Is Now Workers’ Compensation Law

Author, Dave Garcia, President, Rancho Mesa Insurance Services, Inc.

As expected, California Governor Newsom signed Senate Bill 1159 (SB 1159) into law Thursday, September 17, 2020 and it will have several impacts on workers’ compensation and the presumption of the claim. Below is an outline of some of the more important elements of SB 1159. In simple terms, just remember three numbers, 4/4/14 - I’ll explain, later. Additionally, these rules will continue, unless modified, until January 2023. So, SB 1159 may be around for a while.

If an “outbreak” occurs, for the presumption of the claim to rest with the employer (meaning it will be presumed the person testing positive for COVID-19 contracted it at work and is therefore eligible for workers’ compensation benefits), there are several factors that need to be meet for that to occur.

If the employer has fewer than 100 employees and 4 employees test positive, or if the employer has more than 100 employees and 4% of their total employees test positive, during a 14-day period at an employer’s specific location, the COVID-19 case is presumed to be work-related. Thus, the 4/4/14 rule. When in doubt, call your workers’ compensation carrier and discuss the specific situation. They will help you determine whether or not it is a workers’ compensation claim. 

Rob Darby, President of Berkshire Hathaway Homestate Companies, the second largest writer of workers’ compensation insurance in California and I discuss SB 1159 in a recent StudioOne™ Safety and Risk Management Network podcast episode “SB 1159 Impacts Workers' Comp Market.” A week before Governor Newsom signed the bill, Rob and I discussed the impacts of the bill to get an early insight. Take a listen - I think you will find it useful.

Now comes possible confusion with SB 1159. What is considered an outbreak? What is the definition of a specific location?

Outbreaks

The section of the law (Labor Code 3212.88) applies to any employee other than frontline workers and healthcare workers who test positive during an “outbreak” at the employer’s place of business, if the employer has 5 or more employees.

COVID-19 is presumed work-related if an employee worked at the employer’s place of business at the employer’s direction on or after July 6, 2020 and both the following elements are met:

• The employee tested positive for COVID-19 within 14 days after working at the employer’s location.

• The positive test occurred during an “outbreak” at the employer’s specific location.

An “outbreak” is defined as a COVID-19 occurrence at a specific employment location within a 14-day period AND meets one of the following:

• If an employer has 100 employees or less at a specific location and 4 or more employees test positive for COVID-19;

• If an employer has more than 100 employees at a specific location and 4% of the employees test positive for COVID-19;

• The local public health department, State California Department of Public Health or Occupational Safety and Health Administration (Cal/OSHA) or school superintendent orders the specific place of employment to close due to risk of COVID-19 infection.

A specific location or place of employment is a building, store, facility or agricultural field where an employee performs work at the employer’s direction. An employee’s home is not considered a specific place of employment unless the employee provides home health care services to a client at the employee’s home. An employee may have more than one specific place of employment, if they worked in multiple locations within the 14-day period before their positive test.

There is a 45-day timeframe to determine if a positive COVID-19 case meets the above standard.

Outbreak Reporting Requirements

When an employer knows or reasonably should know that an employee has tested positive for COVID-19, they must report the incident to their workers’ compensation carrier.  They should be prepared with the following information to give the carrier.

• The fact that an employee has tested positive, regardless if work-related or not.

• Employers should not include any personal information regarding the employee who tested positive for COVID-19 unless the employee asserts it is work-related or files a claim form.

• The date the specimen was collected for the employee’s COVID-19 test.

• The specific address or location of the employee’s place(s) of employment during the 14-day period preceding the date the test specimen was collected.

• The highest number of employees who reported to work at the specific location(s) in the 45-day period before the last day the COVID-19 positive employee worked there.

It best practices to follow all local, state and federal guidelines for safe workplaces. However, even with the best intentions and precautions, COVID-19 may accidentally spread to employees. Again, when in doubt, report an employee COVID-19 case to your workers’ compensation carrier and allow them to determine how to proceed.

For questions about SB 1159 and how it with affect your organization’s workers’ compensation, contact your broker or reach out to Rancho Mesa at (619) 937-0164.