Resource
Resource CareWorks Consultants has a New Brand Name: CareWorksComp
We are pleased to share with you exciting news about the growth and stability of our Ohio State Fund Third Party Administrator (TPA) business. As many of you may already be aware, York Risk Services Group, Inc., is the parent company of two Ohio TPAs, CareWorks Consultants, Inc. and Frank Gates Service Company. Effective on Monday, March 2, 2015, York Risk Services Group, Inc. consolidated the state fund operations of both of these entities, operating under a new brand name of CareWorksComp. By combining companies, CareWorksComp has enhanced its position as Ohio’s largest workers’ compensation TPA and is better positioned to provide employers with high quality claims management and effective cost controls. The name change will have no direct impact on your business. Every way you did business with CareWorks Consultants, Inc. and your NFIB/Ohio dedicated service team will remain the same (see picture of team below). We will continue to deliver the high quality workers’ compensation services you have come to expect, only now as CareWorksComp. For any questions about this consolidation, please contact your dedicated account executive at (866) 780-NFIB (6342), option 2. Meet our dedicated NFIB/Ohio team at CareWorksComp! Our knowledgeable professionals have a long tenure of working with the NFIB program and are proud to help contribute to the outstanding benefits offered to our members. Please call the team at (866) 780-NFIB (6342) for any questions. Back Row (L-R): Amanda Barr, Laura Elliott, Staci Schwartz, Zack Stewart, Tammy Bowersmith and Nancy Metzger. Middle Row (L-R): Lisa Shaver, Grant Wilson, Candace Uplinger, Dee Amos and Karen Lehnert. Front Row (L-R): Melissa Keys, Shavawn Webb, Jodi Mee and Stacie Betts. Not Pictured: Jan DeCamp, Elizabeth Frank, Wendy Maynard, Jessee Hemping, Ira Parks and Jim Saulters.
Spring 2015
www.NFIB.com/OH
Unemployment Fraud
2
Certificate of Premium Payment
Important Dates
3
4
Unemployment Fraud Additional Steps to Take if Fraud is Suspected In 2014, the Ohio Benefits Payment Control Section identified over $31 million in unemployment benefits paid as a result of fraudulent claims filed with the Ohio Department of Jobs and Family Services (ODJFS). This is a result of a potential scam that ODJFS has been aggressively investigating. The perpetrators steal the identity of a currently employed individual in order to file a fraudulent unemployment claim. What steps can employers take if they suspect benefit fraud? If an employer receives a Request for Separation Information from ODJFS or your Third Party Administrator (TPA) involving a current full-time employee, this could potentially be the first sign of unemployment fraud. Employers should respond promptly to this time sensitive request. In most cases, the fraud can be intercepted at the initial Request for Separation Information, if a timely response is submitted by the employer. If you suspect benefit fraud, or for more information, please contact CareWorksComp's unemployment supervisor, Melissa Keys at (866) 780-NFIB (6342), ext. 51504 or email her at [email protected].
Importance of Providing Accurate Information on the Initial Request for Separation Information Form The Request for Separation Information form is the first notification an employer will receive when an employee files a claim for unemployment benefits with the Ohio Department of Job and Family Services (ODJFS). It is important to provide timely and accurate information on or before the deadline provided by ODJFS. This information is used to determine whether or not an employee is entitled to receive unemployment benefits. It is crucial for employers to provide a return-to-work date if the employee will be recalled for work in less than 45 days. The employer must also properly report all gross earnings paid to the employee in the week in which they physically performed the work. Accurate reporting of return-to-work dates and earnings will reduce improper overpayments of unemployment benefits. The most common overpayments occur when an employee returns-to-work and fails to report this information on his or her weekly unemployment claim. This type of overpayment can be avoided if employers provide a return-to-work date on the Request for Separation Information form. If you need additional information, please contact CareWorksComp's unemployment supervisor, Melissa Keys at (866) 780-NFIB (6342), ext. 51504 or email her at [email protected].
2
How do I Become a Member of the NFIB/Ohio Workers' Compensation Program? It's time to start planning for your 2016 workers' compensation premium savings. NFIB/Ohio strongly encourages you to take the opportunity to receive a no-cost, no-obligation evaluation for the NFIB/Ohio workers' compensation program administered by CareWorksComp (a member of NFIB/Ohio). Thousands of NFIB members choose the NFIB/Ohio workers' compensation program because of: Savings - You can save up to the maximum discount allowable by the Ohio Bureau of Workers' Compensation. Stability - Since 1992, participating members have saved more than $880 million in premiums. Service - CareWorksComp, our group administrator, is the largest workers' compensation third party administrator in Ohio. Our program offers the following valuable services for a very competitive fee: ü Workers' compensation claims management and hearing attendance; ü Workers' compensation rates management and Destination: Excellence savings analysis; ü Comprehensive workplace safety services including safety audits, seminars and webinars; ü Unemployment compensation claims management and hearing attendance; and, ü A legal defense program administered by the prominent law firm of Bricker & Eckler LLP. Enrolling in the NFIB/Ohio workers' compensation program is like hiring an extended team of professionals that can help alleviate the burden of managing workers' compensation and unemployment claims. To learn how the NFIB/Ohio workers' compensation program may save your company money and reduce administrative hassles, please contact CareWorksComp's Jessee Hemping, at (866) 780-NFIB (6342), option 2, then option 51522. Receiving a no-cost, no-obligation analysis of your potential workers' compensation premium savings is easy, just complete the enclosed Temporary Authorization to Review Information Form (AC-3) and: Fax it to (614) 932-1599; Scan and email the form to [email protected]; or, Mail to CareWorksComp, 5500 Glendon Court, Suite 175, Dublin, OH 43016.
Important Dates
March 2015 March 31 - EM Cap requirement deadline. March 31 - DFSP annual report due for preceding July 1 start date. March 31 - BWC's (three day) Ohio Safety Congress & Expo at the Columbus Convention Center. April 2015 April 1 - Destination: Excellence - DFSP, ISSP and TWP application available. May 2015 May 1 - Final 50/50 premium installment due. May 1 - BWC mails estimated premium for policy year beginning July 1, 2015.* May 29 - Drug Free Safety Program (DFSP) application deadline for July 1 start date. May 29 - Industry-specific safety program (ISSP) application deadline for July 1 start date. May 29 - Transitional work program (TWP) bonus application deadline for July 1 start date. June 2015 June 30 - Payroll reports mailed for January 1, 2015 to June 30, 2015.* *Subject to change per Ohio Bureau of Workers’ Compensation.
3
Ohio Bureau of Workers' Compensation Prospective Billing Transition Timeline In May 2015, the Ohio Bureau of Workers' Compensation (BWC) will be mailing each private employer an estimated premium notice along with a certificate of coverage. However, this certificate of coverage will be different from past certificates in that it will not guarantee coverage. The employer must pay their premium in a timely manner to obtain coverage. The notice of estimated premium will show employers the premium amount calculcated based upon the most recent completed year. Then in June 2015, BWC will pay private employers premiums for the January 1, 2015 to June 30, 2015 policy period normally due in August. In addition, BWC will pay the premium due for the first two months (July and August 2015) of the first prospective billing policy period. This transition credit means a private employer will not make a propsective premium installment payment until August 31, 2015. In the first year, every employer will be on a bi-monthly installment payment plan, with the option of selecting other flexible installment plans. This means employers will pay a portion of their annual premium to BWC six times a year. At the end of each policy year, BWC will send employers a notice to true-up. This true-up will require employers to report their actual payroll online at www.bwc.ohio.gov. BWC will adjust an employer's account based upon what they have already paid for that policy period. For more information on prospective billing, please contact CareWorksComp's rates analyst Tammy Bowersmith at (866) 780-NFIB (6342), ext. 51512 or email her at [email protected].
What is a Workers' Compensation Reserve? A reserve is an estimated future cost assigned to a claim at a specific point in time. The Ohio Bureau of Workers' Compensation (BWC) uses MIRA II (Micro Insurance Reserving Analysis) to establish these reserves. MIRA II is recognized as the most accurate, fully developed reserving system available in the United States. MIRA II constantly reevaluates the reserve based on the activity in a claim. The MIRA II system has the ability to consider individual claim facts, such as age, gender and medical codes when forecasting a reserve. MIRA II identifies a number of characteristics as primary cost indicators and then calculates the total incurred cost of the claim. Factors that further comprise claims cost are compensation (indemnity) cost, medical cost and reserves. This is the driving factor for an employer's rates and premiums paid to BWC. Employers can implement cost control strategies to help reduce or eliminate reserves. These strategies include: Salary continuation; Transitional work; Subrogation; and, Claim settlements. For more information on how to implement cost control strategies, please contact CareWorksComp's rates analyst Tammy Bowersmith at (866) 780-NFIB (6342), ext. 51512 or email her at [email protected].
Copyright ©2015 MSC Insurance Agency of Tennessee, LLC (the “Agency”). This NFIB Member Benefit is offered pursuant to a contract that NFIB’s affiliates, including the Agency, have with CareWorksComp (the “Program”). The Agency is qualified to do business in all of the states in which it operates (CA License #0C77420/TN License #47). NFIB membership does not guarantee insurance coverage and NFIB members can be removed from the Program based on claims experience. NFIB, its affiliates, and the licensed producers of such affiliates are promoting the Program as a Member Benefit and are not offering or providing insurance coverage to NFIB members and are not responsible for any claims/losses. This newsletter is published by CareWorksComp While the information in this publication has been compiled from sources and documents believed to be reliable, its accuracy is not guaranteed, nor is any responsibility assumed or implied for any damage or loss resulting from inaccuracies or omissions. The publisher is not engaged in rendering legal advice. You should discuss any legal questions with your attorney.
4
We are pleased to share with you exciting news about the growth and stability of our Ohio State Fund Third Party Administrator (TPA) business. As many of you may already be aware, York Risk Services Group, Inc., is the parent company of two Ohio TPAs, CareWorks Consultants, Inc. and Frank Gates Service Company. Effective on Monday, March 2, 2015, York Risk Services Group, Inc. consolidated the state fund operations of both of these entities, operating under a new brand name of CareWorksComp. By combining companies, CareWorksComp has enhanced its position as Ohio’s largest workers’ compensation TPA and is better positioned to provide employers with high quality claims management and effective cost controls. The name change will have no direct impact on your business. Every way you did business with CareWorks Consultants, Inc. and your NFIB/Ohio dedicated service team will remain the same (see picture of team below). We will continue to deliver the high quality workers’ compensation services you have come to expect, only now as CareWorksComp. For any questions about this consolidation, please contact your dedicated account executive at (866) 780-NFIB (6342), option 2. Meet our dedicated NFIB/Ohio team at CareWorksComp! Our knowledgeable professionals have a long tenure of working with the NFIB program and are proud to help contribute to the outstanding benefits offered to our members. Please call the team at (866) 780-NFIB (6342) for any questions. Back Row (L-R): Amanda Barr, Laura Elliott, Staci Schwartz, Zack Stewart, Tammy Bowersmith and Nancy Metzger. Middle Row (L-R): Lisa Shaver, Grant Wilson, Candace Uplinger, Dee Amos and Karen Lehnert. Front Row (L-R): Melissa Keys, Shavawn Webb, Jodi Mee and Stacie Betts. Not Pictured: Jan DeCamp, Elizabeth Frank, Wendy Maynard, Jessee Hemping, Ira Parks and Jim Saulters.
Spring 2015
www.NFIB.com/OH
Unemployment Fraud
2
Certificate of Premium Payment
Important Dates
3
4
Unemployment Fraud Additional Steps to Take if Fraud is Suspected In 2014, the Ohio Benefits Payment Control Section identified over $31 million in unemployment benefits paid as a result of fraudulent claims filed with the Ohio Department of Jobs and Family Services (ODJFS). This is a result of a potential scam that ODJFS has been aggressively investigating. The perpetrators steal the identity of a currently employed individual in order to file a fraudulent unemployment claim. What steps can employers take if they suspect benefit fraud? If an employer receives a Request for Separation Information from ODJFS or your Third Party Administrator (TPA) involving a current full-time employee, this could potentially be the first sign of unemployment fraud. Employers should respond promptly to this time sensitive request. In most cases, the fraud can be intercepted at the initial Request for Separation Information, if a timely response is submitted by the employer. If you suspect benefit fraud, or for more information, please contact CareWorksComp's unemployment supervisor, Melissa Keys at (866) 780-NFIB (6342), ext. 51504 or email her at [email protected].
Importance of Providing Accurate Information on the Initial Request for Separation Information Form The Request for Separation Information form is the first notification an employer will receive when an employee files a claim for unemployment benefits with the Ohio Department of Job and Family Services (ODJFS). It is important to provide timely and accurate information on or before the deadline provided by ODJFS. This information is used to determine whether or not an employee is entitled to receive unemployment benefits. It is crucial for employers to provide a return-to-work date if the employee will be recalled for work in less than 45 days. The employer must also properly report all gross earnings paid to the employee in the week in which they physically performed the work. Accurate reporting of return-to-work dates and earnings will reduce improper overpayments of unemployment benefits. The most common overpayments occur when an employee returns-to-work and fails to report this information on his or her weekly unemployment claim. This type of overpayment can be avoided if employers provide a return-to-work date on the Request for Separation Information form. If you need additional information, please contact CareWorksComp's unemployment supervisor, Melissa Keys at (866) 780-NFIB (6342), ext. 51504 or email her at [email protected].
2
How do I Become a Member of the NFIB/Ohio Workers' Compensation Program? It's time to start planning for your 2016 workers' compensation premium savings. NFIB/Ohio strongly encourages you to take the opportunity to receive a no-cost, no-obligation evaluation for the NFIB/Ohio workers' compensation program administered by CareWorksComp (a member of NFIB/Ohio). Thousands of NFIB members choose the NFIB/Ohio workers' compensation program because of: Savings - You can save up to the maximum discount allowable by the Ohio Bureau of Workers' Compensation. Stability - Since 1992, participating members have saved more than $880 million in premiums. Service - CareWorksComp, our group administrator, is the largest workers' compensation third party administrator in Ohio. Our program offers the following valuable services for a very competitive fee: ü Workers' compensation claims management and hearing attendance; ü Workers' compensation rates management and Destination: Excellence savings analysis; ü Comprehensive workplace safety services including safety audits, seminars and webinars; ü Unemployment compensation claims management and hearing attendance; and, ü A legal defense program administered by the prominent law firm of Bricker & Eckler LLP. Enrolling in the NFIB/Ohio workers' compensation program is like hiring an extended team of professionals that can help alleviate the burden of managing workers' compensation and unemployment claims. To learn how the NFIB/Ohio workers' compensation program may save your company money and reduce administrative hassles, please contact CareWorksComp's Jessee Hemping, at (866) 780-NFIB (6342), option 2, then option 51522. Receiving a no-cost, no-obligation analysis of your potential workers' compensation premium savings is easy, just complete the enclosed Temporary Authorization to Review Information Form (AC-3) and: Fax it to (614) 932-1599; Scan and email the form to [email protected]; or, Mail to CareWorksComp, 5500 Glendon Court, Suite 175, Dublin, OH 43016.
Important Dates
March 2015 March 31 - EM Cap requirement deadline. March 31 - DFSP annual report due for preceding July 1 start date. March 31 - BWC's (three day) Ohio Safety Congress & Expo at the Columbus Convention Center. April 2015 April 1 - Destination: Excellence - DFSP, ISSP and TWP application available. May 2015 May 1 - Final 50/50 premium installment due. May 1 - BWC mails estimated premium for policy year beginning July 1, 2015.* May 29 - Drug Free Safety Program (DFSP) application deadline for July 1 start date. May 29 - Industry-specific safety program (ISSP) application deadline for July 1 start date. May 29 - Transitional work program (TWP) bonus application deadline for July 1 start date. June 2015 June 30 - Payroll reports mailed for January 1, 2015 to June 30, 2015.* *Subject to change per Ohio Bureau of Workers’ Compensation.
3
Ohio Bureau of Workers' Compensation Prospective Billing Transition Timeline In May 2015, the Ohio Bureau of Workers' Compensation (BWC) will be mailing each private employer an estimated premium notice along with a certificate of coverage. However, this certificate of coverage will be different from past certificates in that it will not guarantee coverage. The employer must pay their premium in a timely manner to obtain coverage. The notice of estimated premium will show employers the premium amount calculcated based upon the most recent completed year. Then in June 2015, BWC will pay private employers premiums for the January 1, 2015 to June 30, 2015 policy period normally due in August. In addition, BWC will pay the premium due for the first two months (July and August 2015) of the first prospective billing policy period. This transition credit means a private employer will not make a propsective premium installment payment until August 31, 2015. In the first year, every employer will be on a bi-monthly installment payment plan, with the option of selecting other flexible installment plans. This means employers will pay a portion of their annual premium to BWC six times a year. At the end of each policy year, BWC will send employers a notice to true-up. This true-up will require employers to report their actual payroll online at www.bwc.ohio.gov. BWC will adjust an employer's account based upon what they have already paid for that policy period. For more information on prospective billing, please contact CareWorksComp's rates analyst Tammy Bowersmith at (866) 780-NFIB (6342), ext. 51512 or email her at [email protected].
What is a Workers' Compensation Reserve? A reserve is an estimated future cost assigned to a claim at a specific point in time. The Ohio Bureau of Workers' Compensation (BWC) uses MIRA II (Micro Insurance Reserving Analysis) to establish these reserves. MIRA II is recognized as the most accurate, fully developed reserving system available in the United States. MIRA II constantly reevaluates the reserve based on the activity in a claim. The MIRA II system has the ability to consider individual claim facts, such as age, gender and medical codes when forecasting a reserve. MIRA II identifies a number of characteristics as primary cost indicators and then calculates the total incurred cost of the claim. Factors that further comprise claims cost are compensation (indemnity) cost, medical cost and reserves. This is the driving factor for an employer's rates and premiums paid to BWC. Employers can implement cost control strategies to help reduce or eliminate reserves. These strategies include: Salary continuation; Transitional work; Subrogation; and, Claim settlements. For more information on how to implement cost control strategies, please contact CareWorksComp's rates analyst Tammy Bowersmith at (866) 780-NFIB (6342), ext. 51512 or email her at [email protected].
Copyright ©2015 MSC Insurance Agency of Tennessee, LLC (the “Agency”). This NFIB Member Benefit is offered pursuant to a contract that NFIB’s affiliates, including the Agency, have with CareWorksComp (the “Program”). The Agency is qualified to do business in all of the states in which it operates (CA License #0C77420/TN License #47). NFIB membership does not guarantee insurance coverage and NFIB members can be removed from the Program based on claims experience. NFIB, its affiliates, and the licensed producers of such affiliates are promoting the Program as a Member Benefit and are not offering or providing insurance coverage to NFIB members and are not responsible for any claims/losses. This newsletter is published by CareWorksComp While the information in this publication has been compiled from sources and documents believed to be reliable, its accuracy is not guaranteed, nor is any responsibility assumed or implied for any damage or loss resulting from inaccuracies or omissions. The publisher is not engaged in rendering legal advice. You should discuss any legal questions with your attorney.
4
