With few exceptions, Workers’ Compensation
insurance rates are in decline across the country. Although rates
are certainly an important component of Workers Compensation insurance
costs, there are other considerations companies must address during
a declining rate environment.
As a starting point, it’s important to have a basic understanding
of the Workers’ Compensation insurance price cycle, Experience
Rating, as well as some history of this coverage’s market.
The Workers’ Compensation price cycle repeats over and over
again in an historically predictable pattern:
• Workers’ Compensation rates rise, often with double
digit increases.
• Rising rates precipitate a public outcry from business leaders
that triggers legislative reforms.
• Over the short term, these reforms create attractive market
conditions for insurance companies to increase their competitive
efforts for market share, a situation that produces price wars.
• With rates declining, businesses “shop for the best
deal.”
• Insurance is purchased for a lower price and complacency
sets in as employers lose their focus on injury prevention and cost
containment.
• Claim costs do not fall in relation to the reduced rates,
so employers suffer from an increase in their Experience Modification
Factor.
• Legislative reforms are either eroded or prove to be ineffective
in addressing the real cost drivers, such as medical inflation and
abuses in the system.
• Insurance companies’ profits grind down and the “low-ball
deals” go away.
• Employers are left with fewer choices, higher Experience
Modification Factors, and higher costs.
• Inevitably, a renewed public outcry starts the cycle over
again.
Historically, a decline in Workers’ Compensation rates is
just a calm before the next storm.
Usually businesses will pay back all of their “savings,”
and then some, as the cycle moves to the next phase.
Relying exclusively on legislative reforms and the insurance marketplace
for stable cost reduction is a fool’s errand. While reforms
can help in the short term, companies with a business objective
to drive down Workers’ Compensation costs in the long term
must take a more proactive approach.
1. The first step is to understand that Workers’ Compensation
insurance functions like a credit line. Employers are typically
financing injury costs through their Workers’ Compensation
policies. To understand this concept, it’s necessary to have
a working understanding of how the Experience Rating Plan works,
since it produces an Experience Modification Factor that is applied
to almost all Workers’ Comp policies. The Experience Rating
Plan is an integral component of the final cost of Workers’
Compensation insurance. While the underlying concepts are complex,
we can simplify their application.
In effect, the Experience Rating Plan is a method for tailoring
the cost of insurance to the individual characteristics of an employer.
It gives employers the opportunity to manage their own expenses
through measurable and meaningful cost saving programs. However,
the Plan cuts both ways and high injury costs are translated into
higher insurance costs.
Actual payroll and loss data for the individual employer are analyzed
over a period of time. Usually, the latest available three years
of data are compared to similar types of businesses to calculate
the Experience Modification Factor.
In general, an employer with better than average injury expenses
receives a credit, thus reducing the premium. On the other hand,
employers with worse than average injury costs will carry a debit
rating, and pay more.
What does the Experience Rating Plan have to do with the price cycle?
Due to the inner workings of the Plan, it is more difficult for
employers to lower their Experience Modification Factor during a
declining rate cycle.
The Plan expects that if rates go down, so should injury costs.
So, if injury costs don’t track downward consistent with the
rate decreases, then the Experience Modification Factor goes up.
An increase in the Experience Mod can, and often does, wipe out
any savings from the rate reduction. Employers may actually find
their total Workers’ Comp costs going up even though premium
rates are going down.
2. To avoid cost increases during a period of rate decreases, it
is critical for employers to be vigilant and proactive in reducing
injury expenses. Ultimately, an employer’s injury costs have
a far greater impact on the company’s eventual net cost than
reforms and rate decreases. This fact shifts the responsibility
of cost reduction from governmental bodies, insurance companies,
and the marketplace directly to the employer.
But employers often feel helpless in managing injury costs. Unaware
of processes that can dramatically improve outcomes, many view the
Workers’ Comp system as out of control. It often takes an
act of faith before discovering that the strategies and methods
for controlling Workers’ Comp costs will work.
Employers should approach the objective of reducing injury costs
in much the same manner as they already do for their other business
imperatives. Once knowing what to do, the tougher part is getting
proven processes implemented and embedded into every day business
practices. This task, like so many others, is an ongoing process
and not a one-time event.
Reducing injury costs can be broken down into two primary categories:
what to do before an injury occurs and what to do after an injury
occurs. One of the major mistakes employers make is to hand over
too much responsibility to the insurance company in managing injury
costs. Insurance companies are neither positioned nor capable of
doing this job alone, primarily since their involvement is usually
after-the-fact. Employer involvement is essential, and begins before
an injury occurs.
The key steps employers must take before an injury occurs include:
• Select and train an Injury Coordinator
• Establish a Return-To-Work Program
• Hire a person who is fit for the job
• Establish a relationship and get commitments from your Primary
Care Physician
• Train supervisors on what to do and say when an injury occurs
• Address human resource issues before an injury occurs
Steps to take after an injury occurs include:
• Follow a written, repeatable, step-by-step process
• Return the injured employee to work as soon as medically
possible even if in a modified work capacity
• Maintain positive communication with the employee and the
doctor
• If an employee is not recovering according to expectations,
address additional underlying causes of the disability
It is often said, “The best injury is the one that never happens.”
Employers are keenly aware that maintaining a safe workplace is
the foundation of prevention. However, too many businesses rely
entirely on traditional loss control engineering and fail to take
the secondary steps indicated above. The majority of injuries occur
from unsafe acts, not unsafe conditions. Safe conditions are required,
but inspecting and addressing conditions alone will not bring desired
results.
In summary, the most effective way to drive down Workers’
Compensation costs over the long term is for employers, medical
professionals, and employees to make the right decisions and do
the right things at the right time.
Practical and proven methods are available. Awareness, knowledge,
and possibly a dose of faith are the initial steps. No government
entity, insurance company, or even the free market system will ever
produce more beneficial long-term results.
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