In California, nearly all employers – even those who have only one employee – must provide workers’ comp insurance. However, there could be exceptions for farm workers or family members. While such insurance is often viewed as being a vehicle that protects and serves the employee, having this insurance also prevents the employer from being sued if a worker is injured during the course of their job duties. This helps to protect the long term health of the business. Employers in California are responsible for paying the full cost of the premium for workers’ comp insurance.
Although the factors that determine the premium that must be paid are variable, there are three primary ones: the business classification code, the business’ safety record and its experience modification.
- The business classification code is a code or a combination of codes that describes your business operations. Restaurants, for example, have different risks than construction companies and hair salons, though they do share some of the same issues as well. The higher the risk for injury to employees while on the job, generally the higher the premium the employer faces.
- A business’s safety record that reflects compliance with industry standard safety practices involving equipment and procedures will reflect favorably on its premium. Conversely, a poor safety record or a company that is out of compliance with OSHA regulations will likely face higher premiums until the issues are addressed for several billing cycles.
- The experience modification involves the number of claims against the workers’ comp insurance. The fewer the claims against this
insurance, the lower the premiums will drop over time while more claims will increase the cost of workers’ comp.
Other factors that are often used to determine the cost of an employer’s workers’ comp insurance. These include special dividend or group programs the business might be eligible for as well as underwriting adjustments that are out of the ordinary such as using a health care organization that is certified.
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Workers’ comp insurance is designed to cover employees should they become injured or sickened while on the job. It protects employees from being responsible for covering medical expenses for accidents and injuries that occur while they are working. Workers’ comp also protects employers by ensuring that they cannot be sued for payment of medical expenses by their employees.
Workers’ Comp Insurance Basics
In California, the law is pretty clear about the responsibilities of the employer when it comes to providing workers’ comp insurance. Even those companies who have only one part-time employee are required to have such insurance.
The penalties for not providing workers’ comp insurance are fines up to $10,000, sentencing to the county jail for not more than one year or both. California can also levy additional penalties of up to $100,000 against uninsured employees. Employers are required to bear the full cost of this insurance.
Is Workers’ Comp Required if There are no Employees?
California does not require you to have workers’ comp insurance if you are self-employed. However, while it is not required, it does not mean that such insurance is not a wise investment – not only for your own health but also for the health of your company. Think about the consequences of an injury that causes you to be unable to work.
If you are the sole employee of your business and you become injured while performing your job duties, it could spell disaster for the long term viability of your business. Common injuries such as those incurred as the result of a car accident or during a slip-and-fall could result in you being unable to fulfill your job duties. Without workers’ comp insurance, you might find it difficult to keep your business afloat while you are recuperating. You could also find yourself struggling to pay your personal bills as well.
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Being a business without workers’ compensation insurance in California is a serious matter. If an employee is injured during the course of business duties and the business is not insured, it does not mean that the business is absolved of its responsibilities. The Uninsured Employers Benefits Trust Fund was established to ensure that employees are still compensated for their medical expenses even if the business did not comply with the law. Using the power vested in this entity, it can pursue many avenues to ensure that the injured employee is compensated, including placing a lien on the business, imposing a stop order so that the business can no longer legally and delivering fines, penalties and jail time.
If you should decide that you do not want to carry workers’ compensation insurance on your employees and one of them becomes injured or sick while on the job, you will be responsible for paying 100% of the cost of their bills. Without obtaining adequate workers’ compensation insurance, an injured or sickened employee can sue your company to obtain the funds necessary to cover their medical bills. In addition, there is the potential that your business will be fined, penalized and even more for not meeting its obligations to its employees.
The California state labor board, the Division of Labor Standards Enforcement, is responsible for ensuring that businesses comply with a range of labor standards, including having an adequate amount of workers’ compensation insurance. If the Division determine that the business was lacking in this regard, in addition to fines and penalties, it is possible that you will serve a jail sentence in the county jail. A stop order is also likely to be issued that prohibits the business from using the labor of those employees who are not covered. It is a misdemeanor to not comply with such an order.
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If you believe you don’t need Workers Compensation insurance, here’s a reality check:
Myth. I only have a few employees, or mostly part-time employees.
Reality: Workers Comp makes sense no matter how many employees you have. It helps cover medical expenses and lost wages for employees with job-related injuries and protects against lawsuits from injured workers if you’re found negligent. What’s more, some customers and clients may require you to carry it.
Myth: My employees won’t sue me.
Reality: Never say never. Injured workers might well sue to pay medical bills that could run into millions – not to mention pain and suffering or punitive damages. Workers Comp provides legal defenses that can slash your liability.
Myth: Workers Comp is too expensive. If one of my employees is injured, I’ll just pay out-of-pocket.
Reality: Weigh the cost of coverage against potential losses from an injury, especially if the employee sues. The longer a worker is off the job, the more it costs to cover lost wages and productivity. Severe injuries can take weeks or months to heal– or even lead to permanent impairment.
Myth: I provide a safe workplace. My employees won’t get injured.
Reality: Mistakes happen even in the “safest” workplace. Many companies post signs proclaiming the number of days without an injury on the job, but rarely do they read “365 days” Even the most minor mishaps can cause major damages.
Myth: Medical costs in the Workers Comp system are too high.
According to the National Council of Compensation Insurance, the medical cost inflation rate for Comp has been similar to that for Group Health insurance during the past several years. Legislation and regulations have led to the expansion of cost-containment programs.
To make sure you have this essential protection, at an affordable cost, just give us a call.
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When your insurance company issued your Workers Compensation policy, you paid an estimated premium for the term of the policy. This rate was based on the nature of your business and your estimated payroll. However, once your policy expires, the insurance company conducts a premium audit to gather data about your actual costs for the applicable policy term. If there is any shortfall, you are responsible for the difference between the original estimate and actual premium.
Naturally, you want to keep the difference between the estimated and actual rate as low as possible. Consider the following list of tips:
- Have all necessary records available for the auditor.
- Break down your payroll by classification code so that the auditor doesn’t have to classify any unexplained payroll. Leaving the decision up to the auditor could result in having the payroll placed in the highest classification.
- Separate overtime wages from regular wages. This allows the auditor to discount the overtime wages back to regular wages.
- Exclude tips, severance pay, meal and travel advances and bonuses paid for inventions, because none of these are included in Workers Compensation premium calculations.
- Divide uninsured subcontractor billings into material and labor costs since you are only required to pay premiums for labor. If you don’t have an actual split, figure on 50% for each. One important exception to this is for heavy equipment operators who are employed as subcontractors. In this case, use a third of their total billings as reportable labor costs.
- Don’t include short- or long-term disability payments in the data given to the auditor because these are excluded from premium calculations.
- Be sure to cap all covered officers’ payroll at the maximum for your state.
- Exclude wages paid to employees who are on active military duty because their wages aren’t included in premium calculations.
- Present the auditor with all Certificates of Insurance for covered subcontractors so you aren’t charged for them.
- Classify all employees in the lower-rated payroll classifications if you aren’t sure about where they should be classified. However, you should never deliberately misclassify an employee.
- Be sure you make the auditor aware of all employees who do only clerical work and are physically located away from the shop floor. These employees qualify to be classified in the lower rated clerical codes. If your clerical staff isn’t physically separate from the shop, you should consider changing their work location.
Contact our office for more information.
Content provided by Transformer Marketing.
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When it comes to Workers Compensation claims, companies are looking constantly for ways to reduce claims and reduce costs.
Ascribing the cost of Workers Compensation claims to applicable internal departments can encourage supervisors and managers to pay more attention to training and safety programs and more carefully monitor injured employees returning to work. Some companies have even deducted the claim cost from the budget of the ascribed department instead of a general company fund as an additional incentive to curb Workers Compensation costs. Through implementing a few procedures that place Workers Compensation expenses directly on internal departments, employers have more control over prevention and injury management measures that can decrease the severity and frequency of workplace injury. The reduced claims and Workers Compensation premiums add up to a substantial amount of savings.
Safety goals can be met by communicating directly with all potential Workers Compensation employees. Use a claim and injury history to identify high-risk employee groups. Then, on a departmental level, discuss the injury management process with employees. Communication will improve as employees are given a chance to discuss how they feel the job could be performed with less risk of injury. It also gives the employer an opportunity to modify safety procedures or dangers in the work environment, such as faulty equipment or inadequate work protocols that are identified by employees.
A common problem related to workplace injuries is a lack of prompt reporting. Too often supervisors don’t appropriately acknowledge workplace accidents. The hope is that the incident will not result in time off of work or medical expenses. However, putting an initial injury off and not reporting it immediately often actually results in increased costs. Managers and supervisors need to know that they aren’t saving money when they don’t report injuries immediately. One study of more than 50,000 temporary total disability and permanent partial disability claims showed:
- Injuries reported one to two weeks following the incident were 18% more expensive than those reported within a week of the incident.
- Injuries reported three to four weeks after the incident were 30% more expensive than those reported within a week of the incident.
- Injuries reported after four weeks of the incident were 45% more expensive than those reported within a week of the incident.
Showing supervisors and managers statistics such as these will help to ensure timely injury reporting, especially if Workers Compensation costs will be coming out of the departmental budget. Although the goal is prevention of workplace injury, once an employee has been injured, the objective should turn to a timely and safe return to work. This can best be achieved if both employer and employee share a desire to obtain the most effective care, which will help to expedite recovery and a safe return to the job.
Since each department is faced with the claim cost coming out of their own budget, managers and supervisors can take a more active role in assisting injured employees returning to work. For example, instead of the usual claim adjuster or attorney contacting the injured employee, the company concern can be conveyed through the department head(s).
One last element is fraudulent claims. Although deliberate fraudulent claims are a rarity, they do exist. These fraudulent claims will be much more difficult to file when Workers Compensation costs are analyzed departmentally.
Accidents are going to happen. There simply isn’t a way to prevent all accidents and eliminate all claims. But, it is realistic to reduce the frequency and severity of workplace injuries by making the department responsible directly, whether by penalty or by reward, for a safe work environment.
Content provided by Transformer Marketing.
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