Assembly Bill No. 2883 was approved and filed August 26, 2016 and it’s causing quite a disruption with existing businesses. The bill focuses on revising the exceptions as what a defined “employee” is considered. The existing law states that officers and directors of a private corporation, and working members of a partnership or LLC were not required to be covered under the company workers compensation policy unless they opted to be covered.
However, the Assembly Bill No. 2883 revises the exceptions so that a director or officer is required to be covered under the company policy. There is still a, albeit narrow, definition of exclusion, but if they do fall under this exclusion they can only opt out if they sign a waiver under penalty of perjury and file it with the company insurer. The officer and director must own at least 15% of the issued/outstanding stock or a general partner, partnership or managing member of an LLC to be considered exempt.
The specific changes were put in place to discourage companies from abusing the previous exemption. Many companies were listing all employees as directors or officers to avoid having to purchase workers compensation insurance. By requiring the waiver to be signed under penalty of perjury, they hope to ensure employees are properly covered and protected in the event of a work-related injury.
The new bill affects all polices that will be in effect on or after Jan 1, 2017 including policies in force any time after this date.
For more information on this new bill or to review your current workers compensation policy, contact us today at 831.661.5697.
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“As the year comes to a close, it is a time for reflection – a time to release old thoughts and beliefs and forgive old hurts. Whatever has happened in the past year, the New Year brings fresh beginnings. Exciting new experiences and relationships await. Let us be thankful for the blessings of the past and the promise of the future.” – Peggy Toney Horton
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It’s frustrating when you suspect that a Workers Compensation claimant is milking the system. However, you can reduce potential malingering significantly if you attend to it from the get-go.
Start by designating a manger as the “firm’s rep,” to ensure that any employee who makes a Comp claim gets a doctor promptly and to inform your insurance company immediately. The rep should transport the employee to the physician, stay at the office during the examination and treatment, and then take him or her home or back to work.
While at the doctor’s office, the firm’s rep should ask the physician about the medical condition, recommended treatment, and a reasonable return-to-work date. If the claimant or physician objects, the rep should assure them that he or she will work with the insurance company to make sure all reasonable and necessary benefits and medical bills are paid.
Resist any employee excuses for not seeing a doctor. If the employee has an attorney, suggest getting a second opinion (which you will provide at no cost). If the claimant already has a doctor, have the firm rep offer to take him or her for a consultation– and ask about diagnosis, treatment, and return-to-work status.
The rep should then: 1) follow up with the employee at least every two weeks – and more often if possible – face to face or by phone; and 2) stay in touch with the claims adjuster to share information about visits with the doctor and claimant that might help him or her return to work as early as possible.
Although these techniques won’t always work, anecdotal evidence suggests that they can reduce malingering claims by up to 70%.
What’s not to like?
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Injured workers who gain weight due to inactivity or as a side effect of medication will probably receive higher workers comp benefits, thanks to the American Medical Association’s recent reclassification of obesity as a disease. That’s the conclusion of a recent six-year study of claims by the California Workers’ Compensation Institute.
According to the report, although this reclassification doesn’t have legal standing, the AMA’s positions often have a strong influence on lawmakers, regulators, and health care providers. Immediately after the decision, senators and congressmen introduced bipartisan bills requiring Medicare to cover more obesity treatment costs, including prescription drugs and intensive behavioral weight-loss counseling, which will give health care providers a financial incentive to use these remedies.
Judging from the results of the California study, this means that businesses can expect to pay more for workers comp. The report found that the costs of comp claims that listed obesity as a “comorbidity,” or additional cause, were far greater than for claims without them. Medical benefits for comorbidity cases cost 81% more than for other cases, while indemnity payments averaged nearly 65% higher. More two in three claimants with obesity comorbidity received permanent disability, nearly five times the rate for the non-obese. Finally, the use of narcotic painkillers was significantly higher among overweight claimants.
Obesity might even become a primary comp diagnosis for jobs such as long-haul trucking or office work that require employees to remain seated for extended periods.
The bottom line: look for the management and financial changes stemming from the reclassification of obesity as a medical condition to create new challenges and incentives for health care professionals, businesses, and workers compensation insurance companies.
We’ll stay on top of these changes to help make sure that your company has the coverage you need at a competitive rate.
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Most states allow company owners and executives to opt out of (or not opt in to) Workers Compensation insurance. But did you know that if you choose this option your Health insurance policy might well not pick up work-related medical claims?
If you carry Health coverage through your company Group plan, you can usually arrange to be covered for work-related injuries under this policy – which then becomes “24-hour” coverage for you. However, many small business owners and managers are insured under the Health Plan of their spouse or parents – which almost always exclude work-related injuries.
Let’s say that you exempt yourself from Workers Compensation and have coverage under your spouse’s Health insurance – and you suffer a serious injury in a work-related, at-fault auto accident. Once you have exhausted the Medical Payments coverage under the company’s Commercial Auto policy, the chances are that you’ll have to pick up the tab for the rest of your medical bills. You might even have to choose between limiting your treatment options or going bankrupt (unpaid medical bills are the nation’s leading cause of bankruptcy).
Even if you have “24-hour” insurance under your own Health policy, this coverage will not reimburse you for income lost during your convalescence.
So, what’s the solution? You might consider buying a Disability income policy – or decide to cover yourself under Workers Compensation, after all.
As always, our agency stands ready to offer our professional advice. Just give us a call.
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We are the land of the free,
we are the home of the brave.
Let’s pay tribute to our brave American Heroes on this special day and forever.
Happy Independence Day!
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