Workers Compensation - Who Really Pays For Your Loss

Workers Compensation premiums typically represent$2,000,000 a year in payroll for the prior three years
a significant portion of a restaurants property andand no claims in years 2003-04 and 2004-05 but one
casualty insurance cost. Premiums can represent as$4,000 claim in 2005-06.
much as 50% or more of the total annual cost. WhatThe experience modification factor for the 2007-08
you ultimately pay in premium is determined by thepolicy if the $4,000 claim is $3,400 medical and $600
losses you incur. Incurred losses are the sum of thelost wages would be approximately .85. Looks great.
losses your insurance company has paid plus theYou have a credit mod but if the claim was medical
amounts they expect they will have to pay to settleonly the modification factor would be .82 or 3%
and close your claims.lower. This $4,000 claim will be used to calculate your
The development of your workers compensationEMR in years 2008 and 2009 as well as the 2007
premium has essentially two elements whichpolicy year.
determine your cost. The first element is determinedThere are several other factors in the formula such
by your classification which is the same for allas expected losses, payroll and the stabilizing value
restaurants. Advisory rates are developed by thethat effect your final modification. Unless there is a
National Council on Compensation Insurance for mostsignificant change in those factors the mod in our
states. Insurance companies either adopt these ratesexample would remain 3% higher for policy years
or file for a deviation from these rates which can be2007, 2008 and 2009.
either a credit or a debit.Let's translate that 3% into premium dollars.
The second element that determines your premium isDepending on how much schedule credit (schedule
your experience modification rating (EMR). Thecredits are discretionary credits underwriters can
application of the experience modification factor addsapply to workers compensation rating) is being
another dimension to your insurance cost by addingapplied to the policy, using advisory rates in Illinois and
what is basically a risk financing component.a $2,000,000 payroll you are talking about a minimum
Your EMR is promulgated through the use of apremium difference of $1,800 at zero schedule credit
complex formula and is developed by comparing yourto a savings of $1,100 per year at a forty percent
actual claims to the expected claims of a restaurantschedule credit. These amounts would increase with
of similar size. It is through the application of thisincreases in the advisory rates in subsequent years.
formula that you ultimately pay for a portion if not allNot only is it important to implement a return to
of your own losses. The EMR is calculated using thework program and stay in touch with injured
three prior year's payroll and incurred losses. Aemployees but it is equally important to work with an
portion if not all of the claim you have in 2006 will beinsurance company who has managed care
paid for in policy years 2007, 2008, and 2009.arrangements with local doctors, clinics and hospitals
For example, a policy effective 11/1/2007 would usein your area. This will allow you to reap the benefits
payroll and incurred losses for the policy years 11/1of pre negotiated pricing for your employees care.
2003-04, 11/1/2004-05 and 11/1/2005-06 to developLet us show you:
the EMR. Many states have adopted the experienceWhy an experience mod of 1.0 is just average.
rating adjustment (ERA) which reduces all medicalWhat your minimum and controllable experience
only claims by 70% before they are used in themodification factors are
calculation of your EMR.How prearranged medical care and a return to work
A medical only claim of $4,000 will only use $1,200 inprogram can reduce your premiums
the calculation of the EMR. Conversely a $4,000 claimA safety program, return to work policy and
that was $3,400 medical and $600 in lost wages willmanaged care arrangements can have a significant
use the entire $4,000 to calculate your EMR.impact on reducing your workers compensation
How does that affect your premiums?premiums, the indirect cost of claims and improving
Let us take a restaurant in Illinois averagingemployee morale.