News and Updates
Category: ACES
Disappointed with Your 2020 Group Retro Refund?
You’re not alone. Now that BWC is releasing the first Group Retro checks (and a few assessments) for the 2020 policy year, many Ohio employers are underwhelmed by the results. In the earlier days of Group Retro, it wasn’t unheard of to see refunds over 50%. Spooner certainly had its heyday in the program, with some of our industry groups reaching close to the maximum return of 63%. In the last ten years, we’ve seen several factors begin to chip away at these big returns: increased loss development factors, fewer premium dollars in pools due to Premium Size Factor Reductions, and more recently – the move to a new reserve calculating system called ACES. The first two changes caused average returns to dip into the 40% ranges, but huge reserves from ACES delivered a sucker punch that left only five of the best performing groups with returns over 40%. Five of the hardest-hit pools will receive an assessment, which means paying back anywhere between 15-25% of their 2020 premiums to BWC. All other groups in the middle of the best and worst averaged returns of less than 24%. For some, that’s less than half of their historical performance average. We’ve been tracking the impact of ACES on Group Retro for a while now, and several TPAs (including Spooner) have voiced their concerns to BWC regarding the dwindling returns. While the complaints were taken under advisement, BWC chose to make such minor changes to the reserve calculations t
The Good, the Bad & the Ugly: 2020 Group Retro Performance
Since the 2020 policy year wrapped, we’ve mentioned the lackluster performance of several Group Retro pools. These poor returns, as well as a few assessments, are occurring largely in part to BWC’s move to the ACES reserves system, and aren’t necessarily tied to the performance of any one TPA. Luckily, Spooner’s pools remain steady (this is the good), but they may not be the returns we’ve seen in years past. On July 28, we received what will be the final numbers used to calculate the first round of Group Retro returns for those enrolled during the2020-2021 policy year. Out of 53 groups across all industries, only five performed above the 40% mark. This is increasingly important to remember as you shop 2023-24 programs this summer, and you’re seeing 50-60% returns being promised. The remainder lingered between 10-38% (the bad), with a few more in the red – meaning employers in those pools will be assessed, i.e. billed for their share of the difference (the ugly). Many decision makers don’t make note of the “maximum assessment” when they complete their Group Retro paperwork. This is a percentage disclosed that equates to how much of that year’s premium you’ll be responsible to pay back to Ohio BWC if the performance of your Group Retro pool is worse than expected. Here’s a real-life example of one of the groups being assessed. This particular pool was assigned a 20% maximum assessment,
BWC to Host Open Forum on ACES
On October 14, BWC will host an open forum with TPAs to discuss the impact of their new reserve system called ACES. Spooner’s goal is to convince BWC that this system is overestimating reserves for lost time claims (as well as some medical only claims) that will have a dramatic effect on Group Retro refunds for the 2020 policy year and future years. This could also have a negative impact on employers’ EMRs for the 2023 policy year. BWC implemented this new system of calculating reserves in January 2021. As early as June, we began noticing reserves jumping to nearly 4-5 times what they would have been under the previous system and industry standard, MIRA II. We shared another update in August, after reviewing the first round of results for 2020 Group Retro and finding that 68% of pools could face a first year assessment, as opposed to getting a refund from the program. These open forums held by BWC are a platform for TPAs to voice concerns over certain policy and procedure changes that may negatively impact Ohio businesses. Spooner is an Ohio business, and our family of companies make it a priority to fight for policy changes that will have a positive impact on the business community that we’re so proud to be a part
Group Retro Updates: 2018, 2019 & 2020
We promised to keep you informed on the status of 2018 and 2019 policy year refunds from BWC’s Group Retro program. As it stands, no employers enrolled during those years will be receiving any refunds. Typically, in the fall of 2021 Group Retro participants should be receiving your first refund from the 2019 policy year and your second refund from the 2018 year. It’s important to understand that if these refunds are normally included in your budgeting process for the coming year, you should not factor that in. For more info on why BWC chose not to release these funds, and what Spooner is doing to help Ohio employers, check out our June blog entry on these missing Group Retro Refunds. If your company was enrolled in Group Retro for the 2020 year, your first refund will be paid out in the fall of 2022. Since the 2020 policy year recently ended, we also have an updated outlook on those returns. Out of the 45 total Private Employer Group Retro pools in Ohio, data from BWC shows that 31 of them will have an assessment for their first year (due in fall 2022). This means that companies in that pool will be billed by BWC for a portion of 2020 premiums instead of receiving a refund. This is largely due to BWC moving to a system called ACES to determine reserves on claims as of July 1, 2020. We believe BWC is open to discussing changes to some of the variables used to calculate refunds in response to the impact ACES is having on 2020 Group Retro
Where is BWC's Group Retro Program Headed?
In our last few blogs and newsletters, we’ve been updating you on the changes we’re noticing in Ohio BWC’s Group Retro program. Initially, there was the withholding of 2018 and 2019 refunds (six total payouts for participating employers). Then, we began noticing the overall degradation of retro refunds. Most recently, we’ve noticed how BWC’s changes to their claim reserve calculations are having a tremendous impact on the performance of Group Retro pools. For those of you who didn’t read our post about reserve calculations, here’s an abridged version: workers’ comp claims have a dollar amount reserved at the onset of a claim (yes, even if you do salary continuation) for additional funds that the insurer thinks it may end up costing. BWC’s method of calculating reserves changed in January 2021 and Spooner’s tracking of these trends show reserves increasing as much as 1900% on some claims. Why does it matter? That pretend money is treated like real money when your experience is calculated for the next year, determining your premiums. That $5000 ankle sprain is now a $29,000 ankle sprain, and the insurer (BWC) will recoup their losses from you accordingly. We’ve been tracking the impact these reserves have on Group Retro, and it shows a vast majority of the pools underperforming. Some competitors even show the possibility of an assessment, meaning that policyholder
Changes in Reserve Calculations
Effective July 1, 2020, Ohio BWC implemented a new reserve system called ACES. Based on a large sampling of claims, we’ve found that this system can drastically increase reserves for future claims costs - which will then impact premiums and Group Retro performance. A reserve is a dollar amount placed on every claim, in which the insurer (BWC) “reserves” assumed future costs within the claim. The concept of a reserve is considered standard practice in workers’ compensation insurance, even for self-insured employers. Once a reserve is set, it will not leave the claim until the claimant has ceased medical treatment for at least six (6) months. The only other way to eliminate a reserve is through the process of a settlement. If a claim has a reserve when Ohio BWC’s September “snapshot” is taken - those reserves will be treated as dollars already spent on the claim, impacting premiums for the coming policy year. Lost time claims will see the largest impact, as medical reserves for 2019 were roughly four (4) times paid compensation and are now 19 times paid compensation. This does not necessarily mean your company should consider salary continuation to soften the blow, as all claims have reserves. That should be discussed with your TPA on a case-by-case basis and not used as a remedy to avoid a lost-time claim with BWC. We are expecting these changes to have an impact on Group Retro refunds for the 2020 policy year a
