News and Updates
Category: Workers Comp
Is Our Company Allowed to Pay Cash for Workers' Comp Treatment in Ohio?
We know it happens. An employer pays cash at an urgent care for that “one and done” work-related injury visit, or maybe a handful of chiropractor visits. The employer didn’t want the claims costs hitting their experience and premiums, or to risk their EMR going even higher. Unless they’re in one of a few specific programs, employers paying cash for treatment of a work-related injury is prohibited. It can go left quickly and create some ugly scenarios for employers. We want to help you understand what can happen, and some above-board ways to reduce the impact of medical costs on future premiums. Paying cash for an injured worker’s medical treatment is a slippery slope. Ohio BWC-approved providers should not be willing to accept an employer’s cash payment for treatment unless they are self-insured for workers’ comp in Ohio, part of the 15K program, or an Ohio-BWC approved deductible plan. If an employee hurts their back at work and claims they just want to see a chiropractor - it may seem both easy and tempting to pay cash for a few visits. No need to file a claim and make a big deal of it, right? Wrong. Especially with soft tissue injuries, treatment could go on for months (even years), and may eventually require an orthopedic surgeon. When BWC finds out that the initial injury wasn’t reported as a claim and the employer chose to pay cash for treatment, that employer now has a non-covered claim. That means the employer will b
How SuretyHR Fits Into the Spooner Family
You may have noticed some of the SuretyHR content looks a lot like the content published on Spooner Inc’s website and LinkedIn. Maybe you also picked up on our employees having multiple logos on their emails, or you might have both Surety and Spooner business cards for the same employee. We get plenty of questions about this, so we want to help you make sense of it all. Surety HR is part of the Spooner Risk Control family of companies. Spooner Inc (our TPA) and Spooner Medical Administrators (our MCO) both have long and storied histories of helping employers navigate the claimant-favoring, monopolistic Ohio workers’ compensation system. We’ve saved thousands of companies hundreds of thousands of dollars, with some even into the millions with our claims and program management. As Ohio BWC continued making changes to programs, eligibility and inflating administrative costs, we found that offering solutions for only our state-fund and self-insured clients wasn’t enough. Enter SuretyHR, our professional employer organization (PEO). We began building the departments that would make up Surety HR in 2015, with the addition of payroll services. By 2017, we had added in-house legal counsel, HR experts and additional support to our existing teams handling workers’ comp, safety, unemployment, and absence management. In September 2019, we were granted self-insured status by Ohio BWC, which greatly increased the amount of savings we could
Are Missing Group Retro Refunds Complicating Your Budget for 2022?
Back in August, we told you that Ohio BWC wouldn’t be paying Group Retrospective refunds to employers who participated in Retro during the 2018 and 2019 policy years. For the past 12 years, many businesses have counted on those checks to budget for the coming year. Normally, Retro refunds would have showed up last month (October), but this time those employers were left empty-handed. Companies that were anticipating tens of thousands (hundreds of thousands, in some cases) in Retro Refunds are now faced with an end of year shortfall and difficulty budgeting. Our actuarial department estimates that Group Retro refund totals for all participating policyholders during the 2018 and 2019 policy years would have been as follows: • $190,000,000 for the 2018 policy year • $155,000,000 for the 2019 policy year That’s $345 Million in refunds not being paid back! If you are concerned with how the state is managing your premium dollars - and more importantly, your refunds - you have options. Self-insuring is one option, or you can look into a partnership with SuretyHR through our Self-Insured PEO program. This provides a lot of the same savings and benefits of self-insuring for workers’ comp, but without the risk and financial burden of directly paying excess
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
