Navigating the Complex World of Workers’ Compensation
After just a few minutes talking with Bonnie Fraser of ActuComp Ohio, it’s clear that she could tell stories for days.
Stories about injured employees illegally working a second job.
Stories about employers committing fraud.
And stories about workers’ compensation audits that result in refunds of $23,000.
It’s also clear that workers’ compensation is a business necessity that can make or break a company.
Injury claims impact premium rates for five years.
“Mishandling claims could put smaller companies out of business if they don’t know the best steps to take,” says Fraser.
Advising companies in all three areas of claims management, discount programs and compliance is what Fraser does best.
“Other TPA representatives or Bureau of Workers’ Compensation employees work in silos, either the claims or premium side, but I calculate the impact of claims costs on future premiums and future eligibility for discount programs,” says Fraser.
Every company with Ohio employees must have Ohio workers compensation.
What about solopreneurs?
Anyone can have an accident, whether from tripping over an electronics cord at the office or while driving to a business meeting.
Work-related injuries are not covered by health insurance.
The minimum yearly premium for an Ohio workers’ comp policy is $120; coverage is 24/7/365 with no deductibles or co-pays.
Sole Proprietors and Partners (including LLCs) who have employees must elect coverage for themselves.
It’s not difficult to add them to the policy but it’s best to get expert input first.
What are the most expensive mistakes a company can make regarding workers’ compensation?
1) Coverage lapses due to late payment of premiums and/or failing to complete True-up.
2) Not having expert advice when filing the coverage application.
Premiums are paid in advance so it’s important to have a clear description of the type of work as well as realistic payroll estimates.
3) Not understanding the impact on premiums when deciding whether to fight an employee’s claim or during the claim settlement process.
4) Not considering the workers’ comp history of an acquisition target company.
The claims and payment experience transfers to the new owner even if it’s an “asset purchase”.
What are the biggest misrepresentations you’ve heard in your industry?
- “Certifying a claim just means you agree that something happened.”
No, it doesn’t.
“It’s always better to settle a claim.”
If the employee still works for you and reinjures the same body part, now you’ve got a new claim.
“If a claim is allowed, your company will get kicked out of group rating.”
“You can’t win at workers’ comp.”
Yes you can, when you work with experts.
“If you don’t KNOW a claim is fraudulent, then certify it.”
“My accountant and business lawyer can help me with my workers’ comp.”
They don’t know what they don’t know.
As a business owner with a background in personnel, I anticipate my clients’ concerns about how claim decisions will impact their employees and premiums.
I provide personalized reminders for each client’s installment, True-up and program compliance deadlines so the company won’t lose its coverage or be eliminated from its discount program.
I attend the audit to make sure the BWC auditor understands my client’s situation.
Also, I am not affiliated with any other companies, like Managed Care Organizations (MCO), so my advice is based solely on what is best for my clients.
Tell us about the monkey.
I was at a NAWBO workshop when another member commented that despite my 30-second commercial she didn’t understand what I do.
“I Get the Workers’ Comp Monkey Off Your Back®” came out of my mouth, and she said, “THAT I understand! Business owners don’t want to be experts in Ohio workers’ comp, so I take care of it for them while they concentrate on running their businesses.