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Arizona Workers’ Compensation At A Glance

Arizona Workers’ Compensation At A Glance. Worker’s Compensation Premium Rankings. Arizona’s Ranking. 2012 Ranking: 36 (15 th lowest in country) Premium Rate Index per $100 of Payroll: $1.61 Percent of National Median ($1.88): 86%.

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Arizona Workers’ Compensation At A Glance

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  1. Arizona Workers’ Compensation At A Glance

  2. Worker’s Compensation Premium Rankings

  3. Arizona’s Ranking 2012 Ranking: 36 (15th lowest in country) Premium Rate Index per $100 of Payroll: $1.61 Percent of National Median ($1.88): 86% Source: Oregon Workers’ Compensation Premium Rate Ranking Summary Reports, Oregon Department of Consumer & Business

  4. Workers’ Compensation Rates

  5. Rate Changes in Arizona

  6. WC Premiums

  7. Taxable PremiumIn Millions

  8. 2012Taxable Premium Allocation by PayerIn Millions

  9. Claims Frequency

  10. Arizona WC Claims Frequency

  11. Claim Frequency of Lost Time Claims Per 100,000 Workers Source: 2012 NCCI Arizona State Advisory Forum

  12. Direct Losses & Costs

  13. Total Direct LossesIn Millions

  14. 1999 to 2011Allocation of Losses by PayerIn Millions

  15. 2012Loss Allocation by Payer In Millions

  16. CY Snapshot of Losses and Frequency

  17. AZ Average Indemnity Cost Per CaseAdjusted to Current Wage LevelActual Source: 2012 NCCI Arizona State Advisory Forum

  18. Comparison to CW Average Indemnity Cost Per CaseActual Source: 2012 NCCI Arizona State Advisory Forum

  19. Average Medical Cost Per CaseAdjusted to Current Wage LevelActual Source: 2012 NCCI Arizona State Advisory Forum

  20. Comparison to CW Average Medical Cost Per CaseActual Source: 2012 NCCI Arizona State Advisory Forum

  21. Distribution of Benefit CostsCarrier Claims Ten Years Ago Today Source: 2012 NCCI Arizona State Advisory Forum

  22. Distribution of Benefit CostsSelf-Insured Claims Ten Years Ago Today

  23. Newsworthy Notes!

  24. Revenue Is On The Rise!

  25. Admin Fund Revenue

  26. Special Fund Revenue

  27. Special Fund Actuarial Picture Actuarial deficit estimated as of 6-30-12: $46.9 million

  28. Tax/Assessment History

  29. SB 1310Special Fund Report

  30. Legislation • The Commission shall publish a report showing the amount of cash and assets held by the Special Fund that are attributable or allocated to the payment of claims of insolvent insurers as of June 30, 2013. • The report shall include all insurance carriers that have had claims assigned to the Special Fund.

  31. Legislation • The report shall be accompanied by an actuarial opinion confirming the adequacy of the reserves reported and shall also include an opinion from an independent CPA that the methodology used fairly presents the attributable cash and assets. • The amount of attributed cash and assets shall include the total amount of monies that are held by the Special Fund from any assessments, recoveries, and released deposits.

  32. Legislation • The Commission must publish the report by the last Commission meeting in 2013.

  33. SB 1148 Workers’ Compensation Reciprocity

  34. A.R.S. § 23-904. Effect of injury without the state; right to compensation of out-of-state employee injured within state The “old” A.R.S. § 23-904 is repealed and replaced with a “new” A.R.S. § 23-904. Subsection (A) is the same as it was and preserves the entitlement to AZ benefits for the worker who is hired or regularly employed in AZ but injured in another state Everything else is new effective September 13, 2013!

  35. Extraterritorial Provisions Insurance coverage from State A follows ER’s workers performing temporary work in State B. Benefits are provided as if the worker were injured in State A.

  36. Reciprocity A state will honor the extraterritorial provisions of another state as long as the other state honors its extraterritorial provisions.

  37. What Claims are Subject to Reciprocity? • Any claim made after September 13, 2013, regardless of the date of injury.   • Any claim that has not been accepted as compensable or adjudicated as compensable as of September 13, 2013.

  38. If Reciprocity Criteria Apply, Then: • An employer and worker from another reciprocity state are exempt from the Arizona Workers’ Compensation Act while the worker is temporarily in Arizona doing work for the employer. • An Arizona employer and worker are exempt from the application of the workers' compensation insurance laws of another reciprocity state while the Arizona worker is temporarily working in the other state doing work for the employer.

  39. If Reciprocity Criteria Apply, Then: • An Arizona worker who is injured in another reciprocity state while temporarily working in that state is entitled to receive Arizona benefits as their exclusive remedy. • A worker from another reciprocity state who is injured while temporarily working in Arizona may not file a claim in Arizona. Their exclusive remedy is under the WC laws of the other reciprocity state.

  40. If Reciprocity Criteria Apply, Then: • An employer is exempt from requirement to obtain WC insurance in reciprocity state where worker is temporarily working because employers’ insurance policy in “home” state covers out-of-state temporary employment (extraterritorial coverage).

  41. Reciprocity Criteria • Employer has WC coverage in home state that covers a worker's temporary employment while in Arizona (e.g. policy with extraterritorial coverage) • Employer’s home state recognizes extraterritorial provisions of Arizona and exempts employers and workers from application of the home state’s workers’ compensation laws. • The workers’ compensation benefits of the home state are the exclusive remedy against the employer for injuries sustained by a worker who is injured while temporarily working in Arizona • Employee has worked less than 90 continuous days in Arizona during the 365 days immediately before the date of injury

  42. But Wait, There is More Talk to your Legal Counsel!!

  43. Commission Process • If the Claims Division receives a claim for a worker injured while temporarily in this state, and no Arizona coverage is found, the Special Fund No Insurance Section will be notified. • If it appears extraterritorial reciprocity coverage exists, the Special Fund will deny the claim and check box 11 with this explanation. • The injured worker can then file in his/her state of usual employment or can protest the denial.

  44. Evidence Based Medical Treatment Guidelines

  45. Legislation A.R.S. § 23-1062.03, requires the Industrial Commission of Arizona to develop and implement a process for the use of evidence-based treatment guidelines, where appropriate, to treat injured workers no later than December 31, 2014.

  46. Advisory Committee Established to Represent Stakeholders • Dir. Laura McGrory, Chair • Donald Dearth, D.C. • Marjorie Eskay-Auerbach, M.D., J.D. • Dennis Kurth, Attorney • Chris Labban, D.O. • Bill Lewis, M.D • Todd Lundmark, Attorney • Melinda Poppe, ICA Staff • Sydney Standifird, State of Arizona Risk Management • Patricia Treharne, M.D. • Cathy Vines, SCF Arizona • Steve Weiss, Attorney • Joe Tracey, York Risk Services Group

  47. Recommendations for the Development and Implementation of Treatment Guidelines Advisory Committee has agreed to the following: • It is appropriate to use treatment guidelines in the management of chronic pain. • Existing guidelines will be considered for adoption (as opposed to drafting Arizona specific guidelines). • A multidisciplinary panel of respected specialists will be established to evaluate case scenarios under the following guidelines: ACOEM, Colorado State, ODG, and Washington State.

  48. 2014 Statutory Maximum AMW Beginning January 1, 2014, for injuries that occur during calendar year 2014, the maximum average monthly wage is $4,256.94.

  49. Change of Physician Requests Under A.R.S. § 23-1062.02 Off-Label prescription of controlled substances; Prescription of schedule II controlled substances; Reports; Treatment Plans; Definition

  50. Change of Physician Requests Under A.R.S. § 23-1062.02 • An employer, carrier, or the Commission may request a change of physicians if the treating physician does not comply with the provisions of the statute • File Request to Change Physician with the Claims Division specifically stating that it is made pursuant to A.R.S. § 23-1062.02(C)(2) • The Claims Division will refer the request to the Administrative Law Judge Division for investigation and resolution. If necessary, the matter will be set for hearing on an expedited basis

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