Comp Quotes
Workers’ comp news for SAIF’s agents
Spring 2018
Comp Quotes articles:
ER mod eligibility change
It’s the first change since 1991.
Experience rating modification premium eligibility will be changing for all policies with rating effective rates of July 1, 2018, and later. This is the first change to eligibility amounts since at least 1991.
Annually, NCCI will use an indexing method based on Oregon’s year-to-year change in average weekly wage, as estimated by the U.S. Bureau of Labor, for determining premium eligibility amounts. The amounts will either remain the same or increase for a given year. NCCI will not decrease the amounts from one year to the next.
This means we could see increases in premium eligibility amounts each year. Oregon will receive notice as part of NCCI’s annual rate filing. Any changes would become effective July 1 of that year. SAIF’s annual rate summary memo will begin including these amounts for your reference.
Here are the new and current premium eligibility amounts:
| Rating effective date | Most recent 24 months of base-period subject premium* equal to or greater than | Base-period average annual subject premium* equal to or greater than |
| July 1, 2018 and after |
$5,500 | $2,750 |
| June 30, 2018 and before |
$5,000 | $2,500 |
* Subject premium is manual premium plus waiver and EL-increased limit premium.
NCCI has begun releasing the July 1, 2018, experience rating modifications using the new eligibility thresholds.
Please contact your underwriter or the SAIF service center (888.598.5880) if you have questions.
Reminder of the exemptions process
Policyholders or agents must designate in writing which eligible officers are exempt.
SAIF requires written confirmation of an exemption designation. Policyholders or agents must designate in writing which eligible officers are exempt from coverage and send the designation to SAIF.
When possible, we would like to receive the signed exemption application form. This form provides the necessary information to help a policyholder or agent make the correct determination based on state law. If the exemption documentation is not received, SAIF will endorse the policy so that all working officers, partners, or members are covered and payroll will be required to be reported.
For additional information regarding exemption process
- Licensed corporations and co-operative corporations (co-ops) in construction, landscaping, or timber harvesting
- Partnership, limited liability partnerships (LLPs) and limited partnerships
ORLA quote process for 2018
We’re using a different process than usual for ORLA.
As of January 1, 2018, the Oregon Restaurant and Lodging Association (ORLA) became SAIF’s newest group partnership. To help launch this program, we’re proactively offering the ORLA/SAIF group program to any accounts in the SAIF service center who met our group eligibility criteria and are not currently in another group at their renewal.
For agents, this means rather than calling SAIF to ask for a group proposal, we’re sending you an ORLA/SAIF quote approximately 30–45 days prior to their renewal. The customer is still getting the nongroup SAIF renewal sent directly to them; we’re asking the agents to forward the ORLA/SAIF quote to their customers.
Although the ORLA quote option is addressed to the customer, it is only being sent to the agent for presentation to the customer. With the quote, we’re providing an email to the agent explaining our process and providing a link to the ORLA membership site so agents and customers can explore ORLA’s member benefits and can check the membership cost.
This process is different than our usual one for group quoting, and we’ll continue to do this for 2018. Our reason for this extra effort is that under DCBS rules, whatever number of ORLA/SAIF group program participants we have at the end of 2018, we can only add 50 percent new group participants in each subsequent year.
Please be sure to have the signed enrollment form back to SAIF prior to the customer's renewal date to be included in the group.
Thank you, agents, for your help so far! We're counting on your help to make sure our 2018 numbers are strong with this ever-growing industry. If you have any questions about this process, or about one of your customers, please contact Pat Morrill (503.373.8827), Kim Turner (503.373.8128) or Erika Meier (503.373.8749).
The SAIF Learning Center, our new training resource, is now live
SAIF policyholders can request access by visiting our new trainings page on saif.com.
Our policyholders have long expressed interest in a system that could provide them and their employees with safety and health trainings and resources. They now have access to that—and a lot more—through our new learning management system.
The SAIF Learning Center is a proactive tool for workplace safety and health, risk prevention, and business management.
Agents access the system using your email address as your user name and “safety” as your temporary password. You will not see specific policyholder training records, and CECs will be available in the future. If you have problems with the user name or temporary password, please call us at 503.373.8200, or email learningcenter@saif.com.
Additional perks
- It’s accessible. Trainings can be accessed on any computer any time.
- It’s tailored to our customers’ needs. Each training catalog includes items based on their relevance and necessity to a specific business.
- It’s a helpful management tool. Automatic tracking helps maintain employee training records, HR requirements, and even allows employers to upload their own policies and procedures.
The training library within the LMS will continue to be updated with SAIF-produced content.
Want to know more? Check out our marketing document for more details, including how to sign up.
Third-party recoveries in 2017
Little-known fact: Recoveries in excess of the third-party lien go directly to the injured worker.
As many of you know, when someone other than the injured worker, their co-worker, or their employer is negligent in causing a workers’ comp injury, a third-party claim may be filed.
As a result, third-party recoveries are applied retroactively against claim costs to help reduce premiums. What you may not know is that when the paying agency (insurer) has the cause of action in a third-party claim, recoveries in excess of the third-party lien go directly to the injured worker to help compensate them for their pain and suffering as a result of the injury.
In 2017, SAIF totalled more than $8,025,000 in third-party recoveries, with about $600,000 going to injured workers when SAIF had the cause of action. SAIF is committed to excellence in its third-party recovery work, and we're proud of the positive impact that it has had on policyholders and injured workers throughout Oregon.
Supreme Court issues limited decision in exclusive remedy case
New law doesn't prevent lawsuits based on partial denial of a previously accepted claim.
The Oregon Supreme Court has ruled (Bundy v. Nustar GP, LLC) that a statute adopted in response to the court’s decision in Smothers v. Gresham Transfer, Inc. does not prohibit workers from suing their employers based on the partial denial of a previously accepted workers’ comp claim.
However, the court stopped short of saying that the law affirmatively authorizes such actions or whether it merely requires a worker to exhaust workers’ comp remedies before pursuing a civil action under some other source of law.
The employer in Bundy was self-insured and had accepted an initial claim for “nondisabling exposure to gasoline vapors.” The employer later denied, on a major-cause basis, the worker’s request that it accept additional medical conditions identified as “somatoform disorders.” When the employer’s denial was upheld, the worker filed a civil action, contending that the law authorized the action and allowed the worker to circumvent the exclusive remedy provision of the workers’ comp law. The employer argued that ORS 656.019 actually prohibited the action because the statute addresses only initial claims that are completely denied on a major-cause basis.
The Supreme Court ruled that ORS 656.019 does not prohibit civil actions based on the partial denial of a workers’ comp claim. But it sent the case back to the trial court to determine whether the statute provides authority for such civil actions, or whether such actions can only be brought pursuant to some other source of law sufficient to overcome the exclusive remedy provision. The court has not yet addressed how its interpretation in Horton v OHSU may impact civil actions based on workers’ comp claims denied on major cause grounds. Thus, more litigation will be needed to clarify the law in this area.