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You’re about to become an employer.  Maybe you’ve been in business for a while, but now you’re ready to hire your first employee.  You’re excited; this means your business is growing.  Or, maybe you’re just starting a business and you need employees to help run that business. 

Either way, being an employer comes with many responsibilities, including ensuring that you purchase the right business insurance.  You may be asking yourself, “What insurance is required by law and what is optional?  What’s in the best interest of both my business and my employees?” 

There are four primary types of insurance every employer should take a look at – Workers Compensation Insurance, Unemployment Insurance Tax, Disability Insurance, and Health Insurance.

Workers’ Compensation Insurance

Workers Compensation Insurance coverage ensures medical and wage-loss benefits to employees who are injured on the job. Plus, it helps protect employers against lawsuits filed by injured workers. Worker’s Comp insurance requirements vary by state.  In Pennsylvania, if you employ one or more employees - whether they’re part-time or full-time (including family members) workers’ compensation insurance coverage is mandatory.

If you are a sole proprietor, Workers' compensation insurance is not required by law, which can save you money; however, if you’re ever injured on the job, workers’ compensation insurance can help pay medical bills and supplement lost wages until you’re able to go back to work.

Click here for information about workers compensation insurance requirements in other states.

Unemployment Insurance Tax

Unemployment Insurance (UI) is a joint state and federal program financed through federal and state employer payroll taxes. It provides temporary payments to individuals who are unemployed through no fault of their own.  Each state has its own unemployment insurance program, which includes additional eligibility requirements, but they all follow guidelines established by the federal government.

Most employers must pay federal employer payroll taxes if they pay employee wages of $1,500, or more, in a quarter or if they have at least one employee during 20 weeks in a calendar year.  Most employers are also required to pay state unemployment taxes. In Pennsylvania, all employers providing employment to one or more workers must register Form PA-100 with the Office of UC Tax Services.

Employment that is not covered under the UC law includes the following:

• An individual employed by his or her son, daughter or spouse
• A child under the age of 18 who is employed by his or her parent
• A student in the employ of an organized camp that did not operate more than seven months in the preceding calendar year

Disability Insurance

Some states require that employers provide partial wage replacement insurance coverage to their eligible employees for non-work related sickness or injury. Currently, if your employees are located in any of the following states, you are required to purchase disability insurance:

• California
• Hawaii
• New Jersey
• New York
• Puerto Rico
• Rhode Island

In Pennsylvania, there are two types of disability insurance available if you decide to purchase it for your employees: short-term and long-term.

Again, if you are a sole proprietor, Disability Insurance is not required in Pennsylvania; however, if your family relies on your income, you may want to consider disability insurance for yourself to help pay medical bills and supplement lost wages if you become sick or injured.

Health Insurance

If you have more than 50 employees you are required to provide health insurance benefits to your full-time employees.  If you have more than 50 employees and don’t offer health benefits, you may be subject to a penalty call the shared responsibility payment.  96% of employers in Pennsylvania are exempt from the shared responsibility requirement. 

Contact Us for All Your Business Insurance Needs

If you’re an employer, contact American Insuring Group at (800) 947-1270 or (610) 775-3848 for more information about required and recommended business insurance, including health insurance, disability insurance, workers compensation insurance, or any other insurance your business may need. We've been helping businesses like yours acquire affordable, high-quality insurance for over 25 years.

Safety and Lower Workers Compensation Insurance Costs Go Hand in Hand

Creating a safe working environment for your employees is one of the best things you can do to help control the cost of Workers’ Compensation Insurance.  Whether you run an office, a warehouse, or a manufacturing facility, there are certain steps that apply to the main structure of any successful safety program.  Here are a few:

Set the Standard

Create an atmosphere and culture of safety; it will spread to your workers.  This can be as simple as carpeting that is free of rips and holes, clearly marked hazards, clean floors, and machines with real guards in place.  If you set the right standard, everything will follow.  

Create an Emergency Response Team

Your workforce may be the most efficient and responsive team during the course of regular business, and you may assume that they would react the same way in an emergency, but too often that efficiency and responsiveness turns to confusion and chaos during an emergency situation.  Employees need to know ahead of time what their responsibilities are in the event of an emergency, so they can react quickly like a group of well-trained marines rather than the bumbling Stooges. 

First, create a team that is a mix of serious-minded workers, supervisors, and management that understand that – in the event of an emergency -  lives may depend on them.  Make sure every employee knows who those team members are and how to reach them.  Consider creating a special code for emergencies or maybe a special name tag for members of this team.  Then, establish protocol for reporting an injury along with the chain of command.  Everyone on that team needs to understand what his or her responsibility is – whether that’s calling 911, applying CPR, or alerting other staff.

Finally, stage a few “accidents” for practice drills.  Don’t let employees know ahead of time and start easy, working your way up to accidents with increasing severity.

Communicate!

Your goal with Workers’ Compensation is to report zero claims, but if you do find yourself filing a claim, make sure your adjuster and carrier are good at communicating with the injured worker.  Set standards and make sure they are followed.  An injured worker should receive a call from a triage nurse or the adjuster within 24 hours.  The injured worker’s manager should call him or her once a week to check in on them.  Let the employee know that he or she matters and that you care about their welfare.

Lack of communication has been the down-fall of many marriages and statistically, it’s one of the biggest complaints of insurance claimants.  Too often, injured workers don’t know what is going on, what doctor they can and can’t go to, etc.   Effective communication decreases litigation, gets workers back to work more quickly, and keeps the claim moving forward to a resolution.

Get Upper Management Involved

My dad used to say to me, “Do as I say, not as I do.”  How do you think that went?  Not very well.  Good leaders lead by example.  If upper management repeatedly breaks the rules, you’ll lose whatever cooperation you’ve achieved with your employees.  Safety standards need to apply to everyone, even if that means writing up someone in senior management for a safety violation.  Your safety program needs to be enforced 100 percent of the time.

We Can Help You Save on Workers Comp Insurance

To find out more ways to save on workers’ compensation insurance, contact American Insuring Group at (800) 947-1270 or (610) 775-3848.

You say you have good business insurance, and that you've taken the time to obtain the right workers compensation insurance protection for your employees and your business. Good for you!

But, have you taken all the proper precautions to protect your construction workers or other employees from asbestos exposure? Doing so is the right thing to do for their protection, and over time it could also lower your workers compensation insurance costs.

What is Asbestos?

Asbestos is a naturally occurring mineral-based material that is widely used in many building products because it is resistant to heat and corrosive chemicals and does not conduct electricity. Asbestos fibers are very fine and can remain suspended in the air for hours. Asbestos comes in all shapes, sizes, and colors, and it’s extremely difficult to see. 

Asbestos that is in good condition and undisturbed is safe, but scientists have confirmed that when asbestos materials start to rot or are disturbed by cutting, scraping, drilling, or sanding, toxic fibers are released into the air.  Once breathed in, these tiny fibers (1,200 times thinner than a human hair) can get trapped in the lungs and remain there for a long time.  As these fibers accumulate, they cause scarring and inflammation, which can affect breathing and cause significant health problems.

Asbestos has been classified as a carcinogen (cancer-causing substance).  Continued exposure to asbestos can cause mesothelioma (a cancer that affects the membranes lining the lungs and abdomen), asbestosis (scarring of the lungs, which causes a loss of lung function that often progresses to disability and death), lung cancer, pleural plaques, and cancers of the esophagus, stomach, colon, and rectum. 

Often, the symptoms don’t appear until many years after the first exposure (20-50 years is the average gap).  Even short-term exposure to a significant amount of asbestos can lead to breathing problems, coughing, and shortness of breath.  And, there is evidence that family members of workers heavily exposed to asbestos face an increased risk of developing mesothelioma, as a result of exposure to asbestos fibers brought into the home on the shoes, clothing, skin, and hair of workers. According to the World Health Organization, 43,000 people die annually from asbestos (10,000 Americans).

Banned in 55 Counties

Asbestos has been banned in 55 countries.  Its use is restricted in the U.S. (asbestos must account for less than 1 percent of the product.), but it has not been banned.  Two million metric tons of the substance are produced every year worldwide. Many U.S. companies have phased out most products that contain asbestos; however, asbestos building materials still exist at many jobsites – especially homes and commercial buildings built before the 1970’s.  In 1989, the U.S. Environmental Protection Agency (EPA) banned all new uses of asbestos; however, uses developed before 1989 are still allowed.  

Why Construction Workers are at Risk:

Everyone is exposed to asbestos at some time during their life.  Low levels of asbestos are present in the air, water, and soil.  However, most people don’t become ill from their exposure.  People who become ill from asbestos are usually those who are exposed to it on a regular basis. 

Throughout the twentieth century, asbestos was incorporated into thousands of construction products, including fire retardant coatings, concrete and cement, bricks, pipes, gaskets, insulations, drywall, flooring, roofing, joint compound, paints, and sealants. Asbestos is a serious risk for construction workers of any trade.  Demolition workers who unsafely dispose of asbestos experience some of the highest risks.  Roofers, electricians, drywall workers, painters, plumbers, and laborers all face regular exposures, but anyone working on an older structure should be cautious of asbestos.

According the National Institute for Occupational Safety and Health, nearly one-quarter of worker deaths caused by asbestosis between the years 1990-1999 were in the construction trades, by far the most dangerous industry in terms of asbestos exposure.

If your employees perform any of the following tasks, they are at risk of breathing asbestos fibers:

• Cut, drill, sand, or otherwise disturb textured wall/ceiling material or drywall that contains asbestos
• Collect asbestos samples for laboratory analysis
• Remove or repair pipe insulation that contains asbestos
• Strip electrical wiring that contains asbestos insulation
• Remove ceiling tiles that contain asbestos
• Drag cable or wiring through asbestos-containing vermiculite insulation or ceiling tiles, or through asbestos-cement conduit
• Remove vinyl floor tiles or linoleum that contains asbestos
• Demolish concrete block that contains asbestos-containing vermiculite insulation
• Remove asbestos-containing asphalt roofing materials

How Can You Protect Your Employees from Asbestos?

• Read and understand the U.S. Occupational Safety and Health Administration (OSHA) regulations covering asbestos exposure in general industry and construction www.osha.gov/SLTC/asbestos
• Train employees who will be working with and around asbestos, including
  • How to recognize asbestos-containing materials http://www.hse.gov.uk/asbestos/gallery.htm
  • Awareness of the health hazards of asbestos
  • Proper use of personal protective equipment
  • Proper handling, removal, and disposal of asbestos
  • Develop and implement an exposure control plan for asbestos work
  • Have qualified people conduct risk assessments for any asbestos-containing materials that might be disturbed
  • Ventilate workspaces
  • Monitor employees for asbestos exposure levels
  • Keep warning signs and instructions in areas where asbestos-related work is performed
  • Require protective clothing, such as overall, gloves, foot coverings, face shields, and goggles.
  • Use protective equipment , such as respirators
  • Supply shower facilities and other post-exposure precautions
  • Require medical examinations for workers who are exposed to high levels of asbestos

Having the Right Health Insurance and Worker's Comp Insurance Pays Off

If one of your employees still becomes ill from exposure to asbestos while working for you, the right insurance – both liability, health, and workers’ compensation insurance – will help ensure the best care with the least financial impact. 

We're Here to Help

To determine your business insurance needs, contact American Insuring Group at (800)947-1270 or (610)775-3848.  We're independent insurance agents who offer insurance from over 25 competing brands. We’ll make sure you have the right coverage for your business at the right price. Contact us today.

The inability to get the right care, from the right provider, at the right time is one of the leading causes of increasing medical costs. 

Every business should complete its due diligence by taking the time to set up a network of medical providers and develop strong relationships with pharmacies to deliver quality care at reasonable prices to its employees. 

But if their employees aren’t taking advantage of those relationships, much of the opportunity for cost savings is lost. 

Better Communication = Lower Workers Comp Costs

This is especially true of employees who are injured on the job and utilizing workers’ compensation.  Too often, medical information is not being communicated properly, which can result in delays of medical treatment, increased absenteeism, duplication of medical services, and other inefficiencies, causing higher workers’ compensation costs for employers.  As medical costs - and nearly every other expense - continue to rise, it’s more important than ever to direct employees to preferred provider networks that provide the highest-quality and most cost-effective care.

Using Web-Based Communication Platforms to Reduce Workers Compensation Costs

One solution is to use a web-based communication platform such as the the Health Ticket. Such systems can include a virtual ID card that transmits all the relevant information – such as employer and employee names, date of injury, nature of injury, and the name of ancillary network vendors and contact information - to medical providers. Helpful information can be provided to the injured employee, such as participating pharmacies, phone numbers for additional medical providers, and network identification numbers.

The patient is able to access all the medical information he needs to find a provider via smart phone.  He can also print out a single page that details his health benefits, co-payments and deductibles.  He is also alerted if he is seeking care from a provider outside his plan’s provider network and how that will affect him financially.

Systems like The Health Ticket can communicate critical information while reducing costs. By providing real-time, accurate information about complex healthcare transactions, the Health Ticket helps guide injured workers through the preferred pathway of care.

What Can Web Based Communication Platforms Do For Your Business?

• Increase PPO network penetration

• Reduce claim costs by avoiding unnecessary or duplicate medical treatments.

• Maintain compliance with ever-changing regulatory environments and PPO contracts. 

• Contain costs by reducing billing errors, administrative costs, and out-of-network usage. 

• Improve the quality of care coordination and employee satisfaction.

• Reduce confusion over benefits and claims.

Contact Us for Workers Compensation Insurance Assistance

For more information about saving on workers compensation insurance, contact American Insuring Group at (800)947-1270 or (610)775-3848.

Fraud, waste, and abuse continue to drive up the cost of administering workers’ compensation programs. Workers’ compensation fraud, which accounts for approximately one-quarter of all insurance fraud, comes in all forms: injury while off work, multiple claims, injury concurrent with termination, and many more. 

Workers comp insurance fraud is a crime. Tens of billions of dollars in false claims and unpaid premiums are stolen every year.  Scams are increasing the cost of insurance premiums — draining business profits and costing honest workers their pay and their jobs.  In addition, these increasing costs are being passed on to you as a consumer with higher prices at the cash register.

Medical Records Investigations: Cost Effective Sleuthing to Cut Workers Comp Insurance Costs

Aggressive pursuit and investigation of fraud can help lower the financial impact of workers’ compensation on businesses. If you’re willing to do a little sleuthing, there is one interesting method of reducing workers’ compensation fraud in your business - the use of medical records for investigation.  This method is often more cost-effective and less expensive than many of the more formal investigative tools.

Where should you look?

There are a few things to consider if you decide to use medical records to investigate a workers’ compensation insurance claim. 

1. Start at the beginning. Using this investigative technique at the onset of a claim allows you to better monitor treatment trends and develop a better understanding of the case.  It’s important that you get ahead of the case before it becomes too complicated.
    
2. Start with primary care providers.  Records from a primary care provider will often provide a good overview of a person’s health, including yearly physicals. 
    
3. Don’t overlook urgent care clinics.  In addition to checking the records of your local emergency rooms, you should also take a look at urgent care facilities in the vicinity of where the claimant both lives and works.  Urgent care facilities are on the rise.  They provide a more affordable option to health care for people who don’t have medical insurance, and they offer access to medical treatment for injuries that occur after hours or on the weekend.
    
4. Look at other medical facilities.  In today’s health care environment, proper treatment often requires a visit to a specialist.  Specialists can also provide information about underlying conditions.

What should you look for?

Here are a few of the “red flags” you should look for in an investigation of medical records:

1. If a claimant receives medical care and/or treatment at more than one facility in one day.
    
2. If a claimant sought medical treatment on a Monday morning or after a holiday, it could indicate that an injury took place over the weekend or during a holiday – and not in the workplace.
    
3. If a claimant received treatment and/or referrals from providers that share common waiting rooms or are located in adjoining buildings.
    
4. If a claimant has a medical appointment while he or she is out of town or on vacation.
    
5. If a claimant receives medical care on a weekend, holiday, or during inclement weather.
    
6. Look for evidence that the medical records have been changed or altered, or if they aren’t consistent with what the primary doctor is recommending. 

Be Proactive and Increase the Odds of Cutting Your Workers Comp Insurance Costs!

Today, you need to be proactive if you want to limit the amount of fraud, waste, and abuse within your business’s workers’ compensation programs, and medical record investigation may be one method to consider for your business. 

For additional methods to reduce the cost of workers’ compensation, including getting the best rate on quality workers comp insurance, contact us at (800) 947-1270 or (610) 775-3848. We're independent agents with the power to lower your worker's comp insurance costs by offering policies from multiple competing insurance providers, so you'll get the best insurance at the best price.

Smart business owners know that insurance is important to protect their business and assets.  But, knowing which ones are right for your business can be a challenge.  No one wants to be caught without the right business insurance if something happens, and no one wants to pay for insurance that isn’t necessary. Here are six questions to ask to help determine what type of insurance you need to protect your business:

1.     Is it possible that someone could be injured or property damaged in the course of doing business with me?

If you answered yes, then you should consider Commercial Liability Insurance. Every business, even a home-based business, needs to look at liability insurance.  This type of policy provides insurance protection for bodily injury or property damage claims that you become legally responsible to pay. Standard policies include premises and operations risks that are common to the business owner or contractor. These policies also include product liability insurance and completed operations liability coverage. Medical payment insurance protection is also standard with most policies.

2.     Do I own a building or any business equipment or property – such as office equipment, inventory, or tools – to run my business?

If you answered yes, then you should consider Commercial Property Insurance. If you own a building or have business property  you should consider protecting those assets from fire, vandalism, theft, smoke damage, etc. with Commercial Property Insurance.  Expanded coverage often includes water damage, sewer back-up, business interruption insurance, and more. A tailored property insurance policy usually pays on a replacement cost basis, which means there is no depreciation in the event of a loss. 

3.     Could someone sue me based on the business that I conduct with them?

If you answered yes, then you should consider Professional Liability Insurance.  This insurance, also known Professional Indemnity Insurance, is a type of commercial insurance that provides protection for an Error and Omission Insurance exposure. This type of insurance protection typically covers negligence claims arising from an alleged act or failure to act that caused harm to another. Doctors, lawyers, and most professionals have some type of Error & Omission Insurance (Professional Liability Insurance) exposure. 

4.     Do I use any type of vehicle to run my business?

If you answered yes, then you should consider Commercial Vehicle Insurance.   This is an insurance that covers owned and non-owned vehicles that employees, contractors, and business owners use to conduct business.  The vehicle could be a truck, a van, a limo, or even a sedan, depending on what that vehicle is used for and what it is equipped with. Standard vehicle insurance coverage includes bodily injury and property damage liability, personal injury protection (including medical and lost wages expense), and uninsured and underinsured motorist coverage and physical damage to your vehicle including comprehensive and collision coverage. 

5.     Do I have any employees working for me?

If you answered yes, then you should consider Worker’s Compensation. Worker’s Compensation Insurance is a type of small business insurance that is mandatory in most states and covers employees for work-related injuries. A typical "workers comp" insurance policy pays lost wages and medical expenses incurred due to a work-related accident, while also protecting the employer against accident-related lawsuits. 

These five business insurance questions are a great starting point for any business owner, but you don’t need to go it alone.  The advice of a trusted and experienced independent insurance agent from American Insuring Group can help ensure that you obtain the right insurance at the right price for your business.  

Don't take a chance - contact us  at (800) 947-1270 or (610) 775-3848.

Every employer is responsible for insuring a safe working environment for his or her employees. If you’re in construction, workplace safety should move to the top of your priorities because more than 20% of the work-related fatalities in 2013 occurred in the construction industry. 

STEP #1: Identify Construction Safety Hazards

First, you need to identify potential hazards.  OSHA lists the following hazards for individuals in the construction industry:

1. Falls (from heights),
2. Trench collapse,
3. Scaffold collapse,
4. Electric shock and arc flash/arc blast,
5. Failure to use proper personal protective equipment, and
6. Repetitive motion injuries.

STEP #2: Address Construction Hazards

Next, you need to address those hazards.  OSHA has identified the following as some of the most frequently cited hazards:

1. Scaffolding – Approximately 2.3 million construction workers regularly use scaffolds, and it is estimated that 4,500 injuries and 50 fatalities related to the use of scaffolding occur each year.  To help avoid some of these injuries and fatalities, you need to ensure that scaffolding is erected by a competent person using stable supports on solid footing and that it is inspected regularly.  Scaffolding should be sound; located at least 10 feet from electric power lines; equipped with guardrails, midrails, and toeboards; and accessible by ladders or stairways.
    
2. Fall protection – Falls account for the greatest number of fatalities in the construction industry.  They’re caused by unstable work surfaces, failure to use fall protection equipment, and human errors.  Using guardrails, fall arrest systems, safety nets, covers and restraint systems, you can prevent many deaths and injuries caused by falls.
    
3. Ladders – there are approximately 24,882 injuries and 36 fatalities each year due to falls on stairways and ladders used in construction.  To avoid some of those falls, you need to use the right ladder for each task, inspect ladders regularly, ensure that ladders are long enough to safely reach the work area, and never over-load ladders. 
    
4. Head protection – You need to ensure that workers wear hard hats where needed to reduce serious head injuries that can result from blows to the head, from falling objects, or other hazards.
    
5. Hazard communication – In order to avoid chemical burns, respiratory problems, fires and explosions caused by not recognizing the hazards associated with chemicals, you should maintain a Material Safety Data Sheet (MSDS) and make the information accessible to employees.  Plus, you need train employees on how to read those MSDS and provide personal protective equipment, a written spill control plan, and spill clean-up kits.
    
6. Electrical – Electric shock, electrocution, fires, and explosions can be serious workplace hazards in the construction industry.  To avoid these hazards in your workplace, ensure that all electrical tools are properly grounded and extension cords have grounding prongs, locate and identify all overhead electrical power lines and inspect and ensure that equipment and materials never come within ten feet of those lines,  and maintain all electrical tools and equipment.

Ensuring the safety of your employees is important to the health and safety of your employees and the health and safety of your business.  Neglecting the safety of your employees can cause lawsuits, higher health insurance premiums, higher construction insurance premiums, and higher workers compensation premiums and related costs. 

Get the Right Construction Insurance

To learn more about reducing your construction insurance costs while acquiring quality insurance protection, contact an American Insuring Group agent at (800) 947-1270 or (610) 775-3848. We're Independent Insurance Agents, so we're free to shop among many competing insurance carriers to find the right insurance at the best price, including construction insurance, worker's compensation insurance, and every other type of insurance your business may need. Contact us today. 

On average, thirteen Americans are killed on the job every single day of the year and nearly 4 million workers are seriously injured on the job each year.  Under the Occupational Safety and Health (OSH) Act, employers are responsible for providing a safe working environment.  Furthermore, employers “MUST provide their workers with a workplace that doesn’t have serious hazards and must follow all OSHA safety and health standards.”  

Good for Employees and Good for Workers Compensation Insurance Rates

Obviously, this is the right thing to do, but the fact is that providing a safe work environment also helps the employer by providing more healthy, happy, and prosperous employees; lower absenteeism; and lower workers’ compensation costs. 

Safety Training Applies to Every Job

Safety is probably top of mind in industries such as construction where more than 20% of the fatalities in 2013 occurred.  But working in an office also comes with its share of hazards, such as slipping and falling, misusing equipment, stacking and lifting, and poor lighting.  Whether your employees sit behind a desk inputing data all day or climb 100 foot poles to work on electrical wires, all employees should receive workplace safety training appropriate to the type of job they perform. 

Here are 10 Training Guidelines for Safer Employees and Lower WC Costs:

1. Educate new employees about company safety and health policies and emergency procedures.
    
2. All employees should be trained on the specific hazards of their jobs.
    
3. Retrain employees when equipment or processes change and when employees change jobs or return from a long absence.
    
4. Adapt training to your audience.  Different people learn in different ways, so use a variety of teaching methods, such as hands-on, lecture, discussion, videos, etc.
    
5. Consider reaching out to local organizations, such as fire departments or medical facilities to help you with training.
    
6. Educate management about key workers’ compensation concepts and how workers’ compensation expenses impact the business.   
    
7. Arrange small-group employee training events to allow for discussions.
    
8. Include information about who a worker should contact in the event of a work-related injury and what their responsibilities are if they see an injury occur.
    
9. Ensure that workers sign off on an in-service acknowledgement showing they have received training.
    
10. Check out OSHA’s website - https://www.osha.gov/dte/index.html - for training courses, educational programs and training materials.  OSHA offers a wide selection of training courses and educational programs to help broaden worker and employer knowledge on the recognition, avoidance, and prevention of safety and health hazards in the workplace.

Get the Right Workers Compensation Insurance Protection

To further protect your company and your employees, contact Amerian Insuring Group at (800) 947-1270 or (610) 775-3848 to learn more about business insurance options, including worker's compensation insurance and more.

The Birth of Managed Care for Controlling Health Insurance Costs

Managed health care started to become commonplace in the US after the enactment of the Health Maintenance Organization Act of 1973, which was created in an attempt to control health care medical insurance costs by stimulating greater competition within health care markets.  It marked a significant shift in the US health care industry by introducing the concept of for-profit health care to an industry that was traditionally not-for-profit. 

Many believe that managed care helped control medical cost inflation in the late 1980s.  On the other hand, many believe that these cost-control efforts also caused the health care industry to become more interested in saving money than in providing quality health care.  Whatever you believe, the fact is that managed health care has become ubiquitous in the US, with 90 percent of insured Americans enrolled in plans with some form of managed care, according to America's Health Insurance Plans.

So What is Managed Health Care?

Managed health care plans are a type of health insurance. Managed Care Organizations (MCOs) establish contracts with doctors, hospitals, clinics, and other health care providers such as pharmacies, labs, x-ray centers, and medical equipment vendors at a reduced cost.  These health care providers and medical facilities are known as the plan’s “network.”  Managed care health insurance plans typically cover a wide range of health services – from preventative care to diagnosis and treatment of illnesses. 

There are Two Basic Types of Managed Care Health Insurance Plans:

• Health Maintenance Organizations (HMO) – HMOs require you to use their "network" of hospitals and doctors only. Coverage is usually broader, with less out-of-pocket expense, but is more restrictive than a PPO. "Out of network" medical expenses are not covered under an HMO medical insurance plan.

• Preferred Provider Organizations (PPO) – PPOs give you an incentive to use their "in network" hospitals and doctors. You can choose to go "out of network," which gives you freedom of choice, but usually with a higher deductible and co-insurance out-of-pocket expense than other forms of medical insurance.

Health Insurance and Worker’s Compensation Insurance Objectives

General health insurance and worker’s compensation have two slightly different objectives.

Health insurance (including managed health care) is "coverage that provides for the payments of benefits as a result of sickness or injury,” according to the Health Insurance Association of America.  It provides coverage for medications, visits to the doctor or emergency room, hospital stays and other medical expenses. 

Worker’s Compensation Insurance covers employees for work-related injuries, including not only medical expenses, but also lost wages incurred due to a work-related accident or injury.  Keep in mind that while Worker’s Compensation only accounts for about three percent of a company’s total health care costs (about $111 billion), more than half of that $111 billion is paid in lost wages.  Therefore, in addition to providing health care for employees, another objective of Worker’s Compensation Insurance is to get employee’s back to work.

How Can Managed Care Help Reduce Workers Compensation Insuance Costs?

By using some of the techniques used in managed care, companies can provide quality medical services to injured workers and get employee’s back to work. 

Some of these techniques include:

• Medical Case Management
• Provider Network
• Precertification
• Record Analysis
• Utilization Review
• Fee Schedule Compliance
• Independent Medical Evaluations

Managed Care Worker's Comp Insurance Savings Example

John is an employee for XYZ Manufacturing.  His normal job is lifting 50-lb bags onto a truck.  One day, while he’s lifting one of those bags, he twists his back, which causes a lower back injury.  The physician advises John not to lift anything over 20 pounds.  Using managed care techniques, John could go back to work on light duty rather than missing work completely, saving XYZ Manufacturing the cost of lost wages for John.

How to Save on Quality Health & Worker's Compensation Insurance

For more information about MCOs and Worker’s Compensation Insurance and to find the right insurance for your business, please contact American Insuring Group at (800) 947-1270 or (610) 775-3848. 

We have been supplying affordable, high-quality worker's compensation insurance and health insurance for over 25 years. And, as a Trusted Choice independent insurance agent we specialize in offering multiple insurance offerings from competing insurance brands. We'll help you get the right coverage at the the right price. Call today.

Worker's Compensation Insurance Costs

According to a recent U.S. Bureau of Labor report, Workers’ Compensation accounts for 2.8 percent of the total cost of a production, transportation, or material moving employee’s compensation and 3 percent for construction and maintenance employee’s compensation.  Businesses interested in reducing those percentages do what they can to improve workplace safety; thereby, reducing the number of workers’ compensation claims and providing a safer and healthier environment for employees.  It’s a win-win situation.

Like Games? Try OSHA’s New Tool to Help Identify Hazards within the Workplace

One of the first steps to creating a safer workplace is to identify potential hazards; if you don’t know a hazard exists, how can it be properly mitigated?  The Occupational Safety and Health Administration (OSHA) has created an interactive, online, game-based training tool to help small businesses effectively identify hazards within the workplace.  This tool, with both an owner and worker mode, is designed to help both company leaders and workers to not only identify hazards, but also learn how to abate and control those hazards. 

Currently, the user can choose between three different scenarios:

• OSHA Visual Inspection Training
• Manufacturing Facility
• Construction

OSHA Visual Inspection Training

The "OSHA Visual Inspection Training" scenario, which contains a saw, industrial chemical mixer, scaffolding and fall protection for inspection, shows users how to identify hazards on items found in the workplace; become familiar with typical hazard categories; and understand common relationships of hazards to equipment components and operations.  It offers the user an opportunity to practice a visual inspection and find hazards. In this scenario, the user can view equipment from 360° to look for hazards. The user can also talk to the employee and observe the employee at work to identify additional hazards.

Manufacturing Facility & Construction

The Manufacturing and Construction scenarios, which focus on the principal skills needed to effectively identify hazards in the workplace and reinforce the key components in the hazard identification process, allow participants to experience the entire workplace. The manufacturing scenario allows the user to be a part of the safety committee in a hovercraft parts manufacturing facility.  In the construction scenario, the user must identify and mitigate hazards to maintain a safe workplace throughout three phases of a construction project.

5 Key Components in the Hazard Identification Process

This tool helps owners and workers understand the five process components in identifying hazards:

1. Collect information: Review all information (manuals, safety data sheets, OSHA data, etc.) you may already have available to find hazards that have already been identified by others.
   
   
2. Inspect workplace: The most basic (yet important) component of inspection is the simple visual inspection. Inspecting the equipment and the surrounding work areas allows the user to look over the equipment without any obstructions that might exist while the equipment is being operated. Certain hazards might only be recognizable when the machine is not in operation.
   
   
3. Observe the operation: Another good way to identify hazards during an inspection is to observe the equipment in operation. Watch the operator and note any hazardous situations. Observing an operation gives the viewer an opportunity to see how the task is actually completed. This can provide insight on additional hazards that would not be recognizable otherwise (positioning of controls relative to the worker, noise and dust levels, by-passing or improper use of safety functions). This can only be done when workers are present and production is underway.
   
   
4. Involve employees: A great way to gain insight into workplace hazards is to talk to the equipment operators. Often, they are aware of issues that may not be apparent during an inspection. Talk to the workers and listen to their feedback.
   
   
5. Investigate incidents: Whenever an incident occurs, use that as an opportunity to learn about hazards that may have been overlooked.

To find out more about this new tool, check out https://www.osha.gov/hazfinder/. 

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