PComp
Pennsylvania Counties Workers’ Compensation Trust
PComp Loss Control
Incentive Program
A Loss Control Incentive Premium Reduction Program
Contents
2007 PComp LC Credit Worksheet
PComp Loss Control Incentive Program 2006
2007 PComp Loss Control Credit Worksheet
PComp Member (County or Agency):
Person Completing
This Form:
(Please print name & phone number)
Check the block next to each portion of the Loss Control Policy that your county or agency has completed. The loss control credit will be applied to the 2007 PComp policy year premium (Jan 01 – Dec. 31, 2007). This reflects activity for the period 12 months prior to date of this worksheet. Then total the credits, sign the form, and you may FAX it to Marsha Elmer, CCAP Insurance Programs. Please mail the original to CCAP Insurance Programs, P.O. Box 60769, Harrisburg, PA 17106-0769. This report is subject to revision after review by the loss control, claims and underwriting departments of the CCAP Insurance Programs. This report may also be subject to a physical audit of the loss control program.
X Mark each block below indicating complete or fully functioning activity.
Credit Available for Each Section
¨ 1.0% Safety or Loss Control Program: fully functioning per the guidelines, with a minimum of 6 safety committee meetings within the last 12 months.
¨ 1.0% Timely Claims Reporting: report to PComp claims all work related injuries within 48 hours or next business day or 24 hours for death claims. 90% of claims submitted have been submitted within these deadlines.
¨ 1.0% Return To Work (RTW): available and implemented for each loss time injury.
¨ 1.0% Human Resources Management: appropriate hiring, administration and termination programs in place and implemented.
¨ 1.0% Education and Training: education and training available for all staff. PComp member staff shall participate in a minimum of four (4) PComp sponsored educational events or workshops per year. Other training may be accepted, with documentation, in lieu of CCAP events.
______Total of blocks marked.
Maximum available 5.00% credit applied to next year premium.
Signature of person authorizing the PComp credit.
PComp Loss Control Incentive Program 2006
Introduction
Adopted by the PComp Board of Directors
October 7, 2005
Conditions to be evaluated for Premium Reduction for the 2007 policy year.
PComp has developed this program to provide recognition for expected activity, in the form of a premium discount to be credited to the next policy year (Jan. 1 – Dec. 31, 2007).
This document provides guidelines for the expected activity of PComp members. The satisfactory development, implementation and continued administration of the policies, procedures and programs shall be rewarded with a premium discount for the following policy year. In the event that the expected activity is not accomplished, the premium for the following year will be surcharged an equal amount. For example, a 1.0% discount for a fully functioning Safety or Loss Control Program will only be credited to the next year premium if the program fully meets or exceeds the guidelines provided. In addition, if the Safety or Loss Control Program does NOT fully meet or exceed the guidelines, a surcharge of 1.00% will be applied to the next year policy premium.
For example, a PComp member with a premium of $100,000 with programs and activity that meets or exceeds the PComp guidelines will be credited 5%, meaning their premium is lowered to $95,000. However, if none of the guidelines are implemented the premium will be debited 5% and becomes $105,000.
The PComp Loss Control Credit Worksheet will be provided to each PComp member with the renewal information packet. The worksheet will be used to report activity, according to the guidelines below, for the period of 12 months prior to the date of the worksheet. The worksheet will be submitted to PComp with the renewal data. The worksheet is subject to review by PComp loss control, claims and underwriting staff. The worksheet is also subject to a potential physical audit of the program at the member’s facilities.
Prior to admission to PComp, the loss control staff of PComp may visit the prospective member and evaluate the objectives listed below. The staff will then prepare a report for the PComp underwriting staff outlining the county's (or county-related entity's) present level of attainment of each of the objectives. If any or all of the objectives are not being met prior to entry, the report shall contain a written affirmation by the prospective member to implement the entire Loss Control Policy, within the time periods indicated below. The report will be considered by the Board when action is taken on the prospective member's admission to PComp.
PREMIUM REDUCTION PLAN
The loss control program guidelines are provided in order to provide a minimum standard to calculate the premium reduction. A maximum of 5% may be deducted from the premium for meeting or exceeding the following loss control program guidelines. Organizations in the private sector may also gain a 5% discount on workers’ compensation insurance by having a certified safety committee, meeting the standards of the Bureau of Workers’ Compensation.
The terms Loss Control Committee or Safety Committee are considered to be synonymous.
Loss Control Incentive Program Guidelines
Claims & Loss Control Coordinator
The PComp member shall designate specific staff for both the Claims Coordinator, and Loss Control Coordinator position. The responsibilities of these positions are indicated below. If the county is also a member of PCoRP, the coordinators may be the same individual for both programs, if desired. The individual should not be selected solely because they work with county property, maintenance or personnel issues.
Claims Coordinator:
The Claims Coordinator acts as the contact for PComp. This person reports claims, and acts as the liaison to the PComp Claims Representative. This individual coordinates timely reporting of all workers’ compensation claims to PComp. Additional information that could assist in the processing of the workers’ compensation claim, such as written statements, personnel information, or witness statements would be the responsibility of this person.
Loss Control Coordinator:
The Loss Control Coordinator should be appointed by the commissioners (council members, county executive, or agency director), and should report directly to the commissioners or agency director. The Loss Control Coordinator should be a management level staff member who has an interest in or knowledge of risk management, insurance or loss control, in addition to having the respect and cooperation of all supervisory staff within the organization. The L C Coordinator shall participate on the safety committee.
Safety or Loss Control Program – 1.0%
A. A loss control committee with a minimum of 5 staff members shall be appointed by the commissioners, executive director or administrator. All departments within the organization should have representation on the committee. The chairperson of the committee should be a management level staff member. The chairperson may be designated by the commissioners, or may be elected from within the committee. It is suggested that the chairperson of the safety committee should not be the designated loss control or claims coordinator for the program.
B. The ultimate responsibility for safety in any organization starts at the top. A safety policy statement for the county or entity shall be developed and signed by the commissioners or executive director. The formal written safety policy statement demonstrates to all staff the support and commitment of the commissioners or executives of the organization. The safety policy statement should be publicized in order that all county or entity personnel are aware of the policy. The policy should be posted and a copy provided to all staff.
C. The committee shall meet a minimum of six (6) times per year. Each safety committee meeting should contain the following:
º Formal minutes should be maintained for each meeting.
º Minutes shall indicate members present or absent.
º Incidents since last meeting should be reviewed. Review should not indicate names and should not assign blame. Review is for the purpose of preventing a recurrence.
º An accident analysis should be developed to note trends or repetition of incidents, hazards, or staff.
º Review progress of old business.
º Discuss new business.
º Minutes should show name of responsible person for action.
º Safety related education or training.
º Minutes should indicate date, time and location of next meeting.
º Minutes should summarize unsafe acts or conditions identified by the inspection reports.
D. Emergency action and evacuation plans shall be developed for each facility. Evacuation drills should be conducted at least twice per year.
E. Self inspection reports or hazard identification reports of the county or agency facilities shall be completed at least quarterly and shall be reviewed by the loss control committee. The inspection reports should be summarized in the safety committee minutes.
F. Recent education or training experiences should be identified and noted in the minutes. Staff who participated in the educational experiences or workshops should report to the safety committee and convey the appropriate information.
G. The committee shall provide regular written reports, or meeting minutes, to the commissioners, committee members, and to PComp. Additional distribution may be designated by the commissioners’ office. The reports shall identify specific programs implemented to reduce/prevent losses, problems with implementation of programs, and future program goals (what to do, why the goals were selected, and how to achieve goals). The minutes of successive meetings should note the progress of the programs. Note: The minutes of the committee meeting are acceptable as the report to PComp, provided the minutes contain the information indicated above in this section. (The minutes will show evidence of the functioning safety committee). If the inspections or Hazard Identification Forms are summarized in the safety committee minutes, it is not necessary to send the inspection forms to PComp.
Timely Claims Reporting – 1.0%
All work related injuries shall be reported to the PComp Claims Department within 48 hours or the next business day, or 24 hours for death claims. (Weekend or holiday incidents shall be reported the next regular business day). The Claims Coordinator shall report the information to PComp. Department managers and supervisors shall provide the report of the incident causing the work related injuries to the Claims Coordinator immediately after the incident. (After the injured individual has received appropriate medical attention, transportation and restoration of the work area have been completed).
Note: In order to claim credit for timely reporting, 90% of the claims shall have been submitted within 48 hours or 24 hours for a death claim.
Initial investigation of the incident shall be completed by the injured worker’s supervisor. The investigation shall be reported to the Claims Coordinator to provide the loss report to PComp. Follow-up accident investigation may be provided by the department head and/or safety committee.
The county or agency shall develop and maintain a Provider Panel List of designated health care providers as required in the Pennsylvania Workers Compensation Act. The employer shall designate a list at least 6 health care providers. The employee with a work related injury shall be required to visit one of the designated health care providers for the first 90 days of treatment. The list of health care providers should be submitted to PComp for review.
Return to Work (RTW) – 1.0%
A return to work policy shall be developed and implemented by every PComp member. This policy shall provide guidelines or directives for establishing and implementing modified, light or restricted duty for a specific period of time for the individual who has sustained a work related injury resulting in loss time.
Supervisors should follow-up by phone with injured employees with the first few days after an injury that results in time lost from work. Should there be extended loss time, the injured employee should be contacted at regular intervals. A notation of the call should be maintained indicating the date, time and general nature of the discussion. This notation should be recorded in the personnel file or an incident file if such is developed.
Human Resources Management – 1.0%
The PComp member shall have documented Personnel or Human Resources policies and procedures. These policies or procedures should include: job description, hiring procedures, orientation and training for new employees, procedures for handling injured workers, and periodic evaluations. Policies and procedures should also include sexual harassment policies, drug & alcohol policies, vehicle use policies and policies/procedures specific to the position. All policies and procedures should be reviewed periodically to determine that they are still appropriate and meet required standards and laws.
Members who terminate employees while the employee is on workers’ compensation will forfeit the right to claim this credit and will be debited 1%.
Education & Training – 1.0%
New staff shall receive appropriate education and training on organizational polices and procedures in addition to the specific job related policies and procedures.
The CCAP Insurance Program conducts numerous educational workshops annually, located in Harrisburg or throughout the Commonwealth of Pennsylvania. PComp sponsors many of these workshops. Information about the workshops is published twice per year in a booklet entitled Glimpse. The information about workshops and registration materials are also available on the website, www.pacounties.org.
In order to claim the 1.0% premium discount for education and training it is necessary for the PComp member to participate in at least four (4) PComp sponsored education or training events annually (or other appropriate workers’ compensation and/or risk management trainings). Most events are free to PComp member’s staff and available to operational staff, supervisory and management staff as well as executive staff. Alternative training events may be accepted with proper documentation, and approval by CCAP Staff, in lieu of the CCAP events.
Implementation Date: The safety program including the safety committee should be developed, implemented and operational within 90 days of becoming a member of PComp. The program and committee shall remain functioning and active as long as the county or agency is a member of PComp.
Essential Basic Activities: