CALIFORNIA WORKERS COMPENSATION:  New Variable Split Point

CALIFORNIA WORKERS COMPENSATION: New Variable Split Point

Workers Comp Insurance Variable Split Point

With the recent changes to the California Insurance Marketplace, specifically the recent adjustments by the Workers Compensation Insurance Rating Bureau (“WCIRB”) to the way in which Experience Modification Factors (“X-Mod”) are calculated; many organizations were not prepared for the full impact of the changes due to a couple main contributing factors…

  1. Lack of Mass Publication of the Change from the Governing Body (WCIRB)
  2. Failure of Agents/Brokers to properly inform and prepare their clients

In response to the large number of new prospective clients we’ve come in contact with that were ill prepared for the change, we are providing the following information as a quick reference guide (“Cheat Sheet”).

What is Experience Rating & Why do we have an X-Mod?

The intent of Experience Rating is to provide a multiplier/factor by which Workers Compensation insurance premiums can be more adequately charged to businesses based more closely to their risk/hazard level.  Ideally a business with ZERO claims should pay a lower Rate as compared to a business with multiple Workers Compensation claims/injuries.

The WCIRB created the Experience Modification Rating Factor, also known as the “X-Mod”, “Mod”, “ERM” (Experience Rating Modifier), as a means to REQUIRE carriers to account for the approximate level of risk of each insured/business – which in turn should eliminate the majority of Gamesmanship in rating of individual policies.

How does my X-Mod impact my Workers Compensation Premium?

  • X-Mod is Less than 100 (1.00):  Considered a “Credit” X-Mod in that the business will receive a credit from the factor on their Workers Compensation Premium.  Example:  A business with an X-Mod of 0.87 would result in the business receiving a rate that is 13% lower than that of an “average” business.
  • X-Mod is 100 (1.00):  Considered a “Neutral” X-Mod in that the business will not receive either a credit or a debit from the factor on their Workers Compensation Premium. Example:  A business with an X-Mod of 1.00 would result in the business receiving a rate that is the same as an “average” business.
  • X-Mod is Greater than 100 (1.00):  Considered a “Debit” X-Mod in that the business will receive a debit (or surcharge) from the factor on their Workers Compensation Premium.  Example:  A business with an X-Mod of 1.13 would result in the business receiving a rate that is 13% higher than that of an “average” business.

The Previous Change

The last change to the California Experience Modification Factor calculation in went effective January 1, 2010 and increased the Primary Loss Threshold to $7,000.00.  At the time, it caused an effective rate increase across the marketplace on an almost blanket basis without the consent or contribution of any individual carriers.  Many businesses that are experience rated have not seen their Workers Compensation NET RATES (effective rate paid once all credits and debits are applied) decrease even though many carriers have taken compounding rate decreases across recent years.

Experience Modification Factor Calculation Change

Businesses that are experience rated are now subject to California’s New Variable Split Point Experience Rating System.  This means that as their payroll and operation grows, as will their Primary Loss Threshold.

The WCIRB recently adjusted its way of calculating an organization’s X-Mod by doing away with the fixed value for the Primary Threshold for Losses and replacing it with a formula that creates a sliding scale, Effective January 1, 2017.  This sliding scale is intended to give a larger Primary Threshold to larger employers (i.e. Organizations with larger payrolls).

The impact we’ve seen has been a compounding of the impact/magnitude of losses on an organization’s X-Mod, which in turn equates to a similar impact to their Workers Compensation premium.

mod formula

We recently witnessed one of our Nonprofit clients have an increase in their X-Mod of nearly 15% due almost entirely to the change in the calculation.  We’ve been working diligently with this Nonprofit as they have approx. 50 employees and volunteers and this 15% increase in their X-Mod will result in an increase in Workers Compensation premium of no less than $18,000 for just this year alone.

Matthew Davis

President

Third Party Action Over Liability – Business & Home Owners Sued for Worker Injuries

Third Party Action Over Liability – Business & Home Owners Sued for Worker Injuries

Are You Responsible For Business Employees At Your Home?

Many business and home owners assume that the employees of others are covered by workers compensation and that the workers compensation coverage protects them (the business/home owner) from liability should some else’s employee be injured.

This assumption is NOT correct!

Although California, like most states, has what is called an “exclusive remedy” rule which mandates that Workers’ Compensation benefits are the exclusive remedy for employees who are injured on the job, this liability protection does not automatically extend to third parties (i.e. business and home owners).

A Third Party Action Over claim occurs when an injured employee pursues damages from a third party (other than his/her employer).  Examples are provided below to show how a home owner (Example 1) and a business owner (Example 2) can be impacted by a third party action over claim.

Example 1:  A home owner hires an air conditioning repair person (an employee of the Air Conditioning Repair company) to fix a broken thermostat.  The repair person injuries his/herself while in the home by tripping over a child’s toy.  The repair person collects from his/her employer’s workers’ compensation policy and files a civil action against the home owner for the same injury.

Example 2:  An employee of a plumbing company is working on a jobsite along with a number of other contractors.  A framer carrying lumber drops the lumber on the plumber while he is working and injures him.  The plumber can collect from workers compensation and pursue civil action against the framer for the same injury.

*In the examples above, even if the employee does not pursue action against the third party, the workers compensation carrier for the employer may elect to subrogate against the third party for their negligence.

There are ways to reduce and/or eliminate one’s exposure to Third Party Action Over liability claims.  One of the most common ways of doing so is through contractual risk transfer.  Contractual risk transfer is the process of transferring a risk to another party by way of contact; in this case it is transferring the risk associated with a Third Party Action Over liability claim.

For a more detailed explanation of Third Party Action Over liability or Contractual Risk Transfer, please contact GDI Insurance Agency 1-888-991-2929.

Matthew Davis MBA, AAI