Appendix C
Comparison of a PEO guaranteed cost program with generalized typical
examples of other forms. This comparison
does not replace your responsibility to compare the forms of various loss sensitve and alternative risk financing methods. Do your own work. This is intended to
be a generalized guide, and is not going to be accurate in every case, as some
forms may vary from this generalized presentation.
|
HCO - 6 months control of
treating doctor |
YES |
If it is available, there will usually be an extra charge
incurred. |
If it is available, there will usually be an extra charge
incurred per employee, per month. |
If it is available, there will usually be an extra charge
incurred per employee, per month. |
If it is available, there will usually be an extra charge
incurred per employee, per month. |
If it is available, there will usually be an extra charge
incurred per employee, per month. |
|
Drug and alcohol testing
expenses included in premium |
YES |
Usually for extra chage, if available |
Usually for extra chage, if available |
Usually for extra chage, if available |
Usually for extra chage, if available |
Usually for extra chage, if available |
|
Background Checking expenses included in premium |
YES |
Usually for extra chage, if available |
Usually for extra chage, if available |
Usually for extra chage, if available |
Usually for extra chage, if available |
Usually for extra chage, if available |
|
Pay Roll Service |
YES |
Not usually available |
Not usually available |
Not usually available |
Not usually available |
Not usually available |
|
IRS & State tax and
regulation administration and responsibility |
YES, except ultimate responsibility for OSHA |
Not usually available |
Not usually available |
Not usually available |
Not usually available |
Not usually available |
|
Employee Staffing Availibility |
YES |
Not usually available |
Not usually available |
Not usually available |
Not usually available |
Not usually available |
|
Over 97
% of claimants either closed or back to work after 6 months of injury. |
YES - extremely successful at this |
TBD |
TBD |
TBD |
TBD |
TBD |
|
CEO
scrutiny of each claim |
YES |
Never heard of this being done except at BBSI |
Never heard of this being done except at BBSI |
Never heard of this being done except at BBSI |
Never heard of this being done except at BBSI |
Never heard of this being done except at BBSI |
|
Deposit |
NO,
depending on credit history |
YES,
usually at least 10% of estimated annual premium |
YES,
usually at least 10% of estimated annual premium |
YES,
usually at least 10% of estimated annual premium |
YES,
usually at least 10% of estimated annual premium |
YES,
usually at least 10% of estimated annual premium |
|
Audits |
NO |
Usually |
Usually |
Usually |
Usually |
Usually |
|
LOC Required |
NO |
NO |
YES |
Usually |
Occasionally |
YES,
usually |
|
Cash tied up in loss fund, to pay claims |
NO |
NO |
YES |
Usually |
Occasionally |
YES |
|
Human Resources, (in addition to claims
management and loss control), Services included within premium |
YES |
Not
usually available |
Not
usually available |
NO |
NO |
Not
usually available |
|
401K / and health Insurance available in program |
YES |
NO |
NO |
NO |
NO |
NO |
|
Pay for your all of, or a portion of your own
claims, in addition to premium |
NO
You will not be required pay for any of your own claims as you will in other
forms |
NO
You will not be required pay for any of your own claims as you will in other
forms |
YES, subject to a maximum amount, significantly
above your estimated premium |
YES, subject to a maximum amount, significantly
above your estimated premium |
YES, subject to a maximum amount, significantly
above your estimated premium |
YES, subject to a maximum amount, significantly
above your estimated premium |
|
ash flow advantage of paying a low beginning
estimated annual premium, delaying the ultimate cost of losses, Collateral
use, LOS's, cash loss funds, etc.until
subsequent years. |
No cash
flow advantge. This is a
guaranteed cost program. Their estimateed annual premium will usually be higher than the
starting cost of a loss sensitve plan. They offer a signifcant
loss incentive, so there is possible return of premium. Ultimate costs after all claims are paid, may be lower than other plans, including loss
sensitive plans. |
No cash
flow advantge. This is a
guaranteed cost program. Their estimateed annual premium will usually be higher than the
starting cost of a loss sensitve plan. They offer a signifcant
loss incentive, so there is possible return of premium. Ultimate costs after all claims are paid, may be lower than other plans, including loss
sensitive plans. |
Costs usually about the same as a
guaranteed cost plan, going in. Ultimate costs may be higher, or claims,
depending on losses and investment income, if any. Ultimate costs much less predictable than
with guaranteed cost program. |
YES
Costs usually lower going in, compared to a guaranteed cost plan. Ultimate costs may be higher, depending on
claims. Ultimate costs
harder to predict than with guaranteed cost program. |
usually NO, pay everything up front, usually in
same range as guaranteed cost programs,
with possibility of return or additional premium after all claims are
closed. |
Costs usually about the same as a
guaranteed cost plan, going in. Ultimate costs may be higher, or claims,
depending on losses and investment income, if any. Ultimate costs much less predictable than
with guaranteed cost program. |
|
Loss performance can create a need for additional premiums, even
several years later. Ultimate cost not
determined for several years. |
NO
- Ultimate cost will be what is paid the first year, (subject to payroll and
mod variation, of course), in the form of a guaranteed cost plan, with the
exception of the possible return of some premium, depending on claims'
performance. |
NO
- Ultimate cost will be what is paid the first year, (subject to payroll and
mod variation, of course), in the form of a guaranteed cost plan, with the
exception of the possible return of some premium, depending on claims'
performance. |
YES - Considerable additional premium, over the first year pay in, may be
required, depending on claims performance |
YES - Considerable additional premium, over the first year pay in, may be
required, depending on claims performance |
YES - Considerable additional premium, over the first year pay in, may be
required, depending on claims performance |
YES - Considerable additional premium, over the first year pay in, may be
required, depending on claims performance |
|
Capitalization (start up) charges |
NO |
NO |
YES |
NO |
NO |
YES |
|
Possible joint liability exposure,
and financial responsibility for other's losses. |
NO You are alone in
your premium and loss experience. |
NO You are alone in
your premium and loss experience. |
Usually
YES, have shared financial responsibility, usually jointly and severable
liable. |
Usually
NO You are
usually alone in your premium and loss experience. |
Usually
NO You are
usually alone in your premium and loss experience. |
Usually
YES, have shared financial responsibility, usually jointly and severable
liable. |
|
Have to take on the shared responsibility of
administering the program, including money management, investments, claims
administrators, brokers, Loss control, and reinsurenace |
NO |
NO |
YES |
NO |
NO |
YES |
|
Possible legal responsibility for how claims are
handled |
NO |
NO |
YES |
NO |
NO |
YES |
|
Registration, legal and audit fees |
NO |
NO |
YES |
YES |
YES |
YES |
|
Loss fund $ tied up for years |
NO |
NO |
YES,
ususally |
YES,
ususally |
YES,
ususally |
YES,
ususally |
|
Possible reduction of annual premium, compared to
a guaranted cost plan, if claims justify a return |
YES,
in the form of a loss incentive |
NO |
YES |
YES |
YES |
YES |
|
LOC usually required, held for several years,
reducing credit line, will multiply at renewals |
NOT
usually |
NO |
YES |
YES,
usually |
SOMETIMES |
YES |
|
Claims performance can cause an additional
premium chargefor the year in which the claims
occurred |
NO |
NO |
YES |
YES |
YES |
YES |
|
Long term commitment / process because of claims
development |
NO,
one year only |
NO,
one year only |
YES |
YES |
YES |
YES |
|
The claims performance of others in your inxuring entity can affect your ultimate costs. |
NO |
NO |
YES |
NO |
NO |
YES |
|
Loss Fund required for claims, in addtion to premium |
NO |
NO |
YES |
YES
usually |
Not
usually |
YES |
|
Penalty for early, mid term cancellation |
NO,
all that is required is 30 days written notice - no penalty |
Yes,
$ penalty involved |
YES,
often difficult and expensive to cancell mid term. |
YES,
often difficult and expensive to cancell mid term. |
YES,
often difficult and expensive to cancell mid term. |
YES,
often difficult and expensive to cancell mid term. |
|
Group $ assessment possible for various reasons |
NO |
NO |
YES |
NO |
NO |
YES |
|
Collateral required |
NO |
NO |
YES |
Sometimes |
Sometimes |
YES |
|
Quality of Reinsurer |
AIG
- A+ XV |
Varies
- TBD |
Varies
- TBD |
Varies
- TBD |
Varies
- TBD |
Varies
- TBD |