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