Self-Insurance Update & Trends for 2018

At the 2017 CWC and Risk conference Lyn Asio-Booz, Chief, California Office of Self Insurance Plans, Jon Wroten, Senior Vice President, Sedgwick CMS, and Joe Carresi, Manager, Workers’ Compensation, Southern California Edison discuss self-insurance trends for 2018. 
Benefits of self administration

• Advocacy based claims model
• Pharmacy benefit network
• Return to work programs
• Cognitive behavioral therapy program for pain
• Nurse case management program
• On call claim representative and nurse case manager
• Better benefit/leave coordination (occupational/non-occupational)
• Better ability to manage claims in terms of costs

Let’s look at a regulator’s perspective 

Office of Self Insurance Plans (OSIP) by the numbers

2015

4.33 MM covered employees

$219.2 BB payroll

191,514 injuries

Claims information 

Private 

3.35% injury rate

90,382 open indemnity claims

5.2 BB reserves

Public

5.60%

180,467 open indemnity claims

$8BB reserves

Future regulations includes but not limited to claims administration affects the reserves and security deposit. Important to focus on this since it does affect the reserves to much

Record keeping is important to keep control over the claims which in turn keeps your reserves more accurate.

Trends to look for over the next 12 to 18 months

California self-insurance influencers 

• Legislation/regulatory
• 2018 gubernatorial elections
• Increasing system transparency
• Soft market ending – rates increasing
• Aging workforce

National self-insurance influencers

• Economy and cost of capital
• Increasing dysfunction of WC system
• Innovation and technology
• Regulatory compliance and enforcement

National self-insurance issues to watch

• Option legislation
• Medical marijuana
• M&A activity
• Bankruptcy courts