CIRB California. All Rights Reserved. WCIRBCalifornia ® Workers’ Compensation Workers’ Compensation Reform Impacts on Loss Reform Impacts on Loss Development Patterns Development Patterns Casualty Loss Reserve Seminar, September Casualty Loss Reserve Seminar, September 2007 2007 Michelle Sheng, FCAS, MAAA Michelle Sheng, FCAS, MAAA WCIRB of California WCIRB of California
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Workers’ Compensation Reform Impacts on Loss Development Patterns
Workers’ Compensation Reform Impacts on Loss Development Patterns. Casualty Loss Reserve Seminar, September 2007 Michelle Sheng, FCAS, MAAA WCIRB of California. Agenda. Recent California WC Reforms Areas of Impact - overall cost level: by provision - payment patterns - PowerPoint PPT Presentation
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Recent California WC ReformsRecent California WC Reforms
Assembly Bill No. 749 HighlightsAssembly Bill No. 749 Highlights
- Changes to maximum and minimum - Changes to maximum and minimum weekly indemnity benefits over 4 yearsweekly indemnity benefits over 4 years
- Annual cost of living adjustments on - Annual cost of living adjustments on Permanent Total & life pension benefitsPermanent Total & life pension benefits
- Repealed primary treating physician - Repealed primary treating physician presumption (under certain presumption (under certain circumstances)circumstances)
Recent California WC ReformsRecent California WC Reforms
Assembly Bill No. 227/Senate Bill No. 228 Assembly Bill No. 227/Senate Bill No. 228 HighlightsHighlights- Replacement of vocational rehabilitation - Replacement of vocational rehabilitation benefits with nontransferable education benefits with nontransferable education vouchersvouchers- Changes to physician, hospital, surgical - Changes to physician, hospital, surgical facility and pharmaceutical fee schedulesfacility and pharmaceutical fee schedules- Adoption of ACOEM medical treatment - Adoption of ACOEM medical treatment guidelinesguidelines- Limitation of number of chiropractic and - Limitation of number of chiropractic and physical therapy visitsphysical therapy visits
Recent California WC ReformsRecent California WC Reforms
Senate Bill No. 899Senate Bill No. 899- Two-year cap on temporary disability - Two-year cap on temporary disability paymentspayments- Apportionment of permanent disability - Apportionment of permanent disability benefitsbenefits
- Change in scheduled # of weeks of PD- Change in scheduled # of weeks of PD- Multi-tiered PD benefits- Multi-tiered PD benefits- PD Rating Schedule- PD Rating Schedule- Establishment of medical provider - Establishment of medical provider networks and independent medical reviewsnetworks and independent medical reviews
Impact of Reforms on Loss Impact of Reforms on Loss DevelopmentDevelopment
History No Longer Representative of FutureHistory No Longer Representative of Future Different Impact on Indemnity versus MedicalDifferent Impact on Indemnity versus Medical Reforms Expected to Reduce Payment Reforms Expected to Reduce Payment
DurationDuration
- Medical treatment reforms- Medical treatment reforms
Impact of Reforms on Loss Impact of Reforms on Loss DevelopmentDevelopment
IndemnityIndemnity Impact Varies by Accident YearImpact Varies by Accident Year Apply Duration and/or Compensation Apply Duration and/or Compensation
Change to Payment Pattern by Type Change to Payment Pattern by Type of Benefit (death, permanent total, of Benefit (death, permanent total, permanent partial, temporary, life permanent partial, temporary, life pension, vocational rehabilitation)pension, vocational rehabilitation)
Retroactive Impact of PDRSRetroactive Impact of PDRS
Impact of Reforms on Loss Impact of Reforms on Loss DevelopmentDevelopment
MedicalMedical Many Reform Impacts by Year of Payment, Many Reform Impacts by Year of Payment,
Regardless of Year of AccidentRegardless of Year of Accident Adjust Pre-SB 228 Fee Schedule Losses to Adjust Pre-SB 228 Fee Schedule Losses to
SB 228 Fee Schedule Level to Create SB 228 Fee Schedule Level to Create Consistent Development Triangle Consistent Development Triangle
Impact of ACOEM Guidelines and Medical Impact of ACOEM Guidelines and Medical Provider Networks on Utilization of Provider Networks on Utilization of Medical Services for AY2004 and PriorMedical Services for AY2004 and Prior
Hypothesis B: Change in Claims Mix Hypothesis B: Change in Claims Mix (Distribution of Claims among Injury (Distribution of Claims among Injury Types)Types)
WCIRB Loss Development StudyWCIRB Loss Development Study Annual Report since 2005Annual Report since 2005 Overall Impact by Provision Based on Law Overall Impact by Provision Based on Law
Evaluation Model simulating reform Evaluation Model simulating reform provisions using actual data, outside provisions using actual data, outside expertise, etc.expertise, etc.
Payment Patterns Adjusted Based on Payment Patterns Adjusted Based on Applying Provision Impact to Historical USR Applying Provision Impact to Historical USR and Call Dataand Call Data
Indemnity and Medical Payment Patterns Indemnity and Medical Payment Patterns Adopted in WCIRB Pure Premium Rate FilingsAdopted in WCIRB Pure Premium Rate Filings
Available on www.wcirbonline.orgAvailable on www.wcirbonline.org
Caveats/PrecautionsCaveats/Precautions Unmeasurable ProvisionsUnmeasurable Provisions Provisions Not RealizedProvisions Not Realized Unanticipated Court Decisions and AppealsUnanticipated Court Decisions and Appeals
- Apportionment provision: % or $?- Apportionment provision: % or $?
- Pendergrass: 1- Pendergrass: 1stst TD payment or 1 TD payment or 1stst med- med-legal report?legal report?
Great Uncertainty on Implementation, Great Uncertainty on Implementation, Regulation and Judicial InterpretationsRegulation and Judicial Interpretations