Category Archives: HR Challenges

Why Job Descriptions Save Money On Workers Compensation Insurance

“Do I really need to write job descriptions?” We are asked this question constantly when we are setting up a workers compensation cost containment program. We say absolutely if you want to distinguish yourself AND save big bucks when you purchase workers compensation insurance!  Job descriptions are by no means required by the Dept of Labor, but they are enormously important to smooth and successful recruiting, hiring, and workers compensation claims processes.  They assist applicants in better understanding the position beyond the typical bullet points of a job posting. 

Hiring & Recruiting: From the initial job post on various posting sites like www.INDEED.com, to the interview and hiring stage it’s so important to be specific and communicate to your potential new hire/employee exactly what is expected of them. Typically a business is not hiring a one off for this position as they will most certainly hire more employees for this role in the future. Rather than re-invent the wheel, spend some time and really drill into the job description. It not only helps your potential hires select right fit for them, it will also help you think though what you want in your future employee.

Employee Injuries: We did an article about the most underutilized tool to gain a competitive advantage, this post might seem familiar. It was all about setting up a Return to Work Program also know as Transitional Duty. This is an extremely effective tool in controlling workers compensation costs.  One of the more important components of the Return to Work program is having a proper job description whereby your staff, the insurance carrier adjusters and the treating physicians can get a full understanding of what is entailed for your injured employee to execute their job function. In  absence of a thorough job description often times the treating physician will not authorize medical clearance for the employee to return to work which drives your workers comp costs up significantly. Further your staff and the carriers adjusters if they are fuzzy on job execution they will often arrive at the wrong answer.

It’s helpful if you have job descriptions already built for your potential alternative duty position too so the treating physician might consider this alternative duty job in lieu of their present job. If you want to know more about building out your own Return To Work Program CLICK HERE

Defining exempt vs. non-exempt:   Job descriptions are key to determining if a position qualifies as exempt (a.k.a. salaried without overtime) under the law.  Actual duties, not titles, drive this determination.  A job description that accurately reflects the realities of the day-to-day functions of a role can help you defend against any claims that an employee is being improperly denied overtime.

Identifying “essential functions”: The Americans with Disabilities Act (ADA), as well as many state anti-discrimination laws, requires employers to provide reasonable accommodation to employees with covered disabilities, provided the employee can perform the essential functions of the job.  A well-written job description is key for identifying those functions that are essential versus those that are marginal, incidental, etc.

Protecting against discrimination claims: Using job descriptions to compare an applicant’s experience, skills and credentials to the minimum qualifications of the job can aid in protecting an organization against claims that it excluded someone based on race, age or other protected class.  Skills and requirements should be identified as minimally required or preferred so it’s clear who meets the bona fide job criteria and who doesn’t.

Need more information on job descriptions? We have a job description tool builder as part of our THINK HR platform which is free to customers of Metropolitan Risk.  We would love to answer any questions you have and assist you in developing them for your organization. Contact Metropolitan Risk today at (914) 357-8444 or click here!

 

Best Workers Comp Class Codes For Adult Day Care Employees

Virtually every business with employees is required to have workers compensation insurance, as this is mandated by state law contingent on where your company operates it’s business.  It can be difficult to know what workers comp class codes for adult day care business should be used when first applying for a workers compensation policy. 

These are the most commonly used Adult Day Care workers comp class codes that are commonly used in New Jersey and New York:

 Workers Comp Codes for  Adult Day Care facilities in New Jersey:  

  • Code 8868 – Professional Employees & Clerical  
    • This classification has a lower rate and includes your office and medical staff such as administration, bookkeepers, nurses, therapists, and social workers.
  • Code 9106 – Non-Professional Employees & Drivers
    • This classification has a higher rate and includes all of your other employees such as aids and drivers.

Keep in mind that in New Jersey adult day care and senior care facilities provide much more skilled nursing and medical care than do adult day care facilities in states like New York. When selecting which codes to use be mindful of the skilled care versus unskilled care component. There is a significant workers compensation premium cost difference between these two classes of employees. Make sure you spend time on coding the employees correctly.

 

Workers Comp Codes for Adult Day Care facilities in New York:

  • Code 9063 – YMCA, YWCA, YMHA OR YWHA, Institution—All Employees—& Clerical
    • This classification typically has a lower rate includes virtually all your employees except for drivers.
  • Code 7380 – Drivers and Helpers NOC—Commercial
    • This classification has a higher rate and would typically be reserved only for your drivers.

These are the codes that typically are used and generate the bulk of the premium. However, there may be clerical codes for employees that only work clerical functions. There may be Executive Officer codes used for the owners or directors of the facilities. These are good to use for those folks as typically their payroll is capped to a maximum amount. This will vary by state. To truly understand how these codes are used and deployed you must refer to your state’s workers compensation rating boards rules and regulations. There each code has a description for how it’s applied. Similarly to the above example in New Jersey be mindful of the skilled versus non skilled medical component.

Careful about shifting payroll from one class code to another purely because it’s cheaper. In certain states like NY they come down hard on companies that unwittingly evade rates through code shifting. They consider that insurance fraud, which may be a felony in states like NY. So definitely stay away from that!

Finally, in New York you might be eligible for the Safe Patient Handling Credit which is an additional 2.5% off the premium.

 

If you have questions or simply want more information, call a Risk Advisor @ (914) 488-4164.

 

 

 

 

Workers Compensation Insurance for Leased Workers

Many companies are increasingly turning to staffing agencies where they lease employees to meet their needs for a variety of reasons, including increased workloads and high employee turnover rates. Companies that use staffing agencies can save money because they avoid selecting, hiring and training new full-time employees. In addition, using staffing agencies frequently offers companies peace of mind because they know that workers will show up and perform their duties consistently. The question becomes when you employ leased workers from a third party who provides workers compensation insurance for leased workers?

But what happens if one of the staffing agency workers is hurt on the job? Who is responsible for covering the injury? What if the injured worker wants to sue the staffing agency’s client company for negligence? Answering these questions requires a thorough understanding of the employment relationships between the staffing agency worker and the client company. And the way employees are classified affects how the staffing agency and the client company’s workers’ compensation and commercial general liability (CGL) policies apply to work-related injuries.

Workers’ Compensation Versus Commercial General Liability Insurance   

Generally, companies are required to cover an injured employee’s medical treatment and lost wages through a workers’ compensation policy. This is a system of no-fault insurance that affords employees some security while recovering from work-related injuries. In exchange for these benefits, employees waive their right to sue their employers for negligence and related damages. Workers’ compensation provisions apply only where an employer-employee relationship exists between a company and its workers.

Commercial General Liability Insurance policies or CGL for short protect companies when third parties (non-employees) are hurt because of the company’s negligence or misconduct. The issue of liability is particularly important for companies with staffing agency workers because it is not always clear whether an employment relationship exists between the company and the staffing agency workers. To fully appreciate the complexity of the issue, companies must be able to properly classify staffing agency workers as either leased workers or temporary workers.

Leased Versus Temporary Workers Compensation

The definitions for leased and temporary workers vary from state to state, so an adequate classification of staffing agency workers requires a solid understanding of state and local requirements.

For CGL purposes, a leased worker is an individual leased to a client company by a labor leasing firm under an agreement between the company and the labor leasing firm to perform duties related to the conduct of the company’s business. The leased worker category does not include temporary workers. Under this definition, leased workers are considered employees of the client company and are, therefore, excluded from the client company’s CGL.

CGL policies define a temporary worker as an individual furnished to a client company to substitute for a permanent employee who is on leave or to meet the company’s seasonal or short-term workload conditions. Temporary workers are considered employees of the staffing agency and are covered by the staffing agency’s workers’ compensation policy and could be covered by the client company’s CGL.

The Coverage Gap

An insurance coverage gap exists when a leased employee is injured while in the client company’s employ. Leased employees are considered to be employees of the client company for CGL purposes, but they may not necessarily qualify as employees under applicable workers’ compensation regulations.

This results in employing individuals who could sue the client company for negligence (because they are not limited by applicable workers’ compensation provisions). A company with no CGL coverage must pay any court-ordered damages (because CGL coverage does not apply to the company’s employees).

Further it’s important to beware that many commercial general liability policies; especially construction general liability policies specifically exclude temporary or leased workers  further exacerbating the commercial general liability coverage gap.

Solutions to the Coverage Gap

To bridge the gap created by leased workers and or temporary workers companies can look at shifting work-related injury liability to the staffing agency through an alternate employer endorsement or an extension of their CGL coverage to injury to leased workers.

  • Alternate Employer Endorsement

Client companies can negotiate with staffing agencies to include an alternate employer endorsement on the staffing agency’s workers’ compensation and employer liability policies. This endorsement protects the client company, providing coverage to the client company in the case of a tort action and by giving the client company all the workers’ compensation coverage the staffing agency enjoys.

  1.   Coverage for Injury to Leased Workers

This endorsement can be added to the client company’s CGL policy by changing the language that excludes leased workers and temporary coverage from CGL coverage. However, companies should recognize that insurance carriers will disfavor this solution as it effectively removes an exception they intentionally built into the CGL policy.

Lastly and most importantly it’s imperative that you speak with a Risk Advisor and lay out exactly what your plan is and why. Insurance is always a trailer and never a leader. Your insurance program should be designed to how you are effectively executing your business. If this is not properly communicated to your agent or broker chances are your current insurance program will fail when a claim occurs. If when you communicate your business plan to your broker the response you get back doesn’t bring clarity to a level of comfort that they understand this nuance it may be time to select a Risk Advisor instead of your current brokerage relationship.

Purchasing EPLI Insurance Coverage Can Protect You With Respect To NJ Wage and Payment Requirements

When evaluating your insurance program an often overlooked coverage is Employee Practices Liability Insurance, or EPLI for short. Failure to properly pay a fair wage and calculate time worked including time off can land any unsuspecting business owner in trouble with the Department of Labor.

In New Jersey, for example, wage payment laws might not be exactly what you expect. Several federal laws regulate wage payments, including the Fair Labor Standards Act (FLSA), the Davis-Bacon Act, and the Service Contract Act. New Jersey law also imposes state wage payment requirements. When federal and state laws differ, the law that is more favorable to the employee will apply.

The New Jersey Department of Labor and Workforce Development (LWD) enforces wage payment requirements throughout the state.

Method of Payment  

New Jersey law requires employers to pay wages in lawful United States currency by:

  •         Cash;
  •         Check;
  •         Payroll debit card; or
  •         Direct deposit.

 

Employers may use payroll debit cards to pay their employee’s wages if they can ensure that each employee can make at least one withdrawal or transfer per pay period without incurring any costs to the amount contained on the card.

In addition, employers must secure each employee’s written authorization before using payroll debit cards. Employee consent must not be a condition of employment nor be obtained through duress, intimidation, or coercion.

Frequency of Payment

In general, employers must pay employee wages at least twice per month on established paydays, designated in advance by the employer. Employers can establish regular paydays once per month for executive, supervisory and other special classifications of employees. Railroad, express, car-loading, and car-forwarding employers must pay their employees at least once per week.

Regular paydays must generally take place within 10 calendar days after the end of the pay period. If a payday falls on a weekend, holiday or other non-working day, employers must pay wages on the working day immediately prior to the non-working day.

Collective bargaining agreements can override the frequency of employee wage payments.

Last Payment of Wages

Employees separated from their employers, whether by discharge, voluntary resignation, or any other reason are entitled to receive their unpaid wages by the next regular payday. If an employee’s wages are paid in part or in full on an incentive system (such as commission), the employer must pay a reasonable approximation of all wages due until the exact amount is computed.

However, when an employee departs because of a labor dispute which involved employees who processed payroll information, the employer has an additional 10 days to pay that employee’s last wages.

In the event of the death of an employee, all outstanding wages may be paid directly to the person who pays for the funeral expenses or to the decedent’s surviving spouse, children over the age of 18 (or their legal guardians, if they are under 18 years of age), parents or siblings.

Disputed Wages

In case of a dispute over the amount of wages due to an employee, an employer must pay any undisputed portion of the employee’s wages in accordance with the regulations described above. In doing so, the parties to the dispute do not waive their right to collect or dispute the remaining balance.

Withholdings and Deductions

Can an employer withhold pay in New Jersey? Yes, they may withhold or divert a portion of an employee’s wages when (1) required or allowed by law (state or federal), (2) necessary to correct a payroll error or (3) authorized by the employee or a collective bargaining agreement.

Payroll deductions authorized by employees or collective bargaining agreement must be in writing and for a lawful purpose accruing to the employee’s benefit, such as:

  •         Contributions to employee welfare, insurance, hospitalization, medical or surgical, pension, retirement and profit-sharing plans;
  •         Contributions to company-operated thrift plans;
  •         Purchase of security options and company stock;
  •         Payments into employee personal savings accounts;
  •         Payments for company products, employer loans to employees, work-safety equipment and replacing an employee identification;
  •         Installment payments to satisfy a financial obligation owed by the employee to the state;
  •         Payments for the purchase of U.S. government bonds;
  •         Donations to charitable institutions and political committees (certain conditions apply);
  •         Payments for the rental or cleaning of work clothing and uniforms;
  •         Labor organization dues, union initiation fees and other labor organization charges permitted by law;
  •         Payments for health club membership fees or child care services;
  •         Mass transportation commuter tickets or other employer-provided transportation, if available to all employees; and
  •         Any other deductions allowed by the LWD.

Employers must record each withholding accurately. Unless authorized by law, wage deductions and withholdings cannot reduce an employee’s gross wages below the minimum wage rate. Employers may not derive any financial gain from making wage deductions.

Statements

Employers that pay their employees through direct deposit or with a payroll debit card must provide each employee with a statement that shows all deductions taken from the employee’s wages at the time the wages are paid.

More Information

Need more information on how EPLI Insurance can protect your business? CLICK HERE or contact Metropolitan Risk Advisory at (914) 357-8444 for more information on wage payment and work hour laws in New Jersey.

Looking for the Root Cause Of Your Problem ? Try Why Analysis

Remember when your kids annoyed you by responding to everything you said with “Why?” Well, there was a genius to that tactic only children can impart.  The 5-Why Analysis is a method used to determine and understand the root cause of a problem by repeating the question “why?” five times. Each answer forms the basis of the next question.

There are no hard and fast rules about what questions to explore, or how long to continue the search for additional root causes (e.g. asking “why?” seven or eight times instead). Therefore, the outcome of the analysis will always depend upon the knowledge and persistence of the people involved.

Here is a relatively simple example of Why Analysis:

Problem: The car will not start!

  1. Why? – The battery is dead. (First why)
  2. Why? – The alternator is not functioning. (Second why)
  3. Why? – The alternator belt has broken. (Third why)
  4. Why? – The alternator belt was well beyond its useful service life and not replaced. (Fourth why)
  5. Why? – The vehicle was not maintained according to the recommended service schedule. (Fifth why, a root cause)

Just as annoying children so often do, it would be easy to continue asking “why?” in order to delve even deeper into the problem. However, five repetitions will generally suffice in leading to a root cause.

About Why Analysis

It is important to note that the determined root cause should almost always point toward a process that is not working well or does not exist, rather than something simple and generally uncontrollable such as “There wasn’t enough time.” Answers that are out of our control are not helpful; further in most cases what you will discover in your 5 Why Root Cause Analysis is a failure of process, which is the ultimate goal. You can’t manage and improve what you don’t know.

The developer of the 5-Why Analysis method  Sakichi Toyoda was head of the Toyota Motor Corp who used this method to great effect. Toyoda has some helpful tips and strategies to think about when performing “ Why Analysis”:

  • Use paper or whiteboard instead of computers
    • Writing the issue helps you formalize the problem and describe it completely. It also helps a team focus on the same problem
  • Look for the cause step by step. Don’t jump to conclusions.
  • Base our statements on facts and knowledge; not conjecture.
  • A root cause should never be something as simple as “human error” or “workers’ inattention”

The Why Analysis can be used in day to day business life, and is especially helpful when dealing with persistent problems that never seem to go away. Stubborn and recurrent problems are often so because they contain deeper issues, and “quick fixes” only solve the surface issues.

Need help dissecting and solving a recurring problem safety or employee injury problem? Don’t hesitate to call us at (914) 357-8444. We have  been invited into thousands of businesses to break down their challenges and help solve for “x” , usually high insurance costs driven by claims. We will help you get to the why that much quicker. Time is money, gives us a call.  

 

Late Reporting of Employee Injuries will Lead to NY Workers Comp Board Fines

At Metropolitan Risk, our best practice clients understand the critical importance of getting employee injuries into the workers compensation system. Each injury that goes undetected or unreported costs the employer up to 39% more for the same exact injury if unreported for more than 4 weeks. This is why Day of Injury protocol can be such a powerful tool if your goal is to lower the high cost of employee injuries.  Recently timeliness has become even more imperative as failure to comply with timely injury reporting not only drives your workers compensation costs up, it will now be a fineable offense through the eyes of the NY State Workers Compensation Board.

From Then to Now

In June of 2013, the eClaims for First Report of Injury (eFROI) was initiated which required all New York State Insurance Fund policyholders to report electronically all “First Report of Injuries” In addition, an expectation that all carriers not just the NYSIF will move to this electronic reporting platform. This eFROI mandate was went into effect on April 23rd, 2014. As a part of this mandate, effective May 23rd, 2014, all employers are required to use Form C-2F, which replaced Form C-2.

As of October 1st, 2015, the Board announced strict enforcement of  timely reporting ; assessing all available statutory penalties to EMPLOYERS for non-compliance in reporting claims.Fines range from $1,000 to $2,500 for late reporting of workplace injuries.  

What Should You Do About This?

Minor Incidents (Internal Incidents Only):

For all incidents that have resulted in a minor injury that only requires first aide of 2 or less treatments and/or lost time of not more than one day beyond the day or shift when the injury had taken place, you MUST complete Form C2-F which is a formal notice of incident. This form does NOT get submitted to the carrier or the NY State Workers Compensation Board. It must be kept in an internal file for no less than 18 years, love that, UGH! If you are a client of Metropolitan Risk it should be attached to the incident record in our portal for safe keeping, please retain your own copy for your internal records. This should be submitted to Metropolitan Risk within 24 hours of the incident.

Filing A Formal Claim:

If your employee has been injured, reported the incident to someone on your staff AND it DOES NOT fit the criteria of a MINOR INCIDENT (see above) you must complete and file a C2-F and submit to your workers compensation carrier of record. Please supply Metropolitan Risk a copy so we don’t keep pinging reminders at you that it needs to be done.

Please note if you are insured with the New York State Insurance Fund you must report the claim electronically by clicking HERE as they do not accept paper forms.

If you neglect to report the CLAIM via the C2-F Form or the NYSIF’s (eFROI)  within 10 days, the New York State Workers Compensation Board may be sending unwitting employers penalties for late reports per the aforementioned change of policy on October 1st , 2015.

New York State has secure procedures in place that allows them to track just how timely you are reporting claims. They have the power to issue a $1,000 fine or a $2,500 penalty directly to your company which maybe the policyholder of record if you neglect to report the claims within 10 days.  We are curious as to how this will be enforced as quite often the employers are not the first to know of a worker’s injury. Thus we recommend that a notice be placed inside each worker’s pay slip advising them that all workplace injuries MUST be reported within 10 days of the injury to be considered and leave it at that. Just to reinforce it. We are not certain how the State will rule when an employee reports an injury. We have inquiries into the State and will issue an advisory to clear some of these ambiguities up.

So, what should you do about all of this? Best practice firms in any industry will make sure to report all incidents to us within 24 hours. We will then guide you when we think it should be reported up to the carrier so as not to trigger a potential fine and reserve your rights as a policyholder.  As of October 1st, 2015 it’s not only a requirement of your workers’ compensation policy, but also the law in New York State.

Coming Soon: The Easiest Way to Report Claims:

We expect to have our mobile app deployed soon, which lets all stakeholders know an employee was potentially injured so our team and yours can jump on the incident. It will also guide you to the nearest medical center. You may even have an account right within the app.

We are also changing our incident reporting procedures for all client HR point people at the client level. You will be reporting the incidents directly into our website which is built to match the C2-F. Once complete you hit a button, the C2-F form will print for your 18 year record. Should we have to report this incident to the carrier we have all the info in our system and can report for you directly so you will be in compliance.

As of this writing we are still building the back end of the system. Until this is deployed, you will be responsible for reporting to the carrier directly as only you have the payroll records, etc.

We hope you find this notice helpful as we are continually working to make your lives more efficient. Any suggestions or recommendations are always welcomed. Thank in you in advance for your cooperation with these new changes in the rules and regulations with respect to NY Workers Compensation Insurance. Just want to be sure all our clients are up to date with the latest and greatest.

To download the C2-F Form directly, click here.

 

Kind regards,

Lisa Schorfheide

(914) 357-8444

lisas@metropolitanrisk.com

Claims Advocacy Supervisor &

Your Metropolitan Risk Claims Advocacy Team

 

Overtime Pay: The Exposure You May Overlook

As a business owner the responsibility of providing a safe, positive, and comfortable work environment falls on your shoulders. The unfortunate reality is that these responsibilities are not always upheld or maintained. To help protect businesses from harmful claims that may arise from a multitude of situations, the Employment Practices Liability Insurance (“EPLI”) policy would come into play. The EPLI policy provides coverage for wrongful acts during the

employment process, with the common claims being wrongful termination, discrimination, sexual harassment, and retaliation.

As part of this policy an insured business has the option to enhance coverage via the (unappreciated and undervalued) Wage and Hour Endorsement. This endorsement provides the named insured coverage for the cost of defending claims alleging failure to pay overtime to a nonexempt employee, with settlements of said claims generally excluded.

Why discuss this coverage now? In recent days President Obama has set his sights on raising the overtime pay threshold for wage and hour employees working 40+ hours per week, with plans for the change to take effect in 2016. Under the Fair Labor Standards Act employers are required to provide overtime pay to employees who work 40+ hours a week, with executives and managers being exempt from the requirement (these individuals are generally earning higher salaries). The target is to raise the threshold for the first time since 1975 from $23,660 to $50,440, more than doubling it.

With the increase in threshold we can expect to see an increase in wage and hour claims as many employers may not be immediately aware of their obligation. In an effort to better protect the company which you have worked so hard in growing, it may be worth:

  1. Familiarizing yourself with the coverage
  2. Discussing coverage options with an insurance professional
  3. Exploring the market for coverage options and pricing

No business owner wants to enter a legal battle, but if required, wouldn’t you sleep better knowing that coverage is in place to help protect your investment?

Does it Make Sense to Pay Injured Employees Twice or Even Three Times?

Unfortunately this is a question facing both interstate and intrastate trucking companies whose home office is in state “A” but they operate in states B,C,D,E. etc… These companies face what is called Multi-State Exposure. This occurs when a driver gets injured on the job in a different state from which his company is domiciled. What nobody tells these companies is that the driver has the ability to receive benefits from more than one state on your dime!

Competitive rates for Workers Comp Insurance in the trucking industry are difficult to obtain due to the difficulty the underwriter faces assessing the risk. Add multiple state workers comp laws into that equation and you have a recipe for high premiums, open claims and payouts that are double and even triple what they should be.

When an out of state claim happens, two jurisdictions come in to play. If the claim is handled by the company’s home state the driver will retain legal counsel in the state in which the injury occurred.  Once qualified to receive benefits from the home state, the driver can go the state where the injury occurred and receive additional benefits. This is known as “Piggybacking.” This is the cost of not fully comprehending the Workers Comp Laws in the states you operate in and this can certainly be an expensive lesson.

Continue reading Does it Make Sense to Pay Injured Employees Twice or Even Three Times?

Did You Receive a Letter Regarding NY Department of Labor ICR 59?

Did you know if your company is located in New York, has annual payroll over $800,000, and a workers comp experience mod. over 1.20, you are required to go through safety procedures?

It’s true. In 1996 Gov. Pataki signed into Law Legislative Bill 111331 intended to improve workplace safety and control the cost of workers compensation insurance. The New York Compensation Insurance Rating Board (NYCIRB) sends out quarterly letters like this one: Compulsory Workplace Safety and Loss Prevention Program, and Q3 is here so many companies just got slapped with these notifications they had no idea were coming. If you’re one of them don’t feel like you missed something, the program is small and not well advertised. Even many insurance brokers haven’t heard of it until a client brings the letter to their attention. That doesn’t mean it’s not important though.

ICR 59 requires you go through a safety and loss prevention consultation and evaluation within 75 days of notification. Within 6 months you must comply with all the consultant’s recommendations. If you fail to get in compliance with the program you will face increased surcharges to your workers comp premium(on top of your already high experience mod.)

If you got the letter, contact us, we’ll get you in compliance. If you didn’t, consider yourself lucky. If your mod is nearing 1.20 we recommend contacting a Risk Advisor and putting together a strategy to prevent any further increase. For more information on ICR 59, including the compliance timeline, please click here.