Integrated MediCompsm

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Presentation transcript:

Integrated MediCompsm Integrated Health and Workers’ Compensation 24 -hour Coverage for Small Group Health care plans provided by Anthem Blue Cross. Insurance plans provided by Anthem Blue Cross Life and Health Insurance Company. Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensees of the Blue Cross Association. ® ANTHEM is a registered trademark. ® The Blue Cross name and symbol are registered marks of the Blue Cross Association. Employers Compensation Insurance Company is a separate entity that does not offer blue branded products or Services.

Anthem Blue Cross Highlights Since 1937, Anthem Blue Cross has provided quality and affordable health plans to the people of California. More small businesses in California choose Anthem Blue Cross plans than any other carrier. Anthem Blue Cross is the leader in innovative health coverage. Anthem Blue Cross’ Group Program offers large and small businesses more plan flexibility than any other carrier in the state. Anthem Blue Cross and EMPLOYERS® work together to offer a highly innovative and unique integrated product. 1/14/2019

Workers’ Compensation coverage is provided through EMPLOYERS®* * Employers Compensation Insurance Company is a separate entity that does not offer blue branded products or Services. 1/14/2019

EMPLOYERS®, a leader of knowledge, innovation and expertise. A full service workers’ compensation insurance company that provides you with the stability and dependability you should expect. At EMPLOYERS®, we measure our success with the satisfaction level of our customers. Our primary mission is to help you sharpen your competitive edge by providing you with a service orientated market and a highly technical and professional staff. EMPLOYERS®, a leader of knowledge, innovation and expertise. 1/14/2019

Integrated MediCompsm Offers you: An additional source of revenue - your commission for selling Integrated MediCompsm is up to 12.5% of the earned premium. Increased client retention - proven results due to easy product accessibility. Greater client satisfaction - help your clients get comprehensive coverage while saving them money. 1/14/2019

Integrated MediCompsm Advantages to the Employer Our Managed Care Provider Network for both personal health and workers’ compensation coverage Over 49% of workers’ compensation costs are medical expenses. Using the Anthem Blue Cross negotiated network fees, the employer has the potential for long-term savings on workers’ compensation premium and the employee is afforded high quality essential care from the Anthem Blue Cross Networks. A variety of Anthem Blue Cross health plans and programs Premiere no-deductible PPO Advantage no-deductible PPO Classic no-deductible PPO HMO’s Basic Hospital Plan Mix and Match Employee Elect Employee Choice BeneFits 1/14/2019

Integrated MediCompsm Advantages to the Employer Premium Savings 10% savings on workers’ compensation for both new and existing qualifying customers Up to a 10 point reduction on the Anthem Blue Cross Small Group R.A.F. Ease of Administration Anthem Blue Cross Small Group and EMPLOYERS® are both located in Newbury Park Combined Bill Pay workers’ compensation premium monthly along with health premium. 1/14/2019

Integrated MediCompsm Advantages to the Employer Increased Employee Satisfaction Greater security and satisfaction with health care, coordinated by the occupational network physician. Access to non-occupational specialists where they are best suited to meet the employee’s medical needs. Return to Work Program – Anthem Blue Cross and EMPLOYERS® work together with participating Network Physicians to help regain the health of the employee and return the employee to work. Increased employee satisfaction results in decreased frictional costs and lower insurance costs. 1/14/2019

How do our agents begin selling Integrated MediCompsm? Contact your current medical customers and ask if they have an interest in possibly lowering their health and workers’ compensation costs. Ask new prospect insureds if they would be interested in an innovative product designed to reduce costs. Meet with the employer and complete an application together picking up any sales or product information. 1/14/2019

Integrated MediCompsm Frequently Asked Questions How do I get a Workers’ Comp quote? Obtain employer’s workers’ comp renewal date. Complete a workers’ compensation application, attach loss runs and fax to EMPLOYERS® at: 805.499.7214 How do I get coverage for my employer? Contact an underwriter and bind coverage What happens after I bind? The company will handle all billing, and will send a claims kit to the insured and contact them if a claim occurs as well as provide the company 800 numbers for questions. Please refer to Integrated MediCompsm Group Health & Workers’ Compensation 24-Hour Coverage for Small Groups for more details on how to obtain an Integrated MediCompsm quote. 1/14/2019

Integrated MediCompsm Frequently Asked Questions How does an employer report a Workers’ Comp claim? An employer must complete a “First Report of Injury” claim form and mail or fax it to EMPLOYERS®. Employers also have the ability to access FastReport, EMPLOYERS’® 24-hour toll-free claim reporting service by calling (877) 258-3824. 1/14/2019

Integrated MediCompsm Frequently Asked Questions What happens once a claim is reported? All lost-time claims are triaged by the claims team of an examiner and RN 3-point contact is made Claimant Insured Treating Doctor Claim is quickly investigated Compensability determined Appropriate medical care is provided in a timely manner Work with insured to return injured worker back to work as soon as is medically able. 1/14/2019

Integrated MediCompsm Frequently Asked Questions How do I protect against E&O Exposure? In workers’ compensation the insurance company is responsible for resolving all claims. Benefits are set by statute. It is recommended that the workers’ compensation for employers be moved only on anniversary. If the employer insists, get it in writing that they accept responsibility for changing carriers mid-term and any penalties that are assessed. 1/14/2019

Premium Calculation Classification Rate 3632 $9.80 Annual Payroll ÷ 100 $300,000/100 x 3,000 Subject Premium = $29,400 Experience Mod (Good) x 0.85 Modified Premium = $24,990 Debit/Credits Schedule Rating 10% credit for integrated account - 2,499 Standard Premium = $22,491 1/14/2019

Loss Control Assists employers in the inspection and correction of workplace safety procedures. An insurer shall maintain or provide occupational safety and health loss control consultation services certified by the Director of Industrial Relations. The insurer shall not charge a fee for the service. It shall include: Conduct of workplace surveys to identify health and safety problems. Review of employer injury records. Development of plans to improve employer health and safety loss records including injury and prevention programs. Development of specific plans to develop and implement loss control programs for target employers with the greatest workers’ compensation losses and the most significant health and safety hazards. 1/14/2019

Integrated MediCompsm Anthem Blue Cross and EMPLOYERS® and Affiliated Companies integrate small group medical and workers’ compensation coverage resulting in a product that offers vital advantages to employers and employees.