Archive for December, 2014

Business Lessons from the Sony Pictures Attack

ON THE hacking scale, the attack on Sony Pictures’ computer systems is pretty much the worst-case scenario for any business.
The amount of data breached is shocking: scripts were leaked and as-yet unreleased movies were also stolen and loaded up to pirate movie download sites.
Social Security numbers and details for a trove of big stars, including superstars like Sylvester Stallone, were also published online, in addition to Social Security numbers of 47,000 current and former Sony Pictures employees.

Furthermore, many employees’ computers were compromised, with all of the data stolen before the malicious software the hackers installed wiped entire hard drives clean.
The financial damage could easily reach into the hundreds of millions of dollars. And while it’s surmised that the North Korean government was behind the hack, the attack illustrates what could become the future of corporate warfare.

Imagine companies hiring overseas gangs to infiltrate a competitor’s data bases.

Sound far-fetched? You shouldn’t bet on it. The Sony hack has set a new bar for cyber espionage and sabotage.

Anyone who runs a business – whether it’s a mom-and-pop shop or a multinational behemoth like Sony – needs to pay close attention to what happened, and begin to take data security seriously.

Though even the FBI has said that few companies – as little as 10% – could have prevented an attack like the one that targeted Sony, much of the damage could perhaps have been avoided had the company had better data-security protocols in place.

Claiming helplessness in the face of a big hack is not a good strategy.  A breach is often an enterprise-level problem.
Sony’s teachable moment is that security has to start at the top and must be part of a company’s corporate culture.

Mindful culture
Any time a hack is perpetrated, company leaders can wind up in the spotlight, whether their personal e-mails were leaked or not. Management must learn to demonstrate a level of sophistication, nuance, sensitivity and respect when communicating internally.

Also, the Sony hack shows that many managers are too flippant in their e-mail exchanges, which can often including harsh criticisms of others. It could even be argued that the lack of respect exhibited in e-mails shows up elsewhere in companies – such as a lackadaisical attitude towards data security that puts personally identifiable information of employees at risk.

To be sure, few companies put under the microscope like Sony would come out looking clean. Is it unreasonable to ask for spotless behavior throughout your organization? Of course it is. Given the reality, however, it’s wise to assume you’ll eventually be hacked. So be good… or at the very least consider picking up the phone if you have something to say that you wouldn’t want to be broadcast on the evening news.

Take care of your assets
In the case of Sony, films were stolen, as were a lot of other assets, including scripts, budgets and even contract negotiations. How can this be prevented?

The first step for companies is to truly take ownership of their assets. Ownership is a state of mind that requires upkeep and vigilance to protect what’s yours. Ownership creates security. Ultimately, this starts with corporate leadership, since fostering a sense of ownership among employees is a trickle-down process.

Maintain a strong culture
A strong corporate culture is constantly evolving. It stays ahead of the curve through clear leadership and a culture where employees feel invested in their work, i.e., they take ownership of the tasks assigned to them. A state of readiness through a culture that puts security first is the only way an attack can be properly contained and managed.

The reality is that any company – whether it’s the size of Sony Pictures or a local online retailer – can be put out of commission in such a spectacular and specific way.

Other tips:
Back up your data – The backup should include the operating system, application software, and data on a machine. Multiple backups should exist in different locations.

Network monitoring – The annual “Verizion Data Breach Investigations Report” consistently points out the need for organizations to monitor security systems. It recommends the use of software that can identify suspicious patterns that could signal an attack in progress.

Antivirus not good enough – The group behind the Sony attack reportedly used destructive malware, wiping the hard drive and the boot loader, making systems virtually unrecoverable. A new class of advanced threat detection and breach detection solutions is available and can inspect both network traffic and endpoint systems for subtle signs of an infection.

Password management – Employees should be trained to use strong passwords. Passwords for different accounts should be different. When possible, single sign-on should be implemented to avoid password fatigue. IT policies should dictate how often employees change passwords and enforce stronger password creation.


Top 10 Questions Employees Have about the ACA

As the Affordable Care Act hits high gear and the individual mandate has been in effect for nearly one year, employees in most organizations have a heightened awareness of the new law.

But just because they are more aware of it, doesn’t mean they understand it, particularly considering the immense amount of misinformation that’s circulating online and in the news.

And as the employer mandate takes effect for companies with 100 or more employees starting in 2015, they will likely have more questions about the law.

According to the International Foundation of Employee Benefit Plans’ “2014 Employer-Sponsored Health Care: ACA’s Impact Survey”, the top 10 questions employees have are as follows (we’ve also provided answers as per HR Morning, a website focusing on human resources issues):


How do exchanges work? Am I eligible? Are they free? Could I qualify for a subsidy? How does exchange coverage compare to my current coverage?

Answer: The exchanges act as an insurance agent of sorts, allowing employees to shop for plans that meet their needs. And yes, everyone can use them, but they are not free. However, whether or not employees get a subsidy depends upon a number of things – like whether or not you offer them coverage, the level of that coverage and their income.


How does the law affect me? Do I need to do anything?

Answer: Individuals are now required to carry insurance or pay a penalty. And if you’re offering them coverage that meets the law’s minimum requirements, they don’t have to do anything.


What will it cost me? Why are my costs going up?

Answer: The costs to your employees will be whatever portion of the premiums and cost-sharing they are responsible for under your employee benefits plan. Your benefit plan summary has all of these answers. Costs are increasing mostly because the cost of care continues rising.


Is the company planning to drop coverage?

Answer: You have to answer this based on what your plans are.


How will our benefits change? Is this benefits change because of the ACA?

Answer: Most likely, your plan has already changed to comply with the ACA. However, if you are planning changes for 2015, be prepared to explain what they are and the reasons behind them.


Can my child stay on the plan longer?

Answer: Under the ACA, a plan’s coverage for dependent children must be extended until they turn 26.


Do I have to get coverage if I don’t have it now? I need to sign up for benefits now because I will be penalized by the ACA; when will there be open enrollment?

Answer: If the employee does not receive health coverage from you, they will be required to obtain coverage on an exchange or in the private market, or pay a penalty. The exchanges opened in November 2014 for the 2015 benefit year. If they get coverage through you, share details of your plan’s next open enrollment period with them.


Will I have an average of 30 hours per week and qualify for benefits in 2015?

Answer: Tell them your plans and if they will qualify for your company plan.


Are we dropping spousal/dependent coverage?

Answer: Under the ACA, dependent children must be allowed to remain on a parent’s plan until age 26. But, employer plans are not required to cover spouses. Some employers will still offer spousal coverage.


How does the law affect the future of the company?

Answer: Only you know the answer to this question. However, if you’re planning to stay the course, you should communicate that with your employees.


The answers provided here are standard ones, and they may vary depending on your organization’s circumstances. To minimize the impact of such questions on your daily workload, be sure to inform employees that you (and not the news, Internet or a neighbor) are in the best position to help answer their questions, and then be prepared to answer these types of questions.

If you have a first-time benefits-eligible population (due to the ACA play-or pay provision), you may want to consider holding an Employee Benefits Basics session as they may be completely unfamiliar with benefits.

But now that you know what’s on the average employee’s mind, you can set about tailoring your employee outreach to cover these topics.

The most popular channels for communicating with employees about the ACA include annual enrollment materials, e-mails, company websites, special meetings and special written communication pieces.


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Safety Tips That You May Not Have Considered

As the New Year gets underway, now would be a good time to double down on your workplace safety efforts to see if there are any areas that you may be overlooking.

While your safety regimen may be top notch, there is always room for improvement and you can consider these options as covered by EHS Today:


Employ a three-second rule

Workers should consider using the three-second rule before resuming a task after a break or disruption. During this time before resumption, the worker can conduct a mental hazard check, which EHS Today refers to as STEP:

S – Stop before resuming a job or beginning a new task.

T – Think for three seconds about the task you are about to do.

E – Ensure that any potential hazards have been identified and mitigated.

P – Perform the job.


Take advantage of OSHA training

The OSHA Outreach Training Program provides training for workers and employers on the recognition, avoidance, abatement and prevention of safety and health hazards in workplaces. The program also provides information regarding workers’ rights, employer responsibilities, and how to file a complaint.

Cal/OSHA in 2010 signed an agreement with federal OSHA to give California employers access to federal outreach trainers. Through this program, workers can attend 10-hour or 30-hour classes delivered by OSHA-authorized trainers. The 10-hour class is intended for entry-level workers, while the 30-hour class is more appropriate for workers with some safety responsibility.

Through this training, OSHA helps to ensure that workers are more knowledgeable about workplace hazards and their rights.


Reward employees for attention to safety

Many companies reward individual employees who are especially mindful of safety procedures. Rewards don’t have to be extravagant. Low-cost rewards such as $10 gift cards for everyday necessities (gas, groceries, fast food) are perfect for on-the-spot rewards or as redemption options in a point-accumulation program.


Communicate with non-English speaking workers

Non-English speaking laborers, and Hispanic workers in particular, have more workplace accidents than their peers. Some safety experts blame this on the language barrier that may exist. The language barrier may keep them from reporting workplace hazards and they may not understand your safety instructions.

If you have non-English speaking workers:

  • Ensure that training is fully understood.
  • Try to get any safety training materials also printed up in Spanish, or in whatever is their language.
  • Give them a contact in your organization that speaks their language, so that they can get answers to any questions they may have or to report concerns.


Urge your employees to speak up

Let your workers know that there will be no retribution for reporting perceived workplace hazards, no matter how minor. You can also implement the third suggestion above and reward employees that point out safety issues.


Temp workers need safety awareness too

Temporary workers often slip through the cracks when companies are training staff on safety. And it’s easy to forget when you get a temp that comes in for a day or two that they need to be aware of the hazards in the workplace and how to avoid getting injured.
The issue is especially important in terms of your company getting cited. Federal OSHA has made the safety of temporary workers one of its priorities. OSHA in 2014 published a guide for protecting temporary workers. To access the guide and for tips, check out:


Make your training engaging

The best safety training programs are those that employees remember. Some good ways to make sure the information is retained include using real-life examples, story-telling, skits and strong video presentations.


Do more than OSHA requires

OSHA’s regulations are meant to be comprehensive, but every workplace is different and for a truly effective safety program you should fine-tune your safety requirement specifically for your workplace. In other words, you can go a step beyond what OSHA requires.


Watching each other’s back

You should also instill a sense of responsibility among your staff to look out for each other. If a worker sees another performing a job in an unsafe manner, the worker should step in to offer assistance. This can be done without being intrusive or confrontational.

Some good approaches include: “Hey, would you like me to watch out for your safety?” and “As you know, you need to be wearing cut-resistant gloves to perform that task.”


Establish a leadership-driven safety culture

A safe workplace starts from the top. The company’s leadership needs to buy into its safety culture. “If your employees see leadership investing time and money into workplace safety, they’ll understand that it’s a priority for your company. And ultimately, they’ll make it a priority for themselves as well,” EHS Today writes.

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More Lawsuits Want Pay for Work Done before, after Clocking in

For years there’s been a debate in the manufacturing, farming, mining and like industries about the merits of paying employees for the time they spend putting on and removing work clothes and protective gear before and after their shifts.

Individual and class-action lawsuits have been filed by employees seeking pay for the time they spend “donning and doffing,” which can sometimes be 15 minutes or more in some industries.

But these lawsuits may no longer be the domain of those labor-intensive industries. In recent years, office and service sector employees have started suing their employers for back wages for time they spent performing what they consider job-related functions before and after their work shifts.


The whole enchilada – Two lawsuits, one filed in October, are seeking class status in accusing the national eatery chain Chipotle of requiring employees to continue working after clocking out. In the latter case, a former employee accused Chipotle of conducting training, meetings and other activities which employees were “required to attend, but for which they are not allowed to punch in.”

Additionally, the suit alleges that the company encouraged managers “to require that work be performed off the clock” after 12:30 a.m. and that systems were put in place for “reward and punishment” of supervisors who either stayed within or exceeded their payroll budgets.


The bankers – A court recently approved a $6 million settlement in a case where two employees accused their employer, TD Bank, of requiring them to arrive early to work each day in order to undertake various procedures to open the branch for business.

Amongst the requirements were various security functions that needed to be performed both inside and outside the branch before the computers could even be booted up for the day’s activities.

The unpaid-overtime lawsuit claimed that such activities took between 15 and 20 minutes to complete each day. Over a five-day week, the work would combine to an hour and 15 minutes at minimum, and to an hour and 40 minutes at the outside.


Warehouse screening – In January 2014, an employee sued Inc. for allegedly failing to compensate her and others adequately for an end-of-shift screening process that “approximately takes between 10 and 20 minutes and, with delays … can last longer.”  The plaintiff further added that Amazon does not pay its warehouse workers for time spent passing through the same screening process during meal breaks or for walking to that screening area.


The takeaway

Under the Fair Labor Standards Act (FLSA), employers must pay covered non-exempt employees at least the federal minimum wage for all hours worked in a workweek, as well as an overtime premium for all hours worked over 40 in a workweek.


In general, compensable hours worked include all time an employee is on duty or at a prescribed place of work and any time that an employee is suffered or permitted to work.

Under the Portal-to-Portal Act, which supplements and limits the FLSA, employers are not required to pay workers for incidental activities before and after work that are not integral to the employee’s principal work activities. This includes things like time traveling to and from work.

At the same time, the Portal-to-Portal Act states that employers must count as working time incidental activities that are integral to the job, such as depositing the mail after the close of business, or changing clothes and showering if required by the employer.

In light of this new legal trend, you need to be careful about how you are compensating your staff for all the time they spend on activities that are integral and indispensable to their principal work duties.

So, if you are requiring your workers to perform duties before or after clocking in, you may be running afoul of the law. If you do, you should revisit your policy and talk to a labor attorney. It would be wise to put in place policies and procedures for tracking the time employers spend on those activities to make sure they are properly paid.




State Compensation Insurance Fund to Drop Its Group Programs

State Compensation Insurance Fund of California (State Fund) will discontinue all of its group insurance programs.

The state’s largest insurer will start phasing out the programs and stop renewing group agreements in April 2015. At the same time, the applicable group discounts will be eliminated for all policies April 1, 2015.

Groups have allowed like employers with good safety records to get together and form essentially a safety cooperative. Typically, an employer could join a group if it had an X-Mod that didn’t exceed a certain threshold. In return, the employer would receive a 6% discount on its premiums.

The groups also provide safety services, typically in the form of education. To help them provide these services, State Fund has been paying group administrators between 4% and 6% of the premium in administrative fees.

The latest move comes on the heels of State Fund’s decision two years ago to drop its stand-alone safety groups and tighten the eligibility criteria for trade associations that participate in the group insurance programs.

At the time, State Fund had agreements with 84 stand-alone safety groups that accounted for 25,000 individual workers’ comp policies in total. Also, it had agreements with nearly 200 trade associations across nearly that many class codes, which represented a similar number of policies.

Since the restructuring, the group insurance program has shrunk to just 35 trade association partners.

Groups have been advantageous for many reasons:

  • The 6% discount, which can be combined with other State Fund discounts.
  • Because the groups have a mandatory loss-control threshold, employers in groups have had an added incentive to create safe workplaces and reduce their claims costs.
  • Some groups have also had access to additional claims-management services, such as alternative dispute resolution for claims.
  • Some groups have performed claims review services.
  • Employers in groups receive industry-focused safety services that may include the interpretation of regulations, emergency-care planning, safety seminars, and a review of workplace accidents and their costs and trends.


State Fund says it made its latest decision in light of its move in March 2013 to implement a tiered rating structure, which puts employers into three levels based on their claims and loss histories and X-Mods, with Tier A being for the ones with the best loss histories.

The tiers work as follows:

  • Tier A – Employers receive a 38% reduction in premium
  • Tier B – Employers receive a 4.9% reduction in premium
  • Tier C – Employers receive a 25% increase in premium


State Fund says it performed an in-depth evaluation to understand how the group insurance discount was working with tiered rating.

Originally, the company introduced the group insurance discount to recognize and reward employers whose loss history demonstrated a culture of safety. Trade associations who had agreements with State Fund received an administrative fee, which as stated above averaged approximately 4-6% of premium.

The study concluded that the tiered rating plan has the same effect on policyholders as the group discount, reflecting individual performance and recognizing employers with demonstrated safety records with appropriate pricing.

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Backlash as Concern Grows over EEOC Targeting Wellness Plans

A backlash is building against the Equal Employment Opportunity Commission’s recent moves to challenge certain workplace wellness programs offered by large U.S. employers.

The EEOC’s actions are threatening to erode backing for the Affordable Care Act among large corporations who have supported the law because it included provisions encouraging the wellness programs. Employers are pleading with the EEOC to issue clear guidelines, but to date none have been issued.

That’s left many employers wondering whether they could be next if the EEOC deems that their wellness plans run afoul of the ACA, the Americans with Disabilities Act (ADA) or the Genetic Information Nondiscrimination Act (GINA), among other laws.

Wellness programs are designed to tackle health care costs by getting employee health plan participants to quit smoking, lose weight, and reduce hypertension and other risk factors that can lead to expensive illnesses. The ACA authorizes employers to reward workers who participate in wellness plans and penalize those who don’t.

But recent lawsuits filed by the EEOC have raised concerns about how far employers can go with their wellness plans.

The latest case, EEOC vs. Honeywell International Inc., was filed in federal district court in Minnesota on Oct. 27. In the case, the EEOC originally sought to enjoin Honeywell from implementing its wellness program, charging violations of both the ADA and GINA.

The ACA allows financial incentives for workers taking part in workplace wellness programs of up to 50% of their monthly premiums, deductibles and other costs.

Often wellness plan participants must fill out detailed health questionnaires, undergo medical screenings and in some cases attend weight-loss or smoking-cessation programs.

One of the arguments presented in the lawsuit against three employers is that requiring medical testing violates the ADA.


The Honeywell case

Starting in 2015, the biometric testing for Honeywell’s employees and their spouses will be part of a screening to help identify health risks. It will include checks for blood pressure, HDL and total cholesterol, non-fasting glucose levels, body mass index and waist circumference. Blood will also be screened to determine whether the employee or spouse smokes tobacco.

Employees will be penalized (or lose incentives) if they or their spouses do not take the biometric tests, including the blood draw. They would be subject to:

  • A $500 surcharge applied to the employee’s medical plan costs.
  • A $1,000 “tobacco surcharge,” even if the employee declines to participate in the biometric testing for reasons other than smoking (since, presumably, absence of tobacco can’t be verified).
  • An additional $1,000 “tobacco surcharge” if the employee’s covered spouse does not submit to the testing, even if the spouse declines to participate for reasons other than smoking.
  • Loss of health savings account contributions from Honeywell, which range up to $1,500 depending on the employee’s annual base wage and type of coverage.


Honeywell says its financial incentives fall within the range specified as allowable under the ACA.

The EEOC claims that Honeywell’s incentives violate the ADA because employees are penalized in order to induce them to go through medical examinations that are not job-related or consistent with business necessity.

Although there is an exception to this rule for “voluntary” health exams, the agency claims that these exams are not voluntary because Honeywell imposes a penalty on employees who decline to participate.

The EEOC also claims it violates the GINA.

Employers are concerned because biometric screenings and incentives to participate in screenings are typically key features of wellness plans.

Wellness programs with biometric screenings have become widespread, as are financial incentives to promote health participation in these screenings. Overall, among large U.S. employers that offer wellness programs, about three in four use incentives to engage employees in them – although not necessarily in health screenings – according to the nonprofit National Business Group on Health.

Employers have been seeking guidance from the EEOC for years regarding how the ADA and the GINA apply to wellness programs.

But to date, the EEOC hasn’t issued any guidance, which is leaving more employers concerned that their wellness plans may also be targeted in the future.

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Get a Head Start on 2015 with This Prep Sheet

OPEN ENROLLMENT can be a stressful experience if you don’t plan ahead. The stakes for pulling off a successful enrollment push are even higher now amid the changing landscape that’s been brought on by the Affordable Care Act.

With all of the new requirements, including minimum levels of coverage, employers are also gravitating towards products that ensure they comply with the ACA and that are affordable for both themselves and their employees.

Mercer, a human resources consulting firm, recommends that employers follow these suggestions for a successful open enrollment:

Consider CDHPs – Consumer-driven health plans are gaining in use thanks to their general lower cost and the fact that they give employees more control over their health care. In 2013, 39% of large employers offered at least one CDHP and 64% say they will likely offer one by 2016, according to Mercer.

The consulting firm says CDHPs can be used to:

•             Reinforce individual accountability for health care decisions;

•             Reduce costs for employers, and often for employees;

•             Meet the ACA-mandated affordable coverage requirement;

•             Help avoid the 2018 excise tax; and

•             Provide a compliant auto-enrollment default selection.


Communication is key – If you have newly eligible employees, you should “start communicating right away with this population as to who is eligible, why they are eligible, how eligibility is determined, what this means and what they have to now consider,” Mercer says.

Besides the enrollment information you’ve put together for your other already-eligible staff, you will need to also have information on how employees who are not eligible for your health coverage can access public exchanges to secure coverage.

Stress voluntary benefits – Voluntary benefits can be “used to overcome [misconceptions] and confusion around other benefit offerings,” Mercer says. It adds that these benefits “help assuage fears of potentially high out-of-pocket expenses.”

Voluntary benefits include critical illness and accident coverage, dental and vision insurance, life and disability. These should be made known to your employees as they may have needs you are unaware of.

Don’t forget wellness plans – During open enrollment you should also ensure that your employees understand the value of participating in any wellness programs that you offer. And if you don’t offer any, you ought to as they can improve the overall health of your workforce and also help reduce health premiums.

And, starting next year, employers will be permitted to apply higher premiums to individuals that don’t participate in health screenings and other types of wellness programs. Under the ACA, the discount can now be up to 30%, and may even reach 50% under some circumstances.

Use technology to help your staff – As more companies direct their employees into CDHPs, requiring them to be more accountable for their health care decisions, they can help by providing the appropriate tools. This includes software and mobile apps to help guide them through decision-making processes when considering how to best utilize the health care available to them through their plans.

Some plans offer digital wallet cards that contain all benefit and contact information in one place for quick access to answers or advice.

Additionally, some health insurers now offer their own apps for enrollees that help them with advice and lists of doctors in their area.

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10 Tips to Shorten the Life of Your Workers’ Comp Claims

One workers’ comp claim can send your experience modifier (X-Mod) spiraling out of control if the injured employee stays away from work for an extended period of time. The longer they are off work, the more costly the claim becomes since they are receiving temporary disability payments, which can cost up to $1,074.64 per week in California.

All of that adds to the cost of your claim, in addition to any medical expenses that are incurred.

The bane of employers in the workers’ comp arena is open claims and it’s to your benefit to work with the doctor and the insurance company claims adjuster to get the claim closed as soon as is feasible, and safe for the injured worker.

That said, there are ways to reduce the time a claim is open, including:

  • Require all employees to report accidents immediately, no matter how minor. While some injuries require just first aid that can be taken care of using in-house medical supplies (which you should have on hand as per Cal/OSHA requirements), others are more serious. If you are unsure whether first aid can fix the problem, it’s best to send the worker to a doctor.
  • As soon as an accident is reported, you should move to investigate to determine exactly what happened. You will need to identify witnesses and separate them and interview them one at a time to fully understand the whole story, and also to ensure there are no drastically conflicting accounts.
  • You should sit down with the employee and explain the workers’ comp process, and also file the necessary claim forms. Answer the employee’s inquiries quickly and efficiently, preferably designating one person as the primary contact.
  • Ask one of your supervisors or managers to accompany the injured worker to the industrial clinic you have pre-chosen. There are good reasons for doing this, including:

1. We have heard of attorneys soliciting employees going into and out of industrial clinics.

2. You gain useful feedback from your supervisor regarding the length of time it takes to be seen and how clean and sanitary the clinic is. This is important because the main reason employees get attorneys is the perception that the employer does not care about them. A filthy clinic with long wait times does not send a good message to your employees.

  • Another reason that injured workers get an attorney is that they feel abandoned by their employer, and the longer they stay away from work the more disaffected they may become. For this reason, you need to stay in contact with the employee. Assign someone, preferably the supervisor, to call or visit with the employee on a regular basis to keep them motivated to return to work and to answer any questions they have.

Positive, encouraging messages of the employee’s value to the company are often the best medicine. It helps also if they know their co-workers are hoping for a speedy recovery and their return.

  • Identify and establish relationships with doctors who have expertise in occupational medicine and understand the value of returning injured employees to work.
  • If you don’t have a return-to-work program in place, you should initiate one. If the injured worker’s treating physician clears the employee for a return to work or for light duty with restrictions, make sure the worker, their supervisor and fellow employee understand the restrictions.
    This is important because one of the main factors in workers re-injuring themselves is that their supervisor fails to educate others about the work restrictions and, unknowingly, peers place pressure on the injured employee to perform tasks beyond the restrictions.
  • Monitor claims progress if your insurance agent is not already doing so. Discuss the claims with the medical provider and your agent to determine how to get the claim on track.
  • Know your claims. Examining your claims, patterns may emerge that identify areas in need of attention.
  • Close claims promptly. Open claim reserves affect the X-Mod in the same way as actual claims paid. In some cases, claims that are closed may be on the books as open or the reserves set for the claim may be excessive based on your knowledge of the claim. Your agent should be monitoring these claims and reserves to ensure they are as low as possible, or are removed if the claim is closed.

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