Line of Duty ActUpdate of HB1345

VGFOA Conference

October 27, 2016

Risk Management | Coverage | Claims Resolution

Chris Carey, VACORP Administrator

Stephanie Heintzleman, Member Services Director

Kathleen Guzi, Public Entity Specialist

• History

• JLARC Study

• Current Position of VRS Trust Fund

• Impact of the Legislation

Agenda

• Impact of the Legislation

• State’s Implementation Plan

• Questions

LODA History – Timeline of Eligibility

Law Enforcement,

Fire and Rescue

Companies

Correctional Officers, ABC

Special Agents

Forest Wardens

Dept. of Emergency

Services Hazmat Officers

DMV enforcement

division1974 1977 1995 2003

Virginia National

Guard

Game wardens

VMRC Employees with arrest authority,

DCR Conservation

Officers, Regional Jail

Officers

Police Chaplains,

Local employees

during a declared state of

emergency

1972

1974

1976

1977

1986

1995

1996

2003

2012

LODA History – Timeline of Benefits

1972 – Death Benefit – Only

direct and proximate cause

- $10,000 benefit

1995 - $50,000 Direct and Proximate benefit -$25,000

Presumptive benefit

2006 - $100,000 Direct and

proximate death benefit

1976 – Death by presumptive

cause - $10,000 benefit

2000 - $75,000 direct and

proximate death benefit, lifetime health insurance

for death and disability added

LODA History – Benefits – Health Insurance

• Requires lifetime health insurance for family

• Requires the same or comparable benefit plan from last day of active duty

– Results in varying degrees of benefits, depending – Results in varying degrees of benefits, depending on the coverage plan

Comparison of LODA Benefits

Comparison of LODA Benefits

State

• Virginia

• Florida

• Washington

Death

• X

• X

• X

Disability

• X

• X

• X

Presumptive Cause

• X

• X

• X• Washington

• Illinois

• Minnesota

• Oregon

• Delaware

• Texas

• X

• X

• X

• X

• X

• X

• X

• X

• X

• X

• X

Comparison of LODA Benefits

State

• Virginia

• Florida

• Washington

• Illinois

• Minnesota

Claimant Recovers from Disability

• X

• X

• X

Claimant has access to other insurance

• X

• X

• X

• X

Spouse Remarries

• X

• X

• X

Reach Age 65

• X

• X

• X

• Minnesota

• Oregon

• Delaware

• Texas

• X

• X

• X

• X

Growth of Beneficiaries and Program Costs

JLARC Study – Causes of Eligibility for Benefits

JLARC Study – Most Claims are with Localities

JLARC Study – Qualifying Injuries or Events

JLARC Study –Covered Population

JLARC Study – Localities with the most Claims

FY 2013 FY 2013

Employer Beneficiaries Population

Virginia State Police 195 1,950

City of Virginia Beach 93 1,715

City of Alexandria 58 744

Fairfax County 55 3,681

City of Chesapeake 51 1,112City of Chesapeake 51 1,112

Arlington County 50 902

City of Norfolk 45 1,791

Henrico County 41 1,612

Prince William County 33 1,801

City of Suffolk 21 702

Subtotal top 10 employers 642 (67%) 16,010 (20%)

Grand total 952 81,982

JLARC Study – Projected Program Costs

JLARC Study – Projected Growth of Obligations

VRS Trust Fund

Impact of HB1345 – General Considerations

1. HB1345 creates a new LODA statute. LODA has been operating under budget language since 7/1/2010

2. “Disabled person” definition amended

3. VRS is creating rules for claimants to have disability recertifiedrecertified

4. Employers can submit information to trigger reconsidered eligibility

5. Creates a single health insurance plan for ALL LODA beneficiaries

Impact of HB1345 – Eligibility Process

1. Transfers LODA decisions to VRS

2. Engages Medical Review Board in all disability determinations

3. Applicant responsible for submitting claim

4. VSP involved only at request of VRS4. VSP involved only at request of VRS

5. Employer may submit claim information

6. Streamlines appeal process

7. Disability status must be renewed after two years, then every five years thereafter

Impact of HB1345 – Ongoing Eligibility Process

1. Eliminates benefit for spouses who remarry

2. Children eligible to age 26

3. All beneficiaries in one health insurance plan

4. Increases training requirements on employers4. Increases training requirements on employers

5. Eliminates benefits at age 65

6. Eliminates benefits for any beneficiary earning pre-injury wages

Health Insurance Plans – Tentative Timeline

• December 2016

– Finalize benefits plan administrative processes

– Confirm contact information

• January 2017

– Send plan info to current claimants/families

• February 2017

– Receive enrollment documents

• July 1, 2017

– Coverage begins for all eligible claimants/families

Implementation – Cross-Agency Coordination

VRS, DHRM, and DOA

• Developing project plan

– Modifying VRS Medical Board to handle LODA

claim appeals

– Continuing outreach to State Police for – Continuing outreach to State Police for

investigations

– Administrative processes for LODA

– Communication plan

LODA Considerations

• For career personnel, internal claims reporting

guidelines will need to be created. Ongoing wage

verification process will need to be implemented.

• For Volunteers, claim reporting guidelines will need

to be created. Strategy for accident and sickness

claims or workers’ compensation claims handling will claims or workers’ compensation claims handling will

need to be considered. Ongoing wage verification

process will need to be implemented. Membership

rosters will need to be actively managed.

• Training requirements, at time of employment/

membership, every two years thereafter

Questions

Risk Management | Coverage | Claims Resolution

For additional information, please contact

Chris Carey, Stephanie Heintzleman or Kathleen Guzi

VACORP

844-986-2705 or info@riskprograms.com