your total cost of risk (tcor) - ironwood insurance...
TRANSCRIPT
IRONWOODINSURANCE SERVICES, LLC
3715 Northside Parkway NW | Suite 1-500 | Atlanta, GA 30327 | ironwoodins.com
Ironwood Workers Compensation Claim Services
MINIMIZEYour Total Cost of Risk (TCOR)
Ironwood Workers Compensation Claim Services Will Help You
REDUCEYour TCOR
More than 74% of Your Workers Compensation Expenses are
Direct Claim Costs…
Focusing on the largest cost driver will have the greatest impact on your Workers Compensation TCOR.Losses
$7,000,00074%
12%
2%7%
5%
Misc Costs - $430,769
Fixed Admin Costs - $646,155
Broker Fees - $215,384
Premium - $1,184,615
Assumptions:Loss Pick — $7 millionFixed Costs — $2.4 millionTotal Cost of Risk (TCOR) — $9.4 million
Loss Cost ComponentsMEDICAL — 50%
□ Hospital Bills
□ Doctor visits
□ Physical Therapy
□ Prescription Medication
□ Diagnostic Testing
□ Drug Screens
□ Nurse Case Management
□ IME
□ Durable Medical Equipment
□ Travel / Mileage
□ Specialists
□ Attendant Care
INDEMNITY — 35% □ Temporary Total Disability
□ Temporary Partial Disability
□ Permanent Partial Disability
□ Permanent Total Disability
EXPENSES — 15% □ Investigators
□ Legal Costs
□ Transportation Costs
□ Translation Costs
□ Surveillance
□ Bill Review
□ PPO access Fees
□ Background Checks
□ MSA providers
□ Pharmacy Benefit Managers
□ Penalties / Fines
Medical
50%
Expenses
15%
Indemnity
35%
Ironwood Workers Compensation Claim ServicesIDENTIFIES GAPS & DELIVERS SOLUTIONS.
YOU WIN. YOU SAVE.TPA/Carrier Contract Review & Negotiation
□ Review current / proposed Claim Service contracts; negotiate cost saving program changes
□ Categories that yield savings include:
»» Bill»Review»Fees
»» PPO»Access»Fees
»» RMIS»Costs
»» Definition»of»Medical»Only»versus»Lost»Time
»» Managed»Care»Direction»of»Services
✔ Anticipated savings 5%-20% of previously negotiated contract
* Example assumes Bill Review Savings
SAVINGS: $465,000
Claim Triage
□ Day of Injury Triage provided by a Registered Nurse
□ One call for medical assistance and to report claim
□ Benefits include:»» Eliminates»unnecessary»
medical»costs
»» Provides»24»hour»services
»» Provides»direction»to»panel»doctors»where»permitted
»» Reduces»overall»claim»count
✔ Anticipated savings 5%-20% of Medical Only claim costs in 12 months
SAVINGS: $150,000
Claim Cost Identification & Solutions
□ Drill down to identify claim cost drivers
□ Develop & implement feasible cost reduction strategies
□ Benefits include:»» Laser»focus»efforts»of»internal»&»
external»claim»resources
»» Allows»for»cost»benefit»analysis»on»recommended»solutions
»» Consider»pilot»programs
»» Reduces»overall»claim»costs
✔ Anticipated savings 5%-20% of overall claim costs
* Example assumes Legal and Pharmacy Savings
SAVINGS: $118,306
Settlement Day
□ Identify cases for negotiation at Settlement Day
□ Coordinate logistics and Settlement Day agenda
□ Coordinate settlement authority with client, carrier/TPA
□ Manage the Settlement Day
□ Report results within 30 days
□ Benefits include:»» Settle»old»stagnant»claims
»» Result»in»overall»reserve»reduction
»» Enhances»collateral»review»negotiations
✔ Anticipated savings 515%-25% of outstanding reserves
SAVINGS: $350,000
Ironwood Workers Compensation Claim ServicesIDENTIFIES GAPS & DELIVERS SOLUTIONS.
YOU WIN. YOU SAVE.Claim Audit
□ Draft and negotiate Performance Guarantee Criteria
□ Draft & negotiate Audit Criteria/Process
□ Conduct & present audit results with narratives, scores and recommendations
□ Provide oversight where performance action plans required
□ Industry most deficient categories include:»» Incomplete»investigations
»» Poor»vendor»management
»» Failure»to»pursue»recovery
»» Overpayment»of»benefits
✔ Anticipated savings 15%-25% of overall claim costs over 12-18 months
SAVINGS: $962,504
Customized Claim Management
□ Client Directed Claim Management
□ Special Projects / Ongoing Services:»» Claim»Manuals»&»White»Papers
»» Self»Insured»Administrative»Services
»» Return»to»Work»Program»Development»&»Management
□ Benefits include:»» Provides»additional»resources»without»overhead»
costs
»» Wealth»of»Best»Practices»/»Success
»» Advance»risk»&»claims»management»goals
✔ Savings depend on assignment
* Example assumes Return-To-Work Program savings
SAVINGS: $332,376
Claim Manager Services
□ TPA & carrier negotiation & implementation
□ Workers Compensation coordinator services include:
»» Claim»reporting
»» Claim»contacts
»» Assistance»with»investigation
»» Ongoing»follow-up»
□ Monthly & quarterly reporting
□ Develop & implement training
SAVINGS: $35,000
TOTAL LOSS COST SAVINGS(Loss Pick = $7 million)
Bill Review Savings ................................$465,000
Claim Cost Identification Savings .......... $118,306
Claim Audit Savings ............................... $962,504
Claim Manager Services .......................... $35,000
Claim Triage Savings ..............................$150,000
Settlement Day Savings ........................$350,000
Customized Claim Mgmt. Savings ........ $332,376
TOTAL SAVINGS: $2,413,186
Focusing on Workers Compensation Loss Costs
DRIVES DOWNYour Fixed Costs...
ProjectedSavings
$2.4M
LOSSES
Premium
Broker Fees
Fixed Admin
Misc Costs
LOSS COST CURRENT ANNUAL SPEND
PROJECTED ANNUAL SPEND
SAVINGS
Medical $3,500,000 $2,289,907 $1,210,093
Indemnity $2,450,000 $1,602,935 $847,065
Expenses $1,050,000 $686,972 $363,028
TOTAL $7,000,000 $4,579,814 $2,420,186
Projected Savings:
$276,769
LOSSES
FIXED COSTS
FIXED COSTS
COLLATERALFixed Admin
Misc Costs
LOSS COST CURRENT ANNUAL SPEND
PROJECTED ANNUAL SPEND
SAVINGS
Premium $1,184,615 $1,042,461 $142,154
Broker Fees $215,384 $215,384 $0
Admin Costs $646,155 $565,386 $80,769
Misc Costs $430,769 $376,923 $53,846
TOTAL $2,476,923 $2,200,154 $276,769
POSTED AMOUNT PROJECTED RETURN OUTSTANDING COLLATERAL
$15 Million $2.4 Million $12.6 Million
IRONWOOD’S POTENTIAL IMPACT ON TOTAL COST OF RISK
TCOR SAVINGS:$2,696,955
Premium Broker Fees Fixed Admin Costs Misc Costs Losses
Without Ironwood
WithIronwood
SAVINGS:$142,154
SAVINGS:$0
SAVINGS:$80,769 SAVINGS:
$53,846
SAVINGS:$2,420,186
FIXED COSTS
Ironwood Insurance Services, LLC3715 Northside Parkway NW | Suite 1-500 | Atlanta, GA 30327 | 404.503.9100 | ironwoodins.com
Ironwood Products & Services
Employee Benefits and Employer Services
□ Integrated Strategic Approach
□ Ongoing Strategy and Stewardship Reporting
□ Compliance and PPACA Consulting
□ Claims Advocacy and Medical Concierge
□ Customized Employee Communications
□ Human Resource Consulting
□ Mergers and Acquisitions Support
□ Corporate Wellness Strategy and Execution
□ Payroll Processing Technology and Support
□ Private Exchange and Defined Contribution
Commercial Property and Casualty
□ Commercial Property
□ Commercial and General Liability
□ Products Liability
□ Commercial Automobile
□ Workers Compensation
□ Umbrella/Excess
□ Inland and Ocean Marine
□ Builders Risk
□ Surety Bonds
□ Large Deductible and Self Insured Programs
□ International Brokerage and Program Management
□ Group Captives
□ Environmental Insurance
□ Professional Liability
□ Directors and Officers and Crime Employment Practices Liability
□ Cyber Liability
□ Product Recall and Contamination Coverage
□ Political Risk
□ Patent Infringement
MEET VANDA HARRISVice President / Claims Practice Leader404-503-9137 | [email protected]
Vanda Harris, Leader of Ironwood’s Claims Services Practice has over 20 years experience in commercial claims management and consulting. Her extensive background includes claims program review, design and implementation for workers compensation, automobile, general liability & property lines with a focus on premium and collateral reduction.
Harris served in key management and consulting roles on all sides of the industry - brokerage, client, and insurer - making her expertise unique in the marketplace. She has worked with many middle market and large risk management accounts with complex claim management needs.
Prior to joining Ironwood in 2012, Harris had 10-year tenure as the Georgia Claim Manager for McGriff, Seibels & Williams, a large regional brokerage firm. She also served 3 years as Director of Risk Management for an Atlanta-based utility locating firm and as Claim Supervisor for CNA Insurance Companies. Vanda is a graduate of Louisiana State University with a degree in Business Administration.