MHA Workers Compensation Reciprocal

MHA Workers’ Compensation Reciprocal

A better way to acquire

Workers’ Compensation

Coverage

Sharing a common vision

About the Reciprocal

SHARING A COMMON VISION THAT THERE IS A BETTER WAY TO PROTECT

EMPLOYEES AND THE FINANCIAL WELL-BEING OF HEALTH CARE

ORGANIZATIONS

Montana’s hospitals have faced difficult challenges with few options for workers’ compensation insurance coverage for many years. As the market continues to be unsettled, workers’ compensation premiums are subject to unpredictable pricing fluctuations. In response to these market irregularities, the MHA Ventures Inc., collaborated with member hospitals to create the Reciprocal.

Structure of the Reciprocal

CASUALTY INSURANCE COMPANY OFFERING EXCESS WORKERS’

COMPENSATION COVERAGE

The Reciprocal is organized and exists under the laws of Montana for the purpose of enabling its Subscribers to inter-insure by exchanging contracts of insurance. The difference in the Reciprocal model over a traditional insurer is a move away from the profit driven commercial model. The focus of the Reciprocal is long term stability and the efficient delivery of workers’ compensation protection by reducing losses through aggressive risk management. This is achieved through an outstanding loss control and risk management program provided by Brentwood Services Administrators, a Reciprocal partner.

SERVICES OF THE MHA WORKERS’ COMPENSATION RECIPROCAL

One of the Reciprocal’s most significant competitive advantages is the depth and breadth of specialized knowledge and services it provides through key partners. The experience of these professionals combined with a solid understanding of the unique needs of Montana’s hospitals has provided significant improvement in prevention of injuries, decrease in claims, and stabilization in the cost of workers’ compensation.

Strategic Goals

 Build strong relationships with Subscribers by understanding their needs and priorities.  Provide a mix of services and vendors that

continually meet the needs of Subscribers and brings them value.

 Ensure that MHA members have a high level of awareness of the Workers’ Compensation Reciprocal and the services we offer.  Earn Subscriber loyalty by measuring

satisfaction, continuously improving loss control performance, claims management, and other services we offer.

 Maintain a strong market presence by remaining innovative and flexible in our approach to program and service development.

 Achieve stabilized pricing for members who purchase our products and services.  Maintain a strong financial position that will

INTERESTING FACTS

Closure rate is 91% on claims for the

MHA Workers’ Compensation Reciprocal

for the past 3 years.

The Reciprocal reduced frequency of

injury by 22% comparing 2011 to 2010

and 41% improvement since year 2007.

Average cost per MHA claims, life of

claim, closed in 2011: $10,950. NCII 2011

on Montana State advisory form states

the average medical cost per claim at

$42,000.

PREVENTION FOCUSED

Reviewing loss information, studying five

year trends, developing a mutual action

plan with the facility, completing a hazard

assessment of each facility and working

with safety committees are all things that

we do to prevent future injuries to our

employees.

TRAINING WORKSHOPS

Training workshops are conducted by the

risk management and claims

administrators annually for Subscriber

staff working with workers’

compensation issues. Special training for

specific issues may be requested by a

facility.

CLAIMS MANAGEMENT

Claims Management is designed to support Subscribers when a claim is filed. The experienced staff at Brentwood Services Administrators evaluates the circumstances, establishes communication with the claimant and their provider, and the Subscriber. The claims manager conducts a comprehensive review of the circumstances surrounding the incident; this process is designed to protect the claimant and the Subscribers’

organization. The claims manager’s assessment will evaluate the merit of the claim, establish reserves, and if necessary, enlist legal services.

RISK MANAGEMENT AND LOSS CONROL

These are key elements in containing the cost of workers’ compensation insurance. Brentwood Services Administrators conduct an initial site visit for all prospective Subscribers to establish a baseline of the organization’s risks and loss issues. Thereafter, Brentwood provides a minimum of quarterly onsite visits to each Subscriber’s facility to evaluate risk management concerns, measure progress on action plans, and make recommendations to enhance risk management programs. The following are a few of the services that Brentwood Services Administrators provides:

 On-site visits which included complete hazard survey.  Spring Conference Education.

 Quarterly loss prevention activities.

 Reporting on loss, frequency, trends to see where changes can be made.  Special training requested by facilities

 Safety Materials, PowerPoint’s, toolbox safety topics and safety videos specific to hospitals have been developed and made available to Subscribers.  Attending Safety meetings at Subscriber facilities upon request.  Face to face review of claims.



JOIN WITH US TODAY!

MHA WORKERS’ COMPENSATION RECIPROCAL

1720 9

_Avenue

Helena, Montana 59601

406-442-1911

Email:

[email protected]

or

[email protected]

www. Mtha.org

SUBSCRIBER SAVINGS ACCOUNTS

Reciprocal Subscribers each have an established ‘Subscriber’s Savings Account’ (SSA) that is created from excess funds available at the end of the year. In 2010 and 2011, a portion of these funds were used to offset one quarter’s premium for each Subscriber. Based on a formula worked out with the Insurance Commissioner’s office, the SSA accounts should continue to grow and provide funds to offset future premiums.

CURRENT MEMBERS

The MHA Workers’ Compensation Reciprocal is currently comprised of 6 hospitals throughout Western Montana.

 Barrett Hospital and HealthCare in Dillon  Clark Fork Valley Hospital in Plains  Deer Lodge Medical Center in Deer Lodge  Mineral Community Hospital in Superior  Northern Montana Hospital in Havre  Pondera Medical Center in Conrad

JOIN US!

To request an application form, please contact Kim Wiens at

“Our focus is to provide hospitals with

ongoing access to fair, affordable

coverage while protecting your

facility and your reputation.”

10

2003 - 2013

Yellowstone has the game winning

plan for hospital liability insurance

and risk management.

Yellowstone Insurance Exchange, RRG is a member

owned professional and general liability insurance

company managed by member hospitals to serve

their liability insurance and risk management needs.

Our primary objective is to ensure the availability of

liability insurance and to maintain premium stability

over the long-term.

Yellowstone offers more than simply insurance.

We take a proactive approach to the entire insurance

process by reducing the likelihood of a claim before

it occurs. Through our superior risk management

services and in-house claims handling, we ensure

Yellowstone has your hospital’s future at the forefront

of our intentions.

By altering what has been thought of as a commodity

based, lowest price wins perception, Yellowstone has

developed a way to turn professional and general

liability insurance into a profitable investment

for rural community hospitals. As a result, any net

income for the company is distributed back to the

member facilities in the form of Subscriber Savings

Allocations. To date, Yellowstone has paid out over

$5.0 Million in Subscriber Savings Allocations and

over $5.3 Million in returned capital.

866-216-7433 [email protected]

www.yierrg.com

We understand the X’s and

O’s of insurance and risk

management for hospitals!

Products

Hospital Professional Liability (HPL): Provides protection for your facility, employees and volunteers for a

claim brought against your hospital for malpractice stemming from services your facility provides.

General Liability (GL): Protects hospitals against payments as the result of bodily injury, property damage,

medical expenses, libel, slander, the cost of defending lawsuits, and settlement bonds or judgments required

during an appeal procedure.

Medical Billing Errors & Omissions Liability (Medical Billing E&O): Provides coverage for common

regulatory actions such as Recovery Audit Contractors Program Audits (RAC), Medicare audits, Allegations of

Non-Compliant Patient Referrals (STARK), Emergency Room Treatment (EMTALA), and alleged violations of

Patient Privacy (HIPPA). As part of the coverage and included within the limits of liability are any associated

defense costs. You will also have access to leading specialists in the area of RAC as well as shadow audit

teams to respond to any allegations under the Federal False Claims Act. You will be assigned defense

coun-sel with special expertise.

Privacy Protection & Security Coverage: In today’s technology driven world, it is imperative hospitals

protect themselves. With data security breaches and employee data being compromised at an alarming rate

this coverage provides timely security to our members. Coverage provides for forensic and legal assistance

from a panel of experts, notification to those parties who must be notified under law, and credit monitoring.

Claims Services

At Yellowstone, we understand the importance of protecting your community as well as your reputation. Clearly,

some claims have no merit. Should a claim occur, the experienced claim staff carefully evaluates the circumstances,

establishes ongoing communication with the member, and begins a comprehensive process designed to prevent the

payment of claims without merit and to contain the cost of legitimate claims consistent with fair and ethical industry

practices. No one likes surprises. So unlike many insurance carriers, Yellowstone does not act without your knowledge.

You will be involved in the claims process from start to finish, every step of the way.

Risk Management Services

Yellowstone’s risk management team is dedicated to improving quality care and decreasing the likelihood of a claim.

Risk Management is a key element in reaching these goals. Our risk management specialists conduct periodic onsite

visits to evaluate your health care organization and make recommendations to enhance your risk management

program. In short, Yellowstone helps translate information into solutions and makes consulting, data management

and training resources available at no cost to member hospitals.