No. 31347 (Amendment): R37-2. Risk Management State Workers' Compensation Insurance Administration

DAR File No.: 31347
Filed: 05/01/2008, 11:38
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

This amendment is necessary to reduce the costs and associated premium costs for workers' compensation coverage to covered entities.

Summary of the rule or change:

This amendment reinforces existing rules that require covered entities to participate in the preferred provider program designated by the risk manager by making that participation part of the workers' compensation premium cost allocation assessment. This amendment reiterates the existing requirement for covered entities to develop and participate in temporary transitional duty procedures to return injured employees to work at the earliest appropriate date.

State statutory or constitutional authorization for this rule:

Section 63A-4-101 and Subsection 63A-4-101(2)(a)

Anticipated cost or savings to:

the state budget:

There is an anticipated annual savings to the Risk Management Fund of $1,026,488. Using an occupational medicine preferred provider will enhance communication between the physician, Workers' Compensation Fund, and the covered entity to effectively coordinate care and expedite the return to work for the injured employee. Any savings to the risk management fund will be returned to covered entities through reduced rates in proportion to their contribution to the risk management fund based on total payroll costs.

local governments:

There is no anticipated actual impact to local government because local governments do not fund or provide workers' compensation coverage or treatment to state covered entities or state employees. There may be a minimal indirect impact to local government if medical services are provided outside the city or county where the employee would have sought initial treatment, if service through a preferred occupational provider approved by the risk manager was not required.

small businesses and persons other than businesses:

There is an indeterminable impact to small businesses as services previously provided by an employee selected health care provider will now be provided by an occupational medicine preferred provider approved by the risk manager. As many covered entities already require use of an occupational medicine provider, there may be a slight increase in revenue to occupational medicine providers approved by the risk manager.

Compliance costs for affected persons:

There is generally no anticipated compliance cost to any person. An employee of a covered entity who intentionally chooses not seek initial treatment for an on-the-job injury through the designated preferred provider program may bear the full cost for that treatment. Costs will vary based on the health care provider selected by the employee and the services necessary for the injury.

Comments by the department head on the fiscal impact the rule may have on businesses:

Occupational medicine providers approved by the risk manager may see a slight increase in revenue. Kimberly Hood, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Administrative Services
Risk Management
Room 5120 STATE OFFICE BLDG
450 N MAIN ST
SALT LAKE CITY UT 84114-1201

Direct questions regarding this rule to:

Melissa Frost at the above address, by phone at 801-538-3589, by FAX at 801-538-9597, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

06/16/2008

This rule may become effective on:

06/23/2008

Authorized by:

Roger Livingston, Director

RULE TEXT

R37. Administrative Services, Risk Management.

R37-2. Risk Management State Workers' Compensation Insurance Administration.

R37-2-2. Authority.

This rule is established pursuant to Sections 63A-4-101[ and 63A-1-110,] which authorize the State's Risk Manager to recommend rules to the Department Director who is authorized to enact rules; and Subsection 63A-4-101(2)(a) which authorizes the State's Risk Manager to acquire and administer workers' compensation insurance for the state.

 

R37-2-3. Workers' Compensation Costs Allocation.

The State's Risk Manager shall allocate workers' compensation insurance costs to state entities on the basis of an equitable and actuarially sound distribution of costs. The Risk Manager shall collect these funds through the state's payroll process. The following factors may be considered in developing this allocation:

(1). Covered entity injured workers' compensation claims and accident history and trends.

(2). Covered entity participation in preferred provider programs designated by the Risk Manager.

(3) Covered entity safety, loss prevention and loss control programs.

[(3)](4). Covered entity disability prevention efforts.

[(4)](5). Covered entity injured worker temporary transitional duty, and return to work programs.

[(5)](6). Covered entity case consultation and cooperation with Risk Management.

[(6)](7). Covered entity payroll by rate classification.

 

R37-2-6. Temporary Transitional Duty.

Covered entities shall develop return to work and temporary transitional duty procedures. Entities shall ensure that these procedures are in accordance with the requirements of the "American With Disabilities Act", and other applicable laws and rules. The procedures shall provide for the return of injured employees to work at the earliest appropriate date.

 

R37-2-[6]7. Agency Notice and Other Requirements.

All state entities shall do the following with respect to any employee or volunteer injury:

(1). Provide immediate notification to Risk Management through a phone call, E-mail, or facsimile, when any of the following conditions occur:

(a). Serious injury.

(b). An injury which is questionable or appears to be fraudulent.

(c). An accident involving the death of an employee.

(d). An accident where a third party action caused the accident, death or injury.

(2). Notify the Division of Industrial Accidents of the Utah State Labor Commission of incidents, as required by Subsection 34a-2-407(4).

(3). Within seven days of an employee injury, complete a "First Report of Injury Form" provided by Risk Management.

(4). Distribute copies of the "First Report of Injury Form", as indicated on the form, to the Division of Industrial Accidents of the Labor Commission, the state's Workers' Compensation insurer, Risk Management, and the injured employee.

 

KEY: risk management, workers' compensation

Date of Enactment or Last Substantive Amendment: [1993]2008

Notice of Continuation: June 8, 2007

Authorizing, and Implemented or Interpreted Law: 63A-4-201