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Auto Dealers Compensation |
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of California, Inc. |
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AD-COMP® |
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Membership has grown to 274 Members and over $21
million dollars in annual contributions |
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Return of $22 million in equity and retroactive
rate reductions to Membership |
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Realization of significant savings as a result
of the Medical Provider Network (MPN) |
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Considerable savings realized with the
implementation of a full time Return-to-Work Coordinator |
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Adoption of a formal payroll audit process and
engagement of Overland Solutions, Inc. to conduct 25 audits of the 2006
program year. |
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“World
Class” Safety and Loss Program continues to assist members in protecting
employees and to develop new programs and services. |
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AD-COMP meets all State regulatory requirements
– program funded at 80% confidence level |
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Bickmore Risk Services |
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Group Administrator |
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Dealer Cover Insurance Services, Doxsee &
Associates, |
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& Sorci Insurance Agency |
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AD-COMP Marketing and Brokerage Services |
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Intercare Insurance Services |
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Third Party Claims Administrator |
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Clifford Sweet, Heggeness & Sweet |
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Board Legal Counsel |
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Ted Kobayashi, Kobayashi & Company |
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Independent Financial Auditor |
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ARM Tech |
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Actuarial Services |
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Lee Sorenson, ARM - Risk Control Manager, |
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AD-COMP Team Leader |
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Dave Beal, ARM - Risk Control Analyst |
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Paul Horvat - Risk Control Analyst |
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Jennifer Bell - Risk Control Analyst |
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Trevor Earle - Risk Control Analyst |
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Patrise Reed, CIH - Risk Control Manager |
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Ann Pudoff, CIE, CLS - Ergonomist |
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Risk Control Site Visits |
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Risk Appraisal – Comprehensive evaluation |
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Informal Risk Control Visits – Quick check-up |
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New Member Risk Control Introduction |
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Safety Management Workshops |
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Regional Group Workshops |
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Dealership Specific Workshops |
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Model Illness & Injury Prevention Program |
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Safety Training Materials |
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Workbooks for Each Department |
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Safe Work Practices Training DVD |
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Computer Based Training |
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Forklift Train-the-Trainer Program |
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Aerial Lift Operator Training Program |
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Safety Sentential (Bi-Monthly Newsletter) |
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Safety Topic Library |
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Job Description Database |
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Telephone Consultation Services |
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Specialty Services |
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Rotary Tire/Wheel Lift Purchase Program |
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Slip-resistant Shoe Program |
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AD-COMP Website Risk Control Section (www.adcompsig.org) |
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Top Ranked Third Party Administrator |
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Experience and stability with examiners |
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Fighting the defensible claims |
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Understanding of the program and its goals |
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Understanding of the employer culture and
workplace |
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Ability to leverage knowledge across 274
dealerships |
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Account management and dedication to improve
cost containment programs |
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Proven claim results based on audit scores |
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Nurse Case Management and Utilization Review
(UR) |
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Every new loss is triaged by a nurse |
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Treatment requests matched to nationally based
protocols like ACOEM guidelines |
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Nearly 25% of indemnity claims have ongoing
nurse oversight |
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PharmacyComp Prescription Drug Card |
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Expedites employee access to approved medication |
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Controls costs |
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AD-COMP Medical Provider Network (MPN) |
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Implemented in December 2005 |
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Statewide network coverage for members |
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Ability to enforce new treatment controls under
MPN law |
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Expanding the quality and scope of the network |
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Focus on provider relations and their
familiarity with the policies and programs of AD-COMP |
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Currently 51% network penetration |
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Goal is 75% penetration |
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Intermed Medical Bill Review |
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Each bill processed to the CA Medical Fee
Schedule for WC |
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Flags over-billings, duplicates, balance-only
charges |
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Over $4 million in savings for 2006 |
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Return-to-Work Coordinator |
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Position added to claims team in 2006 |
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Administers AD-COMP RTW Policy |
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Assists Members with transitional duty |
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identify modified or alternate placement
opportunities |
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establish an early RTW plan with all parties |
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coordinate communication with physician, HR,
Supervisor, and Claims |
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Tracking lost time days for AD-COMP |
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Impact on reducing lost-time costs |
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Fraud Prevention |
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Internal Special Investigations Unit (SIU) |
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Assistance with identifying fraudulent claims
activity and conducting background checks |
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Suspicious claims or activities referred by SIU
Manager for prosecution |
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Member Education and Training |
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On-site claim reviews |
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On-Line Access to Claims Activity |
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On-Line New Claim Reporting |
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Workers’ Compensation |
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Claims Oversight |
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Oversee Third Party Administrator (TPA) |
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Quarterly claims review |
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Provide Claim Settlement Authority |
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Member Contact for Claim Service Issues |
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Perform Loss Analysis |
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Report to the Board of Trustees |
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Legislative and case law changes |
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Loss Trends |
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Develop cost containment programs and policies |
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Member education services |
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The combined effect of the cost containment
programs, reform legislation of SB899, and aggressive claims handling has
resulted in significant savings to AD-COMP and its members. |
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Average cost per claim is declining with
reductions in treatment costs and permanent disability benefits |
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Lost time costs are flat even with more members
and claims |
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Low litigation rates: 4.5% (2005) and 1.5%
(2006) |
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Intercare Report Card Available |
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Pre-Employment Practices Program |
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Safe Work Practices Video will be available in
computer-based training and Spanish versions |
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Alternative fuel vehicle training workbook |
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New self-insurance regulations (hopefully!) |
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Notes