Why Overcharges Occur
Payrolls
Experience Modification
Typical Client
Warning Signs
Prepare for the Audit
How we are Paid
Industries Overcharged
Self Insurer Mods
Required Paperwork
Expert Witness
Links
Tem Agencies
Order Manuals
Contact us
 
 
 

Classifications - The Good, the Bad, and the Ugly

 
   
     
Question:
What is the most common error that is made by insurance companies

Answer:
From our experience, the most common insurance company mistake is the addition of one or more new classifications to the payroll audit.  This procedure, routinely employed by many auditors, violates the Workers Compensation Basic Manual, The Experience Rating Manual, and the standard workers compensation policy's own wording.   

With very few exceptions, insurance premium auditors are not permitted to change a firm's classifications. Of course, if the classifications assigned to a policy don't fit the employer, the insurance carrier may endorse a change - but this must occur long before the premium audit and only after certain often ignored procedures are completed.

If your classes were changed by an auditor, then drop us a line at contact@zapcomp.com.

We will be glad to help.

 

Narrative

Classifications are the insurance industry’s way of lumping together employers with a similar likelihood of claims. The rate that is assigned to each classification anticipates those claims, plus insurance company overhead and profit.

Since rates anticipate future claims, they must come from a base large enough to provide statistically valid conclusions. If that base is too small, then the rates will not closely match claims. The only way to insure a large enough rate base is to limit the number of classifications that are available. This is the underlying rationale for the workers compensation classification system.

Since no two business are identical, all employers are funneled into one or more of the approximately 600 available classes. By definition, the classes that are assigned to an employer can only approximate the operations of that business. Further refinements, such as the experience modification, adjust the final premium to match the policyholder's anticipated claims.

The general rule is to group employers with the same risk into similar classifications. Subject to several exceptions, the overall business of the employer within a state is classified and not the individual duties or operations of employees. The primary classification assigned to an employer is called the governing classification and usually (but not always) is the classification that contains the most payroll.

Because some workplace duties are common to all businesses, four exceptions to the governing class are permitted. Called Standard Exceptions, these include; 1) Clerical office employees (#8810) and clerical telecommuter employees (#8871), 2) Drafting (#8810) and telecommuter drafting (#8871), 3) Drivers (#7380), and 4) Salespersons (#8742).

The governing classification is assigned to a policy by state and by entity. If two or more entities are covered under a policy, then each is entitled to its own governing classification. (This is a loophole that, with a little bit of planning, can save some companies significant money.) Further, if a business operates in two or more states, each state is assigned its own governing class (another overlooked loophole.)

There are several exceptions to the governing class rule. Special rules apply for construction, employee leasing and temporary labor contractors, and farm operations. These businesses are not assigned a governing classification. Instead, employees are classified based on their specific jobs and duties.

Some businesses may not have a classification that exactly describes their operations. For them, a classification is assigned that most closely describes the business.

A recent new rule, called the Interchange of Labor Rule, allows for the division of an employee's payroll between two or more classifications, subject to three conditions;

 
     
 

All classifications that are used are appropriate to the jobs performed

Payroll records exist that allocate wages between the different classes

Division of payroll is not available with the standard exception classes (except drivers)

 
 

 

 

 
 
 
 

This section has provided a brief overview of the Workers Compensation classification system. For a more in-depth discussion of this and other Workers Compensation subjects, I suggest that you order a copy of PRA's Premium Cost Cutting System. For more information, just click on the cover.

 
     
  manual6.gif (4448 bytes)  
     
 
   

Designed and Developed by Webionix
© 1999-2006 Premium Review Associates
 
Home