Nonsubscription
NONSUBSCRIPTION can be one of the best cost-cutting ideas your company will ever make. It is crucial that you have a superior program that keeps you out of court, in compliance, takes care of your injured employees AND your bottom line. GMW should be your company’s strategic partner for nonsubscription.
NONSUBSCRIBERS:
- Save Money
- Employees Receive Better Medical Care
- Fewer Lost Time Days
- Greater Productivity From Your Workers
- Better Cash Flow
- Nonsubscribing Employers Have Higher Rate Of Satisfaction Than Those That Carry Workers’ Comp
WHAT GMW CAN DO FOR YOU:
- Customized ERISA Plans
- Customized Arbitration Agreement
- Employee Rollout
- Regulatory Compliance
- Claims Assistance
- Litigation Defense
- Arbitration Defense
GMW SAVES YOU MONEY
WC Cost Nonsubscriber cost
Texas employers have had spectacular financial results from the decision to become nonsubscribers. While there is no guarantee of future results, nonsubscribers have had a dramatic reduction in claims costs and fewer lost time days after going nonsubscriber.
Nonsubscription also frees up your cash flow. You do not have to put up letters of credit for claims reserves as in workers’ compensation.
ARBITRATION
The biggest development in the last ten years for nonsubscribers is the use of mandatory arbitration agreements. This allows nonsubscribers to take cases out of the hands of an unpredictable (and potentially hostile) jury. Instead, the case is led by a skilled decision maker, such as a retired judge, who is familiar with the issues presented by the typical nonsubscriber case.
GMW dominates this area of nonsubscription.
GMW Keeps You in Compliance
GMW offers even greater savings and satisfaction by making sure you don’t get fined for common — and expensive — compliance oversights.
|
Failure to File DWC-5 |
Up to $25,000 a day |
|
Failure to File DWC-7 |
Up to $25,000 a day |
|
Failure to File ERISA 5500 |
Up to $30,000 per year |
|
OSHA willful violations |
Up to $70,000 per incident |
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OSHA serious violations |
Up to $7,000 per incident |
GMW helps you meet all regulatory requirements. For the state of Texas, a nonsubscriber must file with the Texas Department of Insurance, Division of Workers’ Compensation (“DWC”) a Form-5 when it chooses to become a nonsubscriber. Then, the nonsubscriber must file this form annually to advise the DWC that it is remaining a nonsubscriber. If the nonsubscriber has multiple locations in Texas, the DWC Form-5 must be accompanied by a DWC Form-205 which lists the locations the nonsubscriber currently has in the state. The nonsubscriber must also post the DWC Notice 5 (in Spanish and English) within 15 days of ending its workers’ compensation coverage. Written notice must further be distributed to all Texas employees.
A nonsubscriber must also complete a DWC Form-7 for each death, occupational disease or injury that results in more than one day’s absence from work for the injured employee. This rule is reflected in Title 28, Part 2, Chapter 160, Rule 160.2 of the Texas Administrative Code. Failure to timely make this filing subjects you to a $25,000 per day, per occurrence fine.
In addition to completing the DWC Form-7 and timely filing it with the commission, GMW assists you in considering the information that you are providing the DWC Form-7 in the context of future litigation. The report is not privileged.
On the ERISA side, GMW completes your nonsubscriber 5500 filings required by the Department of Labor.
GMW Helps You Effectively Rollout the Nonsubscriber Program
GMW provides receipt and acknowledgment forms for employees to prove receipt of the Mutual Agreement to Arbitrate and Summary Plan Description. We can meet with your employees to explain the program, or prepare a script for your supervisors to read. We also can customize a DVD for your organization that explains the program in English and Spanish. We handle all necessary employee communications so that your nonsubscriber program can be rolled out to all of your Texas employees quickly and efficiently.
GMW Drafts Your Work Injury Benefit Plan
There is no legal requirement that your company, as a nonsubscriber, provide benefits to an injured employee. However, every prudent nonsubscriber with any meaningful assets provides medical and lost income benefits to their employees. If an employer pays medical benefits to an employee, it is governed by the Employment Retirement Income Security Act of 1974 (“ERISA”).
A properly designed Work Injury Benefit Plan helps resolve most workplace injury claims. It requires an injured employee to follow the terms and conditions of the Plan. It requires the employee to promptly report injuries and then receive treatment only from a competent doctor. Injured employees receive quality care and promptly return to work under nonsubscription.
GMW has drafted the Work Injury Benefit Plans for hundreds of nonsubscribers. We will work with you to design your plan’s benefit levels, cost containment strategies and design to minimize litigation. GMW drafts the Plan and the Summary Plan Description in compliance with HIPPA and the Department of Labor regulations applicable to ERISA Plans. We also draft the Plan to conform to the coverage in your nonsubscriber insurance policy.
GMW Sets Up Your Claims Program and Defends Contentious Claims
With any nonsubscriber program, there are bumps in the road. Some employees will be absent during the rollout. Difficult employees sometimes refuse to go to an approved doctor or otherwise fail or refuse to follow the terms of the Injury Benefit Plan. Some employees will appeal a decision to deny benefits under the Plan. Threatening letters from plaintiff’s lawyers are received. A terrible, terrible accident occurs that results in a serious injury or death.
What happens next? How is the investigation conducted?
Who talks to the family? What if the liability facts are awful for your company?
No one can guide your company through the investigation and claims process better than us. We have been in the tough meetings. We have handled some of the most difficult claims ever brought against nonsubscribers. We know the process.
- We set up your claims program with proper forms for injured employee statements and witness statements.
- We help you timely and properly notify the insurance carrier and where appropriate the state.
- We help you with any ERISA denials or appeals.
- We help conduct the investigation for serious claims.
- We defend you against OSHA citations.
- We defend you if a claim goes to arbitration.
- We take care of you from beginning to end.
GMW Helps You Identify The Best Nonsubscriber Insurance Products For Your Needs
There are many nonsubscriber insurers. Their insurance policies are not uniform. Coverages vary, exclusions vary, the quality of the claims departments vary. GMW has been a primary author of several nonsubscriber insurance policies. We will show you a written comparison of coverage so that you know exactly what you are buying. We consult with you, and your insurance broker, to make sure you buy the best nonsubscriber insurance for your needs.
We Coordinate Nonsubscription with Your Company’s Employment Policies and Procedures
We can make modifications to your existing policies and procedures to inform your employees of the nonsubscriber program, review your drug and alcohol testing policies (which become very important with nonsubscription), and coordinate your nonsubscriber program with your leave of absence and modified duty procedures.
Finally, we will incorporate the documents applicable to nonsubscription which should be a part of your new employee’s orientation procedures.