Insurance for the First Stages

If you’re in the first, or seed, stage of building your startup you are probably excited – and nervous about everything that’s to come. Maybe you’re not thinking about insurance, or think that it’s something that can wait until you’re further along in the process. Nothing could be further from the truth. 

Startups are all about investment, and you need to think of commercial insurance as another investment to grow your business. Without it, you won’t be able to attract the best employees or convince investors that you are serious about your venture and are planning ahead for the long run. Even before you have customers, you should have the following policies:

• General Liability – something that all businesses should have, this type of insurance protects you against lawsuits claiming bodily injury or property damage. But did you know it also provides coverage for personal and advertising injury like libel or slander?

• Commercial Property – if you’ve got office space, then you need this type of policy to protect everything in it from risks such as fire or theft. There are commercial insurance packages available that will bundle liability and property coverage. 
• Workers Comp – if your startup has or plans on having employees, be aware that this type of coverage is required by individual states. It covers medical expenses and lost wages for an employee who is injured at work. 

Tech E&O vs Cyber Liability

Once you’re past that first stage of getting your initial funding, setting up your space, and hiring your employees, it’s time to start thinking about what happens once you are up and running. Now you have customers, and a whole new set of risks.

The above type of insurance policies apply to all businesses, but you may need some specialized coverage for your startup. If you’re dealing with any kind of tech, as many startups do, there are two types of policies you should look into: tech errors & omissions (E&O) and cyber liability insurance. They may sound similar, but they cover different things.

• Tech E&O – If you’re a business selling a physical product, then you need product liability in case a product fails. If you’re a firm offering financial or legal advice, then you need errors & omissions to protect yourself against claims of financial damage. If you’re a tech startup, then you need tech E&O. This type of coverage protects your company in the event that one of your tech-based products fails. If you are developing or licensing software, it is important to note that the insurance industry considers software a service and not a product. Because of this, you will need tech E&O, and not the same type of product liability coverage that might be sufficient for other businesses.
• Cyber Liability – There is one very important thing that that tech E&O doesn’t cover: third-party data breaches. 43% of all cyber attacks happen to small businesses. With all the risks of cyber crime today, this type of insurance is essential if you store any kind of customer data.

While tech E&O covers the failure of software, cyber liability covers the loss of private third-party information. Depending on your startup, you may need both to be fully covered.

As You Grow

If your startup is taking off, congratulations! You’re growing, and are probably looking for more investment and taking on a board of directors. In this case, you’ll need another specialized type of coverage: Directors & Officers insurance.

This type of insurance covers both your business and your management, including their personal assets. It covers:

• Theft of trade secrets

• Misrepresentation, in the case that investors feel they were given
  misleading information, leading to loss
• Wrongful acts, covering anything that managers do in their professional capacity that stakeholders deem  “wrongful,” and that results in a loss

Having D&O is important for attracting investors, who will feel more confident placing their trust (and money!) with you if you have comprehensive coverage. Your board members/managers will also feel confident making decisions without risk of personal liability.

Startups are unique among small businesses. They’re riskier, but they have more potential for growth. If you’re one of the few who have the vision and the drive, make sure that you protect everything you’re building. And remember, EZ.Insure is here to help you sort out your commercial insurance needs. We’re unique, too! We want your startup to succeed and will work with you to keep you covered. Our services are always free and nobody will ever hound you with endless calls. You have enough to worry about! To get started simply enter your zip code in the bar above, or you can speak to an agent by calling (855) 694-0047. 

It pays for a worker’s medical bills if he or she gets sick or hurt at work. It can also help make up for a worker’s lost income if they can’t work for a while. Disability insurance replaces a person’s lost income if they are hurt or sick outside of work and can’t work because they are handicapped. Most of the time, this coverage is not required. However, some states, like California, have state disability programs that require all qualified workers to have coverage.

Workers’ Compensation Insurance

In most places, employers are required to have insurance for workers’ compensation. But if you don’t have insurance, you could be held responsible for paying for any accidents you get on the job. If you or a worker needs long-term care, these costs can be much higher than the cost of insurance. After getting hurt or sick at work, workers’ compensation can help in three important ways: it pays for medical costs for emergency or ongoing care, pays for lost wages while the person is recovering, and protects the employer from claims. When it’s required by state law, not having coverage can leave you open to serious fines from state regulators and legal action from your workers.

The boss also has other duties, such as telling workers what their legal rights are. This is done by putting up health and safety signs at work. Such as the name of the insurance company and how to report an accident. If a worker gets hurt on the job, the boss generally has to give them a claim form within 24 hours of finding out about it. Find out more about cases for workers’ comp.

Benefits of Workers’ Compensation

Salary Replacement

Most of the time, someone who applies for workers’ compensation will get some of their lost pay back. But it won’t be as much as their full pay. Most policies cover about two-thirds of the gross pay of the recipient. Even though the payout is usually not taxed at the federal or state level. People who get money from Social Security Disability or Supplemental Security Income may have to pay taxes on that money, though.

Medical Bills

Workers’ compensation insurance also covers the cost of medical care for a worker who gets sick or hurt on the job. This could mean going to the hospital, having surgery, or taking medicine. If you get sick or hurt at work and it’s so bad that you need more than one treatment. Workers’ compensation will pay for that care. It will also cover accidents that come from doing the same thing over and over again. It’s important to know that most workers’ compensation plans will only pay for medical costs related to injuries that happened at work. For example, a building worker could get paid for injuries they got when they fell from scaffolding, but not for injuries they got on the way to work.

Survivor Benefits

If your employee dies because of something that happened at work, workers’ compensation can help pay for their funeral and give widow benefits to their family.

Disability Insurance

Disability insurance is different from workers’ compensation in many ways. In this case, an employee’s illness or injury that keeps them out of work doesn’t have to happen at work. Depending on the claim, the benefits may be paid for a few days, weeks or even for life. Disability insurance is generally split into two types:

• Short-Term Disability Insurance  – Benefits for short-term unemployment last from three to six months. Many employers give this coverage as part of a group insurance plan. The premiums can be paid by either the employer or the employees.
• Long-Term Disability Insurance – Long-term disability gives disability benefits for more than one year and is for disabilities that last longer or are permanent. Most people buy this from an insurance company on their own. But some employers give it as an option that the employee can pay for through payroll deductions.

Disability insurance is generally not required by law like workers’ compensation. Many workers choose to add their own private plans to the disability insurance that their employers already pay. Depending on the person’s situation, these policies can work with government-funded social security disability as well. As an employer, you might offer disability benefits as a way to make your employees happier and keep them on your payroll. This is because with disability insurance, employees know that if something comes up in the future that makes it hard for them to work, they won’t be left on their own with no options.

Benefits of Disability Insurance

Flexibility

Most of the time, employers can choose a plan that works for both them and their workers. For example, an employer might choose a “guaranteed issue” plan. Which lets workers buy coverage no matter what their health is like right now. Disability insurance also comes with payment flexibility. The company, the employee, or a combination of the two can pay the premiums, either before or after taxes.

Lower tax deductible premiums

Most of the time, group prices are less than individual rates. As a business tax deduction, you can use company-paid insurance that was paid before taxes.

How They Help Employer’s and Employees

Workers’ compensation helps workers with more than just medical care and lost wages. It can also protect employers from having to pay for this kind of care out of their own pockets and keep them from getting sued at the same time.

When an employee accepts a workers’ compensation settlement. They give up the right to sue their company for an accident that is covered by the settlement. This keeps the company from having to pay for expensive lawsuits and lets employees get the help they need right away. Since a workers’ compensation claim can be processed much faster than a lawsuit. Even when it’s not required, many employers give disability coverage because it can be a cost-effective way to keep their employees from having to pay a lot of money because of an accident or illness.

Another thing to think about is that the benefits from workers’ compensation may not be enough for some people who make more money. In many places, workers’ compensation insurance can only replace a certain amount of lost income. So some employers and employees buy disability insurance to make sure they are financially safe.

When You Need Workers’ Compensation Insurance

Depending on the workers’ comp rules in your state, you may need workers’ comp coverage as soon as you hire your first employee. But some states set the bar a little higher. Some states require this coverage for independent contractors who work in jobs that are more dangerous, like construction. For example, California requires employers with one or more workers to provide this service to any regular worker in the state. Even if they work alone, roofers must have their own insurance. Businesses with five or more staff in Missouri are required to have workers’ comp. Independent workers, one-person businesses, and owner partnerships don’t have to pay.

Most states don’t require sole proprietors and contractors with no staff to get workers’ compensation insurance. But some states do for more dangerous jobs. No matter what you do for a living, this coverage may be needed to apply for some contracts. Some companies require their contractors to have their own workers’ compensation insurance. Because it lowers the company’s liability if a contractor gets hurt on the job. Many workers buy this insurance because it protects their money. If you are a sole proprietor or an independent contractor, your normal health insurance probably won’t cover you if you get sick or hurt at work. If you can’t work because of an accident, you can also recoup some of your lost pay through workers’ comp.

State-Specific Disability Plans

Employers are required to take part in state disability insurance plans in the following states:

• California
• Hawaii
• New Jersey
• New York
• Rhode Island
• Puerto Rico

How EZ Can Help

If you are in need of disability insurance for your employees or need commercial insurance to safeguard your business, EZ is available to provide assistance. Our agents collaborate with leading insurance firms around the country. To ensure the identification of optimal insurance coverage for both your business and its employees. Indeed, it is possible to get substantial cost savings amounting to hundreds of dollars annually by collaborating with your financial plan to choose the most optimal insurance coverage. If you require any further clarification, please do not hesitate to contact us at 855-694-0047.

One of the most important concerns for both workers and businesses is the health and safety of their workforce. Workers’ compensation insurance and occupational accident insurance are two important insurance policies. They each come into play when it comes to the protection and safety of the workplace. In spite of the fact that both offer financial aid in the event of a workplace injury, there are substantial differences between them in terms of their structures, coverage, and the conditions under which they are applicable. 

Workers Compensation

Companies that employ a minimum number of workers or employees who work a specific number of hours per week as defined by law are required to comply with the workers’ compensation requirement, which is a state-regulated requirement. The minimum number of employees varies from state to state. In some states, it means one or more employees, while in others, it means five or more. For more information on state-specific workers’ compensation requirements, visit the U.S. Department of Labor’s Worker’s Compensation page. 

Workers’ compensation provides payments for wage loss, medical treatment and related expenditures, and rehabilitation for employees who sustain an injury on the job or who become ill as a result of elements that are present in their workplace environment. In addition, the insurance policy provides coverage for employer liability, which means that businesses are afforded some degree of protection in the event that an employee decides to file a lawsuit in connection with their workers’ compensation claim. More frequently than not, the costs of legal defense are covered up to the limitations of the policy. It is still the responsibility of employers to ensure that their employees are working in a safe environment.

Occupational Accident Insurance

Occupational accident insurance is a policy that provides benefits to independent contractors and employees who are not protected by a workers’ compensation program. This sort of insurance may give medical, disability, and accidental death and dismemberment benefits. But it is not state-regulated, unlike workers’ compensation. Wage loss benefits, medical expenditures, and rehabilitation costs for workers or insured independent contractors may be paid by policies, but only up to policy limits. Employers can determine their coverage and deductible amounts based on their own risk tolerance.

Workers’ compensation is more expensive for businesses, but it provides more complete coverage, particularly in terms of their own liability, which is not covered by occupational accident insurance. Employers who purchase occupational accident insurance may be exempt from the mandatory workers’ compensation system in several states. While the employer still has a legal commitment to employees who are injured or killed on the job, it is significantly less expensive than workers’ compensation. Employers receive statutory benefits through workers’ compensation, however when purchasing occupational accident insurance, you must make the following decisions:

• The limit of liability to carry per accident.
• The deductible to assume per accident.
• The level of disability coverage to provide.
• The level of death benefits to provide.

Companies will still be liable to their employees for legal responsibilities that are not covered by occupational accident insurance. Choosing the wrong coverage selection might expose a company to significant financial losses – a danger that workers’ compensation insurance protects against.

How They Differ

Workers’ Compensation

• Mandatory Coverage – Workers’ Compensation Insurance is a state-mandated program that mandates employers to provide coverage for employees who are injured or ill at work. The standards and regulations may differ from one state to the next.
• No-Fault System – Workers’ Compensation is a no-fault system, which means that employees are eligible for payments regardless of who caused the job accident. This method is intended to give injured workers prompt compensation without the need for lengthy court battles to identify fault.
• Eligibility – In the US, workers’ comp is generally available to all employees, regardless of fault or negligence. It is mandated by state laws to ensure that employees are protected in case of work-related illnesses or injuries. Whether they’re a full-time employee, part-time worker, or seasonal staff, they’re typically covered under workers’ compensation. That is if your company meets the legal requirements.
• Covered Benefits – Workers’ Compensation often pays for medical bills, rehabilitation costs, and a portion of an injured employee’s salary while they are unable to work. Long-term compensation may be awarded in the case of permanent impairments.
• Employer Immunity – When covered by Workers’ Compensation Insurance, employers are generally protected from lawsuits made by employees for occupational injuries. This exemption is a trade-off designed to expedite the procedure and ensure that injured workers receive early compensation.
• State Regulated – Workers’ Compensation programs are governed by state agencies. Each state has its own set of laws governing coverage criteria, benefits, and claim management.

Occupational Accident Insurance

• Voluntary Coverage – Occupational Accident Insurance is often bought by employers to provide additional protection beyond what Workers’ Compensation may provide. 
• Fault Considerations – Occupational Accident Insurance, unlike Workers’ Compensation, usually considers fault when deciding compensation. Coverage may be limited if an employee is deemed to be at fault for their injury.
• Flexible Coverage – Employers can tailor Occupational Accident Insurance coverage to their specific requirements. Medical bills, disability benefits, accidental death benefits, and other benefits may be covered. The scope of coverage, however, is determined by the specific policy chosen.
• Eligibility – Occupational Accident Insurance is designed specifically for workers who are not eligible for workers’ compensation, such as independent contractors and other workers. Due to the fact that they are not typically covered by regular workers’ compensation plans, individuals who are self-employed, freelancers, and gig workers are examples of individuals who can benefit from occupational accident insurance. These non-traditional workers, who may be exposed to a variety of unique dangers and difficulties, are afforded an additional layer of protection by occupational accident insurance. 
• Excludes Certain Risks – Certain hazards or activities may be excluded from coverage under occupational accident insurance policies. And employees may be required to meet specified requirements to be eligible for compensation.
• No Employer Immunity – Occupational Accident Insurance, unlike Workers’ Compensation, does not protect companies from employee lawsuits. If an employee has this coverage and suffers a working injury, they maintain the ability to sue their employer.

Choosing The Right Coverage

• Consider Legal Requirements – Employers must comply with state-mandated Workers’ Compensation requirements. Failure to do so can result in legal consequences. While options, many consider Occupational Accident Insurance to be an additional layer of protection.
• Evaluate Risks and Budget – It is important for employers to evaluate the dangers that are associated with their industry as well as the financial repercussions that could result from injuries that occur on the job. It is possible for occupational accident insurance to provide supplemental coverage that is tailored to specific requirements.
• Communicate With Your Employees – Important is the transmission of the available insurance coverage in a clear and concise manner. It is important for employees to be aware of their rights under Workers’ Compensation as well as any additional coverage that may be given by Occupational Accident Insurance.
• Consult With An Insurance Agent – When it comes to navigating the complexity of Workers’ Compensation and Occupational Accident Insurance, it might be helpful for companies to seek counsel from insurance professionals. They have the ability to help select the coverage that is best suitable for the specific conditions of your company.

Wrapping Up

EZ is the place to go if you are seeking workers’ compensation insurance. We take great satisfaction in making your shopping experience as simple and stress-free as possible. Not only do we provide our consumers with our undivided attention, but we also provide entirely tailored service and quick outcomes. Once you have completed our form, you will immediately be provided with free estimates from one of our representatives. A person who will comprehend your requirements from the very beginning. To ensure that you make the greatest choice possible and obtain the best coverage at the best price, we want to make sure that you do so. Make sure you check out your quotes right away because none of our services cost you anything.

For any questions, please do not hesitate to call us at (855) 694-0047. You’ll speak with a local insurance agent that is able to provide answers to all of your questions. In addition, we can assist you in locating the workers’ compensation policy that is most suitable for your company. Or for free instant quotes just enter your zip code into the box below.

Worker Fatigue

Fatigue is more than just feeling tired. Fatigue is a state of exhaustion that has persisted for an extended amount of time. It can have a significant impact on many aspects of an employee’s life. People are not designed to work for hours on end with no breaks. Our bodies require at least 7 hours of rest and recharge per day. Here are some examples of fatigue symptoms:

• When employees are tired, their reaction time can slow down a lot. This could be dangerous or even deadly at some jobs.
• Making decisions slowly or not at all. When employees are too tired to remember what to do, they often make bad choices. This effect on tired workers is very important because in some places of work, a bad choice can put a lot of people in danger.
• Lack of attention span. It is harder for employees to focus on certain jobs when they are tired. If they can’t think straight, they might forget to do their work, which could lead to a dangerous situation.
• Dozing off at work due to lack of sleep or rest.
• When employees are tired, they might have any of these symptoms: aches and pains in their muscles, a change in their appetite, gastrointestinal issues, sleepiness, anxiety, headaches, or emotional distress.

Imagine that you have to do the same job every day, week after week, with nearly no breaks. Over time, this can and will lead to accidents. When our brains are tired, we have a higher tendency to mess up when we’re figuring things out. For businesses in fields where measures are important, this could be a major problem. Being tired, we might not pay as much attention to our surroundings. If you work with tools or operate heavy machinery, this is especially dangerous.

Impact Of Fatigued Employees

The costs associated with overworked employees go beyond the immediate issue of decreased production; they permeate many other parts of business operations, which has an effect on the bottom line. Employers have a responsibility to acknowledge the significance of treating fatigue in the workplace, putting into action initiatives that encourage employee well-being, and ultimately cultivating a work environment that is both healthier and more productive. Employers have the ability to lessen the financial burden of weariness and contribute to the long-term success of their businesses if they make investments in the health and satisfaction of their workforce.

Decreased Productivity

One of the most direct consequences of employee fatigue is a decline in productivity. Over-tired workers are likely to experience reduced focus, slower reaction times, and impaired decision-making abilities. This drop in productivity can lead to lower output, increased errors, and a general decline in the quality of work, all of which contribute to financial losses for employers.

Increased Absenteeism

Fatigue often leads to increased absenteeism as employees may find it challenging to meet their work commitments. Regular absences can disrupt workflow, result in missed deadlines, and require additional resources to cover the workload gaps. This not only affects immediate productivity, but can also result in additional costs associated with temporary staffing or overtime payments to cover absent employees.

Higher Accident Rates

Fatigue is a known contributor to workplace accidents. Over-tired workers are more prone to making mistakes, and their diminished alertness increases the risk of injuries and accidents. Workplace incidents not only incur direct costs such as medical expenses and potential legal liabilities, but can also lead to increased insurance premiums for employers.

Increased Healthcare Costs

Fatigue is associated with various health issues, both physical and mental. Over time, exhausted employees may experience a decline in overall health, leading to increased healthcare utilization and associated costs for employers. This includes expenses related to medical treatments, doctor visits, and potential long-term disability claims.

Employee Turnover

A workforce experiencing chronic fatigue is more likely to suffer from burnout and dissatisfaction. This dissatisfaction can contribute to higher employee turnover rates as workers seek environments that prioritize their well-being. The costs associated with recruiting, training, and onboarding new employees can be substantial for employers.

Lower Innovation and Creativity

Fatigue not only affects routine tasks, but also hampers creativity and innovation. Over-tired employees may struggle to think critically, solve problems, or contribute fresh ideas. This can hinder a company’s ability to adapt to changing market dynamics and innovate, potentially resulting in missed opportunities and revenue growth.

How You Can Prevent Employee Fatigue

It can be dangerous for employees to work when they are tired. According to research, being tired is just as bad for the brain as driving while drunk. Memory, balance, focus, decision-making, and movement skills are all affected by fatigue in workers. It also leads to about 13% of accidents and injuries at work every year. It’s true that you can’t suddenly make sure your employees get enough rest to do their job safely and well, but these tips can help companies make jobs safer by keeping workers from getting too tired at work.

Educate Your Employees

In some of the most significant incidents that have ever occurred in the workplace, fatigue has been identified as a contributing cause. It is important to provide training to all employees, particularly supervisors, in order to identify signs of exhaustion in workers. When employees are aware of the indicators, they are able to take greater precautions to ensure that they get sufficient sleep at night. For those in charge,  bringing it to the attention of workers and encouraging them to take breaks is helpful.

Think About How You Schedule Shifts

Employees who work shifts that are late at night or overnight are more prone to experience high levels of fatigue. When scheduling staff, try to avoid arranging them for shifts that are irregular or rotating. Additionally, fatigue tends to develop tremendously during a shift that lasts for twelve hours. Employees should be given at least a 24-hour rest in between 12-hour shifts, and overtime should be prohibited for those working those schedules.

Enforce Breaks

In order for workers to recover from repetitive tasks, it is the responsibility of employers to guarantee that they receive their permitted breaks. It is possible to restore essential functions to the brain and boost focus with as little as fifteen minutes of break time.

Avoid Extended Shifts When Possible

According to the recommendations of the Occupational Safety and Health Administration (OSHA), companies should make every effort to prevent their employees from working more than forty hours per week or working odd shifts whenever it is feasible to do so. Some examples of uncommon shifts include working two shifts in the same day, such as working four hours in the morning and then returning for a three-hour shift in the evening. Another example is working two shifts in a single day. It may also involve shifts that are not consistent with one another, such as working an evening shift, then a morning shift, and then continuing on to work overnight shifts. Please do not hesitate to get in touch with OSHA directly if you consider your schedules could potentially compromise your safety in accordance with this recommendation.

Paid Sick Leave

If you’re a business owner, paid sick leave might seem like an extra cost to think about, but new paid sick leave isn’t just a perk for workers. It’s also good for business. Employees who can take paid sick leave are less likely to miss work, which is good for business. Being sick at work makes you much less effective, and there’s a chance that you could spread the infection to other people. Putting your whole staff at risk to meet business goals is a very unprofessional thing to do. It can also cost a lot more in the long run than just giving employees a few sick days a year. 

One thing we can say for sure is that using employee scheduling tools to track and manage your staff is a must if you want to make your business run more smoothly. Without a doubt, it can be very helpful for people who have problems with their workers being too busy or people who don’t want it to happen in the first place. 

Finding Business Insurance With EZ

We are able to assist you in obtaining commercial insurance to safeguard your company as well as group health insurance for your employees. To ensure that you are able to get the most suitable insurance coverage for your company and its employees, our representatives collaborate with the most reputable insurance providers around the country. In fact, we are able to save you hundreds of dollars annually. We do this by working with your budget to locate the most suitable coverage for you or your family. If you have any inquiries, please do not hesitate to contact us at the following numbers: 877-670-3531 for assistance with group health insurance, and (855) 694-0047 for assistance with commercial insurance. You can also simply enter your zip code into the bar below for free instant quotes.

An assigned risk plan is a workers compensation plan set up by the state for businesses that cannot get a workers compensation plan from a ‘regular’ insurer. Plans with an assigned risk are also known as the leftover market or the assigned risk pool. This safety net is the last option for employers who don’t have any other way to get coverage. All states except those that have a monopoly have made a plan. How the plan is run and paid for depends on the laws in each state.

Reasons You Could Be In The Assigned Risk Pool

When insurance companies don’t want to write a workers’ comp contract for a specific business (for reasons we’ll list below), that business goes into the workers’ comp pool to be assigned to an insurance company. These less desirable businesses will be spread out fairly among the workers’ compensation carriers. You may be in the workers’ comp pool for the following reasons:

• Poor claims history – If a business has too many claims for injuries, insurers might think that its owners don’t care about safety.
• New company – An insurer can’t tell much about a new company because it doesn’t have a track record. This makes it difficult to judge the risk the company would take by insuring you.
• High-risk industry – Many insurance companies don’t want to cover employers in dangerous jobs like logging, trucking, and roofs with workers’ compensation insurance.

Insurance companies think that businesses with these traits are more likely to have a claim, so they may not want to offer a workers’ comp insurance. But because most states require workers’ comp insurance, the pools are set up to choose a company for you.

Assigned Risk Plan Administration

All states have a person in charge of running the plan and making sure policies are given out. In most states, the National Council on Compensation Insurance (NCCI), the state competitive insurance fund, the state rating group, or a third party is in charge of managing workers’ compensation insurance. The NCCI is in charge of running assigned risk plans for 22 states. Each of these 22 states requires all workers’ compensation insurers that do business within its borders to take part in the assigned risk plan. Insurance companies can either be:

• Direct assignment – This means the NCCI assigns workers’ compensation policies from the companies that have to purchase a policy through the assigned risk pool. The business applies then the NCCI hands their application to one of the direct assignment companies.
• Reinsurance – The insurers in this group basically insure the direct assignment companies. So if a direct assignment insurer has a claim or policies that they cannot pay for themselves the reinsurance company financially protects them so they can pay the claim without being bankrupt.

In some states, the state competition fund is in charge of running the assigned risk plan. This means they give businesses the option to either buy from the state fund or buy from private insurers. So, the state fund competes with the private insurance companies for business. These states are:

• Arizona
• California
• Colorado
• Idaho
• Kentucky
• Louisiana
• Maine
• Maryland
• Minnesota
• Missouri
• Montana
• New Mexico
• New York
• Oklahoma
• Oregon
• Pennsylvania
• Rhode Island
• Texas
• Utah

Most of the other states have either chosen their rating group or an insurance company to run their plans.

Cost Of Assigned Risk Plans

The assigned risk pool is supposed to be a last-resort market for high-risk businesses. Because of this, the rates are supposed to reflect the risk that the insurance companies are taking by covering this group of high-risk plans. Rates vary from state to state, but in general, it’s safe to think that the rates in the pool are the highest available for most workers’ compensation class codes. In fact, many companies in the standard voluntary market base their rates on the rates of the given risk pool.

Getting Coverage

If you or your insurance agent can’t find workers’ compensation coverage for your business in the standard market, you or your agent can send an application to your state’s assigned risk plan provider. How to apply changes from state to state. If your state’s plan is run by the NCCI, you can apply online 24 hours a day or send your application through the U.S. Postal Service to the NCCI. To get coverage from an assigned risk pool, you must have tried to get coverage from an insurer, but have been turned down. Each state has its own rules about how many rejects are needed. For example, West Virginia companies can only apply for coverage in the assigned risk plan if they can show that two insurers have turned them down.

Getting Out Of The Assigned Risk Pool

If you’re in the pool, there are no extra fees or charges. The only problem is that you don’t get to choose your insurance company, and you usually don’t have much choice about how to pay. Your payments can also be up to 400% higher than those of businesses that aren’t in the risk pool. If that bothers you, you may want to get out of the workers’ comp pool as soon as possible. This is how:

Improve Your Claims History

If you are in the workers’ compensation pool because you have made too many claims in the past, the only way out is to make fewer claims in the future. And a detailed safety plan is the best way to cut down on claims. This should include figuring out what the risks are and how to deal with them, as well as giving all workers ongoing safety training. You could also set up a safety committee or use tools for safety or incident management.

Even if you do all of the above, you can’t stop all accidents from happening, so it’s also important to know how to handle them when they do. This is because, in addition to how often you file a claim, the length of a claim can also make your workers’ compensation costs go up. Insurance companies want as few open claims as possible, so claims that take a long time to settle will make your workers’ comp cost go up. 

Because of this, you should have a plan to help wounded workers get back to work as soon as possible. This could include a strategy called “light duty,” which lets employees go back to work without having to do any tasks that will make their injury worse.

Have Patience

If your business is new and you are in the workers’ compensation pool, you have no choice but to wait it out. If you don’t have any claims and don’t work in a high-risk business, you should be able to get out of the workers’ comp pool in a few years. So patience is key here. Bide your time in the risk pool and put safety procedures in place to keep your claims low and claims length short that way when it’s time to move out of the pool you can do so easily.

Work With An Independent Agent

If your business is in a high-risk field, you may not be able to do anything. Because of your risk, insurers might not be ready to give you a policy. Each provider is different, though. Just because one insurance company won’t give you a policy doesn’t mean that no one else will. Even if one insurance company doesn’t take your business one year, that doesn’t mean they won’t the next. Carrier insurance rules change so often that the same rules may not apply from one year to the next. 

So you might be able to do a little research to see if there is a company that will take you on. Even better, you could work with an independent agent who can shop around to different companies to find one that might be willing to cover you.

How EZ Can Help

Workers’ compensation can be stressful. Hope is often at the end of the tunnel. There are usually ways to improve your workers’ compensation position. An independent insurance agent can help you choose a workers’ comp company. They can also assist you in managing your workers’ compensation policy in other ways that save time and money. EZ is the place to go if you need workers’ compensation insurance for your business. We are proud of the fact that we pay attention to each customer as a person and try to make sure you feel comfortable while you shop.

We offer personalized service and instant, free quotes from an agent picked based on your needs. If you’d like to get started with a quote you can enter your zip code in the box above. We want you to make the best decision possible and get the best deal for your money. Our services are always free, and there are no hassles or obligations to sign up. You can also call us at 877-670-3538 if you still have questions. You can talk to an insurance agent in your area, who will be able to answer all of your questions and help you find the best workers’ compensation policy for your business.

You know how important it is to have workers’ compensation insurance if you run a business. More often than not, you legally have to have this kind of insurance. But workers’ compensation is one of the hardest types of business insurance to understand and follow the rules for. Each state has its own rules about workers’ compensation insurance. Such as whether or not a business needs it and how much the payment should be. However, one thing that all states require is that insurance companies must do a workers’ compensation audit to make sure that companies are paying the right amount for their benefits.

What Exactly Is The Audit?

When you buy workers’ comp insurance, you usually have to give an estimate of how much your employees will be paid and what kinds of work they will do during the policy time. Along with other things, your estimate is used by your insurance company to figure out how much your workers’ comp insurance will cost.

You usually make estimates for one year’s worth of payroll. But sometimes those don’t match up with your actual payroll by the end of the year. There may be more work than expected during the year, or unplanned events may cause your verified payroll to be less than what was planned. Because of this, most state regulators need an audit every year so that the premium can be adjusted as needed so you’re never paying too much or not enough for your coverage.

During the audit your insurance company will check that the expected payroll and other records you supplied at the start of the policy match the confirmed payroll and work done during the policy period. If the records aren’t consistent your premium will change. If you overestimated then your policy will be cheaper and vice versa. There’s a few things you should know about the audit:

Audits are mandated by law

The word audit sometimes has a jarring reaction because we’re used to hearing it in a negative light around tax time. However, with workers’ comp you aren’t being audited because they think you’re committing fraud. They are checking to see if the payroll and class codes listed at the start of your insurance policy match the ones listed at the end, and they also want to know if any substitutes you hired had their own insurance. It’s just fact finding to not only make sure you’re paying what you should but also makes sure the insurance company isn’t charging you too much.

Types of Audits

There are three types of audits your company can go through depending on the size, the industry, and the auditor themselves.

• Preliminary Audit – When you first apply for workers’ compensation insurance, your insurer may do a preliminary audit of your business to figure out your initial rate. 
• Mail Audit – The mail audit is when your insurance company gives you a workers’ comp audit form in the mail. It is also called a voluntary audit. You just need to fill out the workers’ comp audit form and send it back to the insurance company along with any other paperwork they ask for. If you run a small business, this is probably how your workers’ comp audit will go.
• Phone Audit – This type of workers’ comp audit still requires you to send in payroll information and fill out some forms. The only change is that someone from the insurance company will call you to go over your paperwork. Medium-sized businesses are most often given the phone audit.
• Physical Audit – A physical workers’ comp audit usually only happens if your business is very big or is thought to be committing major fraud. When your insurance company does a physical audit, they will send someone to your business to talk, look at your payroll records, and possibly ask for more paperwork. If you need a physical workers’ comp audit, you might want to hire a workers’ comp audit attorney to make sure you follow all the rules of the audit and don’t put your business at too much risk of being sued.

Pay-As-You-Go Workers’ Comp

“Pay as you go” workers’ comp insurance is not a new idea, but small businesses are using it a lot more now that workers’ comp prices are going up. A business typically pays a premium for normal workers’ comp insurance based on how much they expect their payroll for the upcoming year to be. Pay-as-you-go uses real-time payroll to figure out workers’ comp premiums month by month instead of an estimated yearly payroll amount. This means that premium payments are more accurate. This makes it less likely that you’ll pay too much during the year or have to pay more at the end of the insurance term because you didn’t report enough payroll.

How To Prepare

Once your insurer has contacted you and set up when and how your audit will take place it’s time to prepare for the appointment. 

1.Work With The Auditor

Talk to your insurance auditor and be polite and friendly when you answer questions or give them information. Also, remember to be clear, and honest. Look over any workers’ compensation audit worksheets they make, and don’t sign off on any that aren’t finished or correct. This will keep the inspector and you from having to fill in the blanks over and over again. For your own notes, you should also make a copy of the final workers’ comp audit worksheet.

2.Collect Your Records

The cost of workers’ compensation insurance depends on your payroll, risk, and claims history. The auditor needs to know about all of these things. Most of the time, audit notices list the papers that the auditor can use to check the information. This list may be different for each insurance company, but most of them will want some or all of these things:

• Company operation description
• Employee job descriptions
• Number of employees
• Owners names and titles
• Description of any contractor or subcontractor work 
• Accounting ledger
• Federal 1099, W-2, and W-3 transmittals
• Federal Profit and Loss From Business Schedule C (Form 1040)
• Payroll register
• Federal Employer’s Quarterly Tax Return (Form 941)
• Business checkbook
• Federal Employer’s Annual Tax Return (Form 944)
• Federal Employer’s Annual Unemployment (FUTA) Tax Return (Form 940)
• State unemployment insurance tax reports
• Time cards
• Overtime records
• Any payments made to independent or subcontractors and laborers
• Receipts for materials
• Subcontractors’ insurance certificates (if any subcontractors were hired)
• Business experience modification worksheet

Payroll

Payroll, which is also called remuneration, is where your workers’ comp premium starts, so when you’re getting ready for an audit, you want to make sure that number is correct. Each state has its own meaning of “remuneration,” but in general, it includes:

• Gross wages and salaries
• Commissions
• Bonuses
• Overtime, holiday, vacation, and sick day payments
• Employee contributions to 401ks, savings plans, or IRAs
• Any lodging or meals provided to employees
• Payment or allowances for employee tools

Alternatively, payments that aren’t normally considered salary when workers’ comp premiums are calculated may be included in an employee’s paycheck. Many states, for instance, don’t include:

• Tips and gratuities
• Employer payments to group insurance
• Severance pay
• Reimbursed business expenses
• Special rewards for individual invention or discovery
• Active military duty pay
• Uniform allowances
• Employee discounts on goods and services

In most cases, business owners don’t need to be covered by workers’ compensation insurance, so their pay isn’t looked at during a workers’ comp audit. Nevertheless, some states let sole proprietors, corporate officials, partners, and members of limited liability companies (LLCs) choose to get coverage. As a result, their pay is handled differently because it is usually a lot higher than regular workers’ pay.

The state generally sets an annual wage for sole proprietors or partners that is different from their normal salary. The rate the state sets is what goes into the workers’ comp audit paperwork. For example, corporate officers who choose to participate in workers’ compensation get a weekly salary that is between the state’s maximum and minimum wages. This depends on the workers’ compensation rules in the member’s state.

3. Update Job Descriptions

The dangers your employees face at work are also taken into account when figuring out your workers’ compensation costs. This is done so that the auditor can look into everyone’s tasks and how your business runs in general. This could mean going over the job titles you already have or filling out a form that lists what each employee does. You should know a lot about what the people who work for you do, no matter what. Job titles should be kept up to date, or they should be made from scratch if they aren’t already.

You might want to skip this step, but in the event of a workers’ comp check, having clear job descriptions can be very helpful. Your inspector can figure out the right governing class code for your business with the help of accurate job descriptions. There is a base rate for that class code that is used to help calculate your premium. 

4. Review The Audit

Once the audit is over, look over the auditor’s work to make sure it matches what you know about the payroll and processes of your business. After looking over the auditor’s work, sign any papers they ask for to show you’ve done your part and understand the results. If you did the audit over the phone or mail, you might not be able to do this step, but your insurance company should send you a summary of what the inspector found. You can ask your insurance company for more details if those results don’t make sense.

Working With EZ

If you need any help with coverage for your business, EZ.Insure is here to help. We’ll get you instant quotes and set you up with your own dedicated agent – for free! You’ll get all of your questions answered and get the most accurate quotes. You have enough on your plate, so let us take care of your insurance needs. To get started simply enter your zip code in the bar below, or you can speak to an agent by calling 877-670-3538.

Workers’ compensation insurance can help pay for medical care for workers who get sick or hurt on the job. But what happens if a person gets hurt on the job and dies because of it? If an employee passes away due to a work injury or illness, workers’ compensation provides death benefits that may offer financial support for their family. If you own a small business, you need to know about workers’ compensation death payments and what they mean for your business. Especially because each state has its own rules and laws about death benefits.

Alabama

Workers’ compensation insurance pays death benefits to a worker’s family if he or she dies from an illness or injury that happened at work. Who can get death benefits depends on their link to the person who died. And how much they depended on them financially. Eligible family members can get weekly death benefits of no more than 75% of the employee’s average weekly wage. This amount can’t be more than the average weekly pay for the state.

The amount of the weekly benefit for survivors who are only partly dependent on the deceased person will depend on how much money each dependent got from the person who died. Survivors can get benefits for up to 500 weeks, no matter how much they need them. Alabama also lets the worker’s family get a lump sum payment for funeral and other costs if the worker died within four years of the accident. The size of this one-time payment is based on the average weekly wage in the state.

Alaska

In Alaska, families are eligible for a death benefit of $10,000 to cover funeral costs and $5,000 for the employee’s surviving partner and/or children. Workers’ comp also gives weekly payments to your employee’s family after he or she dies on the job. The total amount of the benefit must be the same as the employee’s total handicap rate. 

Dependents are people like children, widows, and widowers who need help. Children who weren’t biologically connected to your employee but were supported by them or lived in their home are also considered dependents. Children who are in high school or in their first four years of a trade, professional, or college program are eligible for benefits until they turn 19. So are all dependent children who are not married. If there is no widow, widower, or children, payments may be made to the worker’s parents, grandchildren. Or other relatives who depended on them.

Arizona

According to Arizona state law, if an employee dies because of an accident or illness at work. The employee’s family can get up to $5,000 for funeral costs and death benefits. If there is a living spouse but no children, the spouse will get 66.23% of the average monthly wage of the person who died. The payments will keep coming to the remaining spouse until they die or get married again. If they get married again, they will get two years’ worth of payouts all at once.

If there are kids and a living spouse, the surviving spouse will get 35% of the average monthly wage of the person who died. As mentioned above, they will get this until they die or get remarried. The children will also get 31.2 percent of the dead parent’s salary, which will be split evenly between them. 

Arkansas

In Arkansas, family members who depend financially on a worker who dies because of an illness or injury at work can get death benefits from workers’ compensation. If there are no full dependents left, partial dependents may get benefits. Dependents or partial dependents can be spouses, children, parents, siblings, grandparents, and grandkids. In Arkansas, workers’ compensation pays out payments equal to 67% of the worker’s average weekly wage. Up to a certain amount per year. The money will be split between the people who depend on the person who died.

California

Death benefits are a big part of workers’ compensation payments in California. If an employee dies because of an illness or accident they got at work, your workers’ compensation insurance will pay up to $10,000 for their funeral. And give death benefits to their surviving family members. Death benefits will be paid at the total temporary disability rate until the youngest dependent child turns 18. Dependents who are disabled will be paid for life. How much your employee gets in death benefits depends on how many people count on him or her:

• A single dependent: Up to $250,000
• Two or more dependents: Up to $290,000 
• Three or more dependents: up to $320,000 
• One total dependent. Plus one or more partial dependents: $250,000 plus four times annual support for partial dependents (up to $290,000)
• One or more partial dependents: Up to $250,000 in annual support.

Colorado

In Colorado, workers’ compensation death benefits may be given to the surviving family members of a person who died at work because of an injury. Dependents include:

• A spouse who was living with your employee at the time of their death.
• Children under the age of 18, or under the age of 21 if they are full-time students.
• Parents, adult children, or grandchildren may qualify as partial dependents if there is no spouse or dependent children. In that case, the family member must demonstrate financial dependency on the deceased worker.

For their families to be qualified for death benefits, your employee must have died from an illness or injury that was caused by their job. If the death was caused by something unrelated, the family may be able to get unpaid permanent disability payments. In Colorado, workers’ compensation death benefits are usually about two-thirds of your employee’s average weekly wages, up to a law limit that changes every year. This is the total amount given to all of the people who rely on you.

A spouse gets death benefits for as long as they live or until they get remarried. At which point their share is split between the people who are still depending on them. Children can get benefits until they turn 18 or until they turn 21 if they are full-time students. Partial dependents can get benefits for up to six years. If a worker under 21 dies from an illness or injury at work, their parents will get a lump sum of $15,000 instead of weekly benefits. The workers’ compensation insurance company would also pay up to $7,000 for the funeral costs of your worker who died on the job.

Connecticut

Connecticut workers’ compensation law says that their dependents are eligible up to $4,000 to pay for funeral costs. The surviving partner of the employee who died can get death benefits until and unless they remarry. They will also get benefits for their minor dependent children who are still alive. If the children do not live with the remaining spouse or are not that spouse’s children. The death benefit will be split evenly among the dependents. The benefit will be given to the minor child’s remaining parent or guardian.

Delaware

In Delaware, a worker’s compensation claim can be made by anyone who was financially dependent on the person who died. If the employee was the only one taking care of the dependent, the death benefit will be two-thirds of their normal pay. If the worker who died did not pay for all of the dependent’s needs, the weekly death benefit will be less. For example, if a worker who died provided 60% of their family’s income and their partner provided the other 40%, the weekly death benefit would be 60% of the worker’s weekly pay before the injury or illness. All qualified dependents would get this benefit.

Depending on the circumstances, survivors can get death payments for at least five years and up to twelve years. Benefits may last longer if a child was disabled before the worker died, is still in school (up to age 18). Or is involved full-time in an accredited post-secondary program (up to age 23). When the beneficiary is not a surviving husband or child, benefits are limited to a fixed dollar amount that is changed every year. Delaware workers’ estates can also get $7,000 to help pay for funeral costs. This is paid whether or not the person left behind a spouse or children.

Florida

In Florida, a worker’s family may be able to get death benefits if the worker dies from a work-related injury within one year of the accident or within five years of being disabled continuously. Most of the time, workers’ compensation will pay up to $150,000 to the person’s relatives (up to 66.67% of the person’s weekly wage). And pay up to $7,500 for the funeral.

Georgia

Georgia law says that anyone who depends on the worker for money is eligible for benefits. The partner and children of a deceased worker are usually considered dependents, but there are a few requirements:

• The surviving spouse must be legally married to the deceased. If the couple lived apart for 90 days prior to the date of injury or death, the claim may be denied. But only if it can be proved that the surviving spouse was not dependent. Common-law partners may also be ineligible.
• Children under the age of 18 are considered dependents. As are stepchildren, legally adopted children, and children born posthumously to the deceased. Children over the age of 18 who are unable to work due to a physical or mental disability. As well as children under the age of 22 who are full-time students, are also covered.
• Anyone else who can show they were financially dependent on the deceased may be able to file a claim for benefits. For instance, an elderly parent.

The most a surviving partner who has no other dependents can get in death benefits is $150,000. These benefits are paid until the person turns 65 or gets 400 weeks of payments, whichever comes first. If the widowed partner gets remarried or moves in with someone else, they will lose their benefits.

Hawaii

In Hawaii, a cash payment can be given to any family member who was financially dependent on the person who died. The amount given depends on how many people in a family ask for benefits. But the total amount of family benefits can’t be more than two-thirds of the average weekly wage of the worker who got hurt. In Hawaii, workers’ compensation pays for funeral costs as well.

Idaho

In Idaho, the surviving spouse of a worker who died on the job can get workers’ compensation death payments for 500 weeks. Unless they get married again during that time. Up to three children who need help can also get assistance until they turn 18. Other family members who were financially dependent on the worker who died, such as parents, siblings, grandparents, or grandkids, may also be able to get benefits. If your worker dies within four years of getting hurt or sick, some funeral costs may also be covered.

Illinois

In Illinois, death benefits from workers’ compensation are paid out every week. A qualified dependent can get up to two-thirds of the deceased person’s average weekly earnings. As long as the amount is between the minimum and highest amounts set by the state each year. When the payments hit $500,000 or 25 years have passed, whichever comes first, the payments will stop. Death payments from workers’ comp also cover funeral costs of up to $8,000.

Indiana

In Indiana, dependents can get 500 weeks of lost pay at 67% of the average weekly wage of the person who died. All of the dead person’s hospital bills and up to $7,500 in burial costs are also paid for. In Indiana, there are two kinds of dependents: presumed dependents and dependents-in-fact. Death benefits are distributed evenly among presumed dependents, who include:

• Spouse (as long as they do not remarry)
• Children under 21 who aren’t married and who resided with the employee
• Children under 21 who did not reside with the employee, but who the employee was legally obligated to support 
• Children over the age of 21 who have never been married, are physically or mentally ill, or are caring for the employee’s home but are not otherwise employed

Dependents-in-fact can get benefits even if there are no supposed dependents at the time of the employee’s death. People who are linked by blood or marriage and who relied on the employee who died are among these people.

Iowa

You are required by Iowa law to pay death benefits through your policy. The amount of these benefits will depend on whether or not the employee’s dependents were fully or partially financially dependent. Children under 18 years old, children with disabilities of any age, and a living spouse are all considered to be fully dependent. Children under 25 who can prove they were the worker’s dependents are also qualified. Dependents who are physically or mentally unable to take care of themselves will also be able to get weekly workers’ compensation payments.

Surviving family members who were fully dependent on the worker who died can get pay equal to 80% of the worker’s average weekly after-tax income. The 80% amount will be split evenly among all full-time kids. And the most anyone can get is the average weekly wage in Iowa. If the employee has no full dependents, only partial dependents will get death payments. Survivors can also get a one-time payment of up to 12 times the average weekly wage of the state to cover funeral costs.

Kansas

The following rules govern how death benefits are given to the families of Kansas workers who die because of an illness or accident they got at work:

• For survivors to get money, they don’t have to be citizens or live in the United States.
• Weekly death benefits are based on 67% of the average weekly wage of the worker who died. Up to the highest amount allowed by law.
• The minimum death payment is equal to 50% of the state’s average weekly wage.
• The total amount of death benefits can’t be more than $300,000. Unless they are going to a child under 18 who needs them.
• In Kansas, the boss or their insurance company is responsible for paying all hospital and medical bills related to the death. As well as up to $5,000 in funeral costs.
• The surviving legal spouse or children who are fully dependent must get an initial payment of $40,000 from the employer (or their insurer), or the amount must be split evenly between the dependents.

Kentucky

Eligible family members can get weekly death benefits of no more than 75% of the average weekly pay of the worker who died. This amount can’t be more than the average weekly pay for the state. How much a partly dependent survivor gets each week will depend on how much they depended on the deceased for money.

Survivors are eligible for payments for up to 500 weeks, no matter how dependent they are. In Kentucky, if a worker died within four years of getting hurt on the job, his or her family may get a lump-sum payment to help pay for the funeral. The average weekly wage for the state will be used to figure out the lump-sum amount.

Louisiana

The state of Louisiana assumes that the employee’s surviving partner and children depended on him or her and should get benefits because of this. Other family members who lived in the same house as the worker who died and were financially dependent on them may also be able to get death benefits.

• Partners who aren’t married can’t get benefits unless they are getting them for children they have together.
• The worker’s surviving spouse is eligible for 32.5% of the average weekly wage of the worker who died.
• A spouse who has died and one child can get 46.25%.
• A spouse who has died and two or more children can get 65%.
• If there is no partner, a child who is still alive can get 32.5%. Two children can get 46.25%. And three or more children can get 65%.
• If there is no partner and no children. A parent who needs help can get 32.5% and two parents who need help can get 65%.
• If there is no spouse, no children, and no parents, a sibling who needs help can get up to 32.5 percent of the benefit, and each new sibling can get up to 65 percent.

Workers’ compensation insurance also pays up to $8,500 for burial and funeral costs.

Maine

In Maine, the surviving spouse and dependent children are considered “wholly dependent” when figuring out workers’ compensation payments. That means they are entitled to a share of the worker’s income. Other family members may also count on you in some ways. Benefits will only be given to relatives who are partly dependent if there are no fully dependent family members left. Those who qualify can get weekly death benefits equal to two-thirds of the dead worker’s average weekly pay. This amount can’t be more than the average weekly pay for the state.

The amount of money the person who died gave each dependent will decide how much the survivors will get each week. Survivors can get benefits for up to 500 weeks, whether they are fully or partly dependent. Dependents in Maine can also get up to $4,000 to cover reasonable funeral costs. You will also have to pay $3,000 to the estate of the employee who died to cover miscellaneous costs.

Maryland

In Maryland, benefits can be given to any family member who depends financially on the person who died. Most of the time, a living dependent is entitled to two-thirds of the worker’s average weekly wage, up to the legal limit. This depends on how much money the person who died brought in for the family. In other words, if the person was responsible for 60% of the family costs, their dependents can get 60% of their average weekly wage. Depending on the circumstances, survivors can get death payments for at least five years and up to twelve years. In Maryland, workers’ compensation pays for acceptable funeral costs of up to $7,000.

Massachusetts

Dependent family members of Massachusetts workers who died will get death benefits. The payments are based on the person’s weekly pay before the accident. Surviving partners can get weekly payments equal to 66% of the average weekly wage of the worker who died. But not more than the average weekly wage in the state at the time of death. Once two years have passed since the worker’s death, the partner can get a cost-of-living adjustment every year. If their partner gets remarried, the children will get $60 per week, up to the amount of the spouse’s benefit.

Michigan

Children in Michigan are considered dependents if they are under 16. Or if they are 16 or older but can’t work because they are sick or too young. Also, for children to get death benefits, they must have been living with the employee or an ex-spouse at the time of death.  After taxes, Social Security, and Medicare are taken out, dependents can get 80% of the average weekly wage of the worker. However, the state of Michigan sets a minimum and highest weekly benefit amount for workers’ compensation death benefits each year. Dependent family members who are “wholly” dependent will get the same amount of benefits. If there are no “wholly” dependent family members, partly dependent family members can get benefits.

Dependents can get benefits for up to 500 weeks, or until the youngest claimant is 21 years old, whichever comes first. If the dead worker’s widow or widower remarries, their benefits end. However, their children’s benefits continue until they turn 18 (or 16 if they’ve been able to support themselves for six months). In Michigan, workers’ compensation pays for up to $6,000 in funeral costs.

Minnesota

If an employee dies because of an illness or accident at work, certain family members may be able to get death benefits. These benefits cover funeral and burial costs. As well as weekly payments that cover a part of the employee’s earnings. The family of the worker who died will get death benefits equal to no more than 67% of the worker’s average weekly wage. Which cannot be more than the highest amount set by law for an entire year. Payments must also be adjusted every year for the cost of living starting 3 years after the worker dies.

Mississippi

In Mississippi, your workers’ compensation insurer or assigned risk administrator will pay death payments to the employee’s dependents at least once every 14 days. After a worker dies on the job, these payments can keep going for up to 450 weeks. Death benefits are based on a percentage of the average weekly wage of the worker who died, up to a weekly limit set by law. Also, you or your insurance company must pay up to $5,000 for the funeral costs. And give the remaining spouse a one-time payment of $1,000.

Missouri

In Missouri, death benefits include up to $5,000 for funeral and burial costs. And weekly payments that cover a part of the employee’s income. Dependent family members of the worker who died will get death benefits based on the worker’s weekly pay before the accident. This amount, however, can’t be more than 67% of the average weekly wage of the employee who died. Up to the minimum and highest benefit amounts set by the state. The remaining spouse will get benefits until he or she dies or gets married again. If this happens, the partner will get a final lump sum payment equal to two years’ worth of benefit payments.

Montana

The Montana Workers’ Compensation Act says that you have to pay death benefits to a worker’s family if he or she dies because of an accident or illness at work. Beneficiaries will get two-thirds of the worker’s weekly wage. The most these benefits can be is the state’s average weekly wage. If the worker dies and doesn’t leave behind any children, their parents or anyone else who can show they were financially dependent on them must get a lump-sum payment of $3,000.

Nebraska

If one of your employees dies at work because of an accident or illness, their family will get death benefits from workers’ compensation. In Nebraska, the employee is financially responsible for the following people:

• A surviving spouse
• Children younger than 18 who live at home with the employee’s spouse
• Children younger than 22 who are enrolled in an accredited higher education program
• Adult children who are mentally or physically unable to support themselves. Or who depended on the deceased worker for financial support in the past

The worker’s surviving spouse is eligible for two-thirds of the worker’s previous pay until the spouse remarries. 

Nevada

If an employee dies because of an accident or illness that happened at work, his or her dependents could get death benefits. If the worker who died didn’t have a partner or children, benefits could be given to their parents or younger siblings who depended on them financially, as well as to other family members.

The worker’s partner can get up to a certain amount each year, based on the worker’s average monthly wage. This benefit is for the spouse and children. If the partner is not the parent of the children, the benefit will be split. In that case, half of the income would go to the spouse and the other half would go to the children. Workers’ compensation payments also pay up to $10,000 for funeral costs.

New Hampshire

If an employee dies because of an accident or illness at work, their dependents may be able to get death payments from workers’ comp. These perks include funeral costs that don’t go over $10,000 and a weekly payment. If the worker died without a partner or children, benefits could be given to their parents or younger siblings who depended on them for money, as well as to other family members who depended on the worker for money.

New Jersey

In New Jersey, death benefits from workers’ compensation are made up of:

• Payment of approved medical bills
• Up to $3,500 for burial or funeral expenses
• 50% of the deceased employee’s wages to one dependent
• 5% more for each additional dependent, up to a maximum of 70% of the worker’s wages for five or more dependents
• Up to 450 weeks of payments to the surviving spouse, up to a maximum amount set each year by the Commission of Labor
• Up to 450 weeks of payments to mentally or physically disabled children

Children are thought to be dependents until they turn 18 or until they turn 23 if they are still in school full-time. A kid who needs care and who has a physical or mental disability may get more benefits. If the surviving partner gets remarried, they will no longer be able to get benefits. Unless there are still children who need help. The benefits could then go on for up to two more years. A civil union partner can also get death benefits. Also, the parent(s) and sibling(s) of the person who died who depended on your employee may be able to get compensation if they can show it.

New Mexico

If an employee dies because of an illness or accident at work, workers’ compensation death benefits may be given to their surviving partner and dependent children (or other dependent relatives). Children are thought to be dependents until they turn 18 or until they turn 23 if they are still in school full-time. A kid who needs care and who has a physical or mental disability may get more benefits.

Your employee must have died within 2 years of the date of their injury for their dependents to be qualified for death benefits. The most they can get is the same amount that the employee would have gotten in temporary total disability payments over 700 weeks. In New Mexico, funeral fees are paid for with $7,500 of the workers’ compensation death benefits.

New York

In New York, the main people who count on you are your spouse and your minor children. Unless they get married again, the surviving spouse of your employee will generally get benefits for the rest of their lives. If they do get married again, they will get a lump sum that is the same as two years of payments. 

If there are no children, the spouse can get up to the highest amount allowed by law, which is 66.67% of the worker’s average weekly wage. When there are children, the rate stays the same, but the benefits will be split so that the husband gets 36.6% of the weekly rate and the children each get 30%. When a child turns 18 or 23 if they are a full-time student, their benefits stop. If there is no surviving partner or children, benefits can be given to the worker’s parents or the worker’s estate.

As part of workers’ compensation death payments, New York helps pay for funeral costs. How much money is given for funeral costs depends on where in the state the person who died worked for pay. For example, in Bronx, Kings, Nassau, New York, Queens, Richmond, Rockland, and Westchester counties, New York helps pay up to $12,500 for funeral costs. 

North Carolina

As long as the spouse lived with the worker at the time of his or her death, they will be qualified for benefits. Minor children are any children under the age of 18 who were dependent on the worker at the time of death. This includes adopted children, stepchildren, and known illegitimate children. It also includes children born after the worker died.

If there are no completely dependent family members, benefits will be given to people who were partly dependent on the worker who died, based on how much help the worker had been giving them. One lump sum can also be given to the next of kin. If there are no close relatives, workers’ compensation insurance will only pay for the funeral costs.

In North Carolina, the weekly death benefit is two-thirds of the average weekly wage of the worker who died. This benefit is paid for at least 500 weeks or until a child who is getting benefits turns 18. Up to $10,000 can be paid for funeral costs. In some situations, North Carolina workers’ compensation death payments can be more flexible than those in other states. This is because the North Carolina Supreme Court set up the “Pickrell presumption,” which says that the children of a worker who died may still be able to get workers’ compensation benefits even if the exact cause of death and the details of the accident are unknown.

North Dakota

Workforce Safety and Insurance in North Dakota will pay for funeral costs of up to $10,000. Also, wives and children will be able to get two-thirds of the average weekly wage of the worker. A one-time payment of $2,500 plus $800 for each dependent child will also be given to the surviving partner. If the worker died without a partner or children who depended on them, the other people who cared about them would get a lump sum of $15,000. Benefits will depend on whether the employee left behind a husband, children, or other survivors.

Ohio

In Ohio, workers’ compensation death payments can be given to people who were financially dependent on the worker who died. Other family members may also be considered wholly or partly dependent, but this will depend on each individual case. Death benefits will be equal to 66.67% of the worker’s average weekly wage, up to the maximum and minimum amounts set by the state each year. The Bureau of Worker’s Compensation (BWC) will decide how payments will be given to dependents. Most of the time, the partner will get benefits until death or remarriage, and if they remarry, they will get two years’ worth of benefits all at once. A burial allowance of up to $5,500 is also part of the workers’ compensation death payouts.

Oklahoma

If one of your employees dies because of an illness or accident they got at work, your workers’ compensation insurer must pay death benefits to the employee’s family. This means paying benefits to the surviving partner and/or other dependents of a worker who has died. Surviving employees who were not financially dependent on the person who died but who lost money because of the death may also be qualified for a lump-sum payment. State laws set up a plan for how to figure out death benefits. Benefits include one-time payments, weekly payments, and money to cover funeral costs. 

Oregon

To get benefits, the survivor must have been financially dependent on the person who died, either in whole or in part. Most of the time, workers’ compensation insurance in Oregon also pays up to $20,000 for funeral and burial costs. Go to the Workers’ Compensation Division’s page on death payments to find out more.

Pennsylvania

In Pennsylvania, a worker who dies because of an injury at work will usually be able to get death benefits from workers’ compensation. Payments of death benefits can start on the day the worker dies. As part of workers’ compensation death benefits, a $3,000 payment is made for funeral costs.

Rhode Island

If an employee dies because of an illness or injury they got at work, their relatives will get death benefits. As part of these benefits, a person can get up to $20,000 to help pay for burial and funeral costs. A weekly benefit will also be given to a surviving partner, any minor children, and any other people who depend on the person who died. This payment will be based on whether or not the worker is married and how many people count on them. But the total benefit can’t be more than what the state’s highest total weekly disability benefit is.

South Carolina

In South Carolina, a worker’s dependents may be able to get death benefits if the worker dies from a work-related accident or illness. Benefits for a death include weekly payments as well as money to pay for the funeral and burial. Surviving family members can usually get two-thirds of the worker’s average weekly wage for 500 weeks from the date of the accident. They can also get up to $2,500 to cover funeral costs. There are some exceptions to this general rule. For example, if the worker who died was getting benefits from workers’ compensation insurance before he or she died. The amount of benefits that the worker’s relatives can get may be cut.

South Dakota

State law in South Dakota says that a worker’s survivors must get death benefits if the worker dies from an illness or injury at work. These perks include money to make up for the worker’s lost income and money to help pay for funeral costs. The worker’s partner will get 67% of the worker’s average weekly wage, which includes overtime pay at the straight rate. If the partner remarries, the payments will stop. But your insurance company will give them a lump sum equal to two years of the worker’s salary.

When the employee leaves behind children who were qualified for income benefits. Those benefits will end two years after the surviving spouse remarries. If children are the only ones left alive, they will get payments equal to 67% of the worker’s average weekly wage until they turn 18 (or 22 if they are in school full-time). Children who can’t work because they are too young or too sick will get money for the rest of their lives.

Your insurance company will pay an extra $50 a month to each of the dead employee’s legally dependent children. Starting the date of death until the child turns 18. Also, your insurance company will have to pay an extra $2,000 per year for up to five years for each child who goes to a recognized post-secondary school full-time. In addition to widow income benefits, funeral costs of up to $10,000 will be paid for each survivor.

Tennessee

If an employee dies because of an accident or illness at work in your state, their dependents will be able to get death benefits. Benefits for replacing lost wages can be different depending on how many dependents your employee has:

• If the employee died and had no children, your insurance company will pay $20,000 to the employee’s estate.
• If the employee has a surviving partner but no children who depend on them. The insurance company will pay up to 50% of the person’s average weekly wage.
• If the worker dies and leaves behind a partner and children who depend on them. The insurance company will pay the spouse two-thirds of the average weekly wage.

In Tennessee, workers’ compensation also pays up to $10,000 for funeral and burial costs.

Texas

If a worker with Texas workers’ compensation insurance dies from a work-related illness or accident, the worker’s family will get death benefits. Most of the time, the death benefit will be 75% of the worker’s normal weekly wage. Up to an amount set by the state each year. The money will be given to the employee’s family and loved ones. Workers’ compensation also pays up to $10,000 for funeral costs.

Utah

If one of your workers dies because of an injury or accident at work, their family will be able to get death benefits. This includes covering for the cost of a burial or funeral. Under the Utah Workers’ Compensation Act, survivors can get money every week. This amount is based on 67% of the employee’s average gross weekly pay. The exact amount depends on how many children the worker had and if they were still living.

Vermont

If an employee dies in Vermont because of an illness or injury that was caused by their job, their family will be able to get death benefits. These include up to $10,000 for burial and funeral costs. And up to $5,000 for getting the body to the place where it will be buried. Workers’ compensation insurance will also pay weekly benefits to the person who died. Depending on whether the worker had a partner and/or children, the amount of these benefits can range from 67% to 77% of their previous weekly pay. The base and maximum limits for survivor benefits are the same as for all other Vermont workers’ compensation benefits.

Virginia 

Under Virginia law, a worker’s spouse, children, and other dependents may be able to get death benefits if the worker dies from an illness or injury that was caused by their job. Dependents of a worker may get weekly payments equal to two-thirds of the worker’s average weekly wage. For up to 500 weeks from the date of injury. Up to $10,000 will be paid for funeral costs, and up to $1,000 will be paid for transportation costs.

Washington

If a worker dies in Washington because of an injury or illness that happened at work, a survivor who is qualified can get a one-time death benefit payment and a monthly survivor’s pension. The spouse of the worker who died will immediately get death benefits. If the employee’s children are legally dependent on them, they will also be qualified. Workers’ compensation in Washington also pays for funeral costs, up to twice the average monthly wage of the state.

West Virginia

If an employee dies because of an accident or illness that happened at work in West Virginia, his or her dependents may be able to get death benefits. Survivors will get death benefits based on how close they were to the person who died. People who can get benefits are:

• The surviving spouse of the worker
• Children under the age of 18 (or under age 25 if the child is a full-time student)
• Disabled children of any age

If there are no survivors who meet these requirements, the benefits can be given to the worker’s living parents if they are financially dependent on the worker. When there are no living parents, benefits may be given to grandchildren and/or siblings who are dependent. If the person who died didn’t have any dependents, the death benefits will only be used to pay for hospital bills and the funeral. Dependents of the worker who died will be able to get two-thirds of the worker’s average weekly wage at the time of the accident. Dependents will get a share of that benefit, with the amount they get based on the situation. Up to $7,000 may also be paid for funeral costs.

Wisconsin

Under Wisconsin law, the surviving spouse, children, and other dependents of a Wisconsin worker who died from a work-related injury or illness may be eligible for a death benefit. This includes weekly payments to those who depended on the worker financially and coverage for burial costs. Death benefits will go to family members who are totally dependent on the person who died. Like a living spouse or registered domestic partner, or surviving children under 18 or who are physically or mentally disabled.

Other partially dependent family members won’t be able to get death benefits unless there are no full dependents. All of the beneficiaries cannot get more than four times the employee’s annual salary in death payments. State law also says that workers’ compensation insurance must cover up to $10,000 in funeral costs.

Wyoming

Workers’ compensation in Wyoming pays death benefits to the family of a worker who dies from an illness or injury that happened at work. Their surviving spouse, minor children, and other dependents could get monthly benefits for up to 100 months. At least 80% of the average monthly wage in the state will be paid as a death benefit. The limit is twice the state’s average monthly wage. Both numbers are based on how much the worker was making before he or she got hurt or sick. Wyoming law also gives people $5,000 for funeral costs and $5,000 for other costs connected to death.

Workers’ Compensation With EZ

We do everything we can to make shopping for workers’ compensation insurance as easy and stress-free as possible. And we give each customer our full attention. After you fill out our form, you’ll get free quotes right away from your dedicated agent. Who will give you personalized service and try to figure out what you need. We want you to make the best choice possible and get the best coverage at the best price. Our services are free, so check out your prices right away. You can call us at 877-670-3538 if you still have questions. You will be put in touch with a local insurance agent who can answer all of your questions. And help you find the best workers’ compensation policy for your business.

Your workers’ compensation premium is calculated with a formula that has 3 primary components. First the type of business you own, second your claims history, and finally, your total payroll. The formula is Payroll (per $100) x Class Code Rate x Experience Modifier (if applicable) + State Taxes & Fees = Premium. The National Council on Compensation Insurance (NCCI), a trade association for the U.S insurance industry, and state agencies such as the Workers’ Compensation Insurance Rating Bureau (WCIRB) collect and analyze data to make sure that insurance companies in every state use the formula consistently and reliably. Below we’ll look at the specifics of each portion of the formula. As well as the full formula to help you understand how your premium will be calculated. We will also look into a few ways to lower your premiums. 

1.Business Type

For this portion of the formula your company is put into a hazard group based on the likelihood that an accident will occur in the workplace. A business with a low risk profile, like a professional services firm, will have a different hazard group than a business with a higher risk potential, like a construction company. For each classification, the average cost per injury and death is first calculated. As you can imagine, workplace injuries from a construction site will likely cost more than injuries that could happen in an office setting. It’s very important that your employees are correctly classified, as it has a direct impact on your workers’ compensation premium. Additionally, if you classify your employees incorrectly you can face penalties and your insurer can even refuse to cover claims if they find the employee was put in a lower classification than they should have been.

2.Claims History

The next portion of the workers’ compensation premium formula is based on the amount of workplace accidents your company has had in the past. This is also called your experience modifier. Your company will compare this amount to the average accidents for businesses in your same classification with the same or similar amount of employees. The average modifier rate is set at 1.0 for the scale, the less injuries the lower your modifier rate is, the more injury claims you have the higher the number. During a specified measurement period (typically 1-3 years), if your business experiences less workplace accidents than the average, your premium will most likely be lower than what a similar business with more accidents paid. Having a lower premium is a huge incentive for businesses to do more to prevent workplace injuries.

3. Payroll

The final portion of the formula for workers’ compensation premiums is the total payroll of your business annually. The higher your payroll, the higher your workers’ compensation premium will be. This also means the more workers you have, the more potential for on the job injuries or illness. To make sure your payroll amount is accurate, every business is required to complete a workers’ compensation payroll audit a few months after their policy is renewed. If you don’t complete this audit you will face a penalty for noncompliance, so it is mandatory. If the audit shows that your payroll was actually higher than what you reported, you will have to pay the additional workers’ compensation premium on the correct information.

On the other hand, if you overestimate the amount of your payroll then you will be issued a refund for the overpayment of your premium once the insurance company adjusts the rates. Every state has a different average of how much they can expect per $100 of payroll. To find out more about your state’s rates check out our state by state workers’ compensation guides.

Ways To Lower Your Workers’ Compensation Rates

Now that you know what affects your premium rates, you’re able to calculate and get a rough estimate of what you could be paying. If you know your premium is likely to be more than you’d like, there are ways to start lowering your premiums to make it more affordable, as well as make your company safer not just financially, but physically as well.

Develop A Drug Policy

Certain industries are actually more prone to drug use and alcoholism in the workplace according to the Substance Abuse and Mental Health Services Administration (SAMHSA). For example, the mining industry has the highest rate of alcohol abuse at work sitting at 17.5% and right behind them is the construction industry at 16.5%. Since these industries are already considered high risk based on the type of work they do, it’s very important for these types of businesses to follow drug-free policies because their policies will already be more expensive. For drug use, Food industry workers sit at 19.1% and construction workers are at 14.4 percent. 

You have the right as an employer to conduct drug tests on both current and prospective employees. Although, you’ll want to look into your state laws first as some states only allow drug testing once there’s a job offer on the table. However, making sure that your employees are not working under the influence of drugs or alcohol prevents catastrophic accidents. Promoting a drug free workplace can lower your workers’ compensation premiums as well as increase productivity, lower absences, lower employee turnover, and improve morale.

Aside from drug testing there’s a few other things you can do to help promote a drug-free workplace. For one, you can make it a point to educate your employees about the risks of working while impaired. You can also help workers who struggle with substance abuse by offering resources such as helpline numbers and treatment center information to help them seek treatment for their addiction. 

Drug Free Policy State Discounts

Not only will a drug free workplace lower your premiums by preventing accidents, but in 13 states there is a discount for workers’ compensation premiums if you implement a drug-free policy within your business. The following 13 states already have discounts for drug-free work policies:

• Alabama – 5% discount
• Arkansas – 5% discount
• Florida – 5% discount
• Georgia – 7.5% if the drug-free workplace program is certified by the state Board of Workers’ Compensation.
• Hawaii – 5% for safety and health programs
• Idaho – Premium reductions for conducting drug and alcohol testing for current and prospective employees.
• Kentucky – 5% discount
• Mississippi – 5% discount
• Ohio – 5 year phased-in premium reduction that can reach up to 20% discount.
• New York – Workplace Safety and Loss Prevention Incentive Programs have a 6% discount.
• South Carolina – 5% discount
• Tennessee – 5% discount
• Virginia – 5% discount

Safety Protocols

Creating a safe work environment can boost employee morale and reduce workers’ compensation costs. Establishing a culture of safety is easier than you might think, and you’re probably already doing some of this work. 

• Ensure that your employees have access to the tools and information necessary for their safety on the job.
• If you have not already done so, schedule regular safety inspections. 
• Utilize daily safety checks to constantly remind employees to exercise caution while at work.
• Plan weekly or monthly deep dive inspections. 

Putting an emphasis on safety will not only reduce workplace accidents and injuries and lower your workers’ compensation premiums, but it will also demonstrate your concern for their well-being.

Safety Rewards

Check with your insurance provider to see if they will lower your premiums in light of the fact that your company has become safer over the past year. Typically, these types of safety bonuses are distributed after a period of one year in which fewer claims were filed. It is important to check with your insurer to determine whether or not safety rewards are currently being offered, as they are not guaranteed.

Review Employee Classifications

This recommendation may be so simple as to be overlooked. While it is true that each type of business will have a different overall rate, the costs associated with each classification of employee will also vary. For instance, a sheet metal worker will have different standards than a bookkeeper who rarely visits the production floor. Ensure that each employee is correctly classified in their current position according to your policy. This simple tip will save you a substantial amount of money.

Workers’ Compensation Insurance With EZ

The majority of states require businesses to carry workers’ compensation insurance. Which will not only protect your business but also your employees. Keeping your employees safe does not have to be an expensive endeavor for your company. There are numerous ways to promote safety routines and programs. All of which will help you reduce your workers’ compensation expenses. If the best practices for claims management are implemented and followed in a timely manner, your employees will be able to return to work as soon as they receive medical clearance to do so. Not only will production return to normal, but workers’ compensation costs will decrease as well. 

Come to EZ for free, instant quotes from one of our licensed agents to help you look for the best workers’ compensation policy. If you already have workers’ compensation benefits but are looking for a better deal, we can assist you. Your EZ agent will be familiar with the local regulations and able to provide guidance as you shop around for the best policy at the most affordable price. Enter your zip code in the box above. Or call us at 877-670-3538 to speak with one of our licensed agents.

Workers’ compensation insurance is designed to protect you and your employees financially in the event of a workplace accident or unjust. Workers’ compensation insurance isn’t just a good idea, depending on your state it may be a legal requirement. When it comes to workers’ comp claims, the majority of them are approved because workers’ compensation is considered “no-fault”. Meaning that employees do not need to prove that their employer was at fault for their injury.

As long as the employee files their claim on time, has witnesses to their accident, and seeks medical treatment for their injury, the employee will receive benefits. There may come a time, however, when one of your employees files a claim that you find questionable. In this case, you do have options, including the option to contest the claim. Below we’ll look at how you can fight a questionable claim. As well as the impact workers’ compensation claims can have on a business. 

Reasons To Dispute A Workers’ Comp Claim

You can’t fight a workers’ comp claim for no reason, you and your insurance company must have a legal basis for disputing any claims. Here are some of the reasons you could have for disputing a claim:

• Your employee missed the deadline to file a claim
• The wrong paperwork was used to file a claim
• The injury didn’t happen at your company
• Your employee quit before filing a claim
• The injury happened while the employee was at work but was not working
• The injury was intentional

Always File The Claim

Even if you suspect the workers’ compensation claim is false. You have to file it when the employee comes to you with it. You can be penalized if you fail to report a work-related injury with a full report of all related details as soon as possible. The insurance claim adjuster’s job is to determine whether or not the claim is valid or not. You are paying premiums to your insurance company so that they can handle these matters. If your report is thorough and you work closely with your adjuster, there is a good chance the adjuster will catch the fraudulent claim and deny it anyway. So, delaying or not filing a report because you think it’s invalid could backfire on you, best to just let the adjuster do their job. 

Work With The Claims Adjuster

Once you’ve filed the workers’ compensation claim with your insurance company, an adjuster will be assigned to the case. They will contact you and the employee personally, as well as review all documents associated with the case including medical records. The adjuster ultimately decides if the claim will be denied, but at this point you will have more information about the claim than the adjuster. If you have reason to believe the employee lied, or was injured outside of work, now is the time to gather all information that supports why you think it’s invalid. Document, date, and save everything that indicates why you think the claim is fraudulent. Most importantly, inform your adjuster immediately that you believe the claim to be questionable. Indicating in your initial report that you believe there are reasons to deny the claim serves 2 purposes.

First, it lets the adjuster know they may need to file an extension early, since workers’ compensation claims have to be completed in a certain time frame, and disputing a claim will take more time to investigate. Secondly, marking your claim as questionable from the beginning will actually make your adjuster pay closer attention. They will spend more time looking through the paperwork, medical records, and searching for warning signs that otherwise may have been missed. Finding one of these red flags doesn’t necessarily mean anything, as accidents and coincidences do happen. But if an adjuster notices that more than one exists, they will look into it further to make sure if the claim is or isn’t fraudulent.

Warning Signs

• A new hire who immediately filed a claim after being hired
• An employee who has immediately hired an attorney after the injury
• Claims from an employee who may have been “disgruntled”
• Employees with poor attendance, poor work records, or financial issues
• Injuries with no witnesses, or that happened in an area the employee isn’t assigned to normally work
• Injuries that occur late on a Friday or right when they return to work on Monday

Learn Your State’s Procedure

While workers’ comp is mandatory in almost every state, each state has its own laws and procedures for dealing with claims. Including disputing them. You can call your insurance provider and ask about what you need to know about local procedures. So you don’t accidentally make a misstep and cause trouble for yourself or your company. 

If you want to learn more about your state’s specific workers compensation laws you can read our state by state guide here.

Dispute The Claim

You have the option to dispute even if the adjuster doesn’t deny the claim after the investigation. In some states, such as Texas, you have to submit a form or attend a hearing to dispute the claim in front of a judge. In other states, such as New York, or Tennessee, you may have to appear before a judicial panel or speak with a state-assigned workers’ compensation arbitrator. However, regardless of the state your company is in, you will most likely have to defend your position orally, in writing, or both. You will also need to provide all of the evidence you gathered when you first filed the claim and informed the adjuster of your concerns. Remember the “document, date, and save all information” part? This is where that step comes in handy.

How Workers’ Comp Claims Affect Businesses

Workers’ compensation claims tend to have a greater impact on smaller businesses. This is because larger companies have deeper pockets and larger payrolls, allowing them to absorb the financial cost with not much issue. Regardless of how big or small your business is though, workers’ comp claims can cause your business issues. Below we’ve detailed how claims can affect you. So, you understand why it’s important to fight fraudulent claims to protect yourself. As well as explain why doing everything you can to avoid workplace accidents is even more important.

Premium Hikes

Your workers’ compensation insurance premiums are determined by your industry, number of employees, payroll, and claims history over the last 3 years. A single claim will not necessarily result in a higher premium. But depending on the nature of the claim and the resulting medical bills and disability benefits even one claim could make a mark on your record. The more often you have workers’ compensation claims the more likely it is that your premiums will increase.

Additionally, your insurer also takes your experience modification rate (EMR) into consideration. Your EMR is how insurance companies compare your claims history to other companies in the same industry. The average EMR is 1.0, the more claims you have the higher above average you are. And then the higher your premiums will be because your company will be considered a higher risk to insure. Regular safety training and following industry-specific safety guidelines can help reduce your premiums.

Administrative Costs

Processing a workers’ compensation claim can take a lot of time. Especially if you’ve signaled that you believe it’s fraudulent. The insurance company will want to examine all relevant evidence, including the employee’s medical records. Effectively giving you or your claims specialist more work to do. Your company may also need to spend a lot of time and money to fix or check any equipment that was involved. As well as repair it if needed. Especially if the machinery involved is found to be defective after the accident. There may also be more paperwork and more hours involved in reporting the incident to state and federal regulators. Particularly if an OSHA violation is suspected. New equipment or training that stems from a regulator’s requirement can take a chunk out of your bottom line.

Legal Action Expenses

If you believe it is false, and you decide to take it to court you could also end up paying. While your attorney will advise you on whether or not you should go to court in the first place. Keep in mind if you lose the case, you will have significantly higher legal fees than you would have if you settled the claim. So, if you are planning on disputing your claim make sure your legal team agrees with the decision. And that you have absolute proof that the claim was fraudulent.

Reputation Damage

Impact on your company’s brand is difficult to predict. Your reputation can be affected by the severity of the accident. Whether it is covered by local news outlets, and whether it spreads on social media. A serious accident, repeated incidents, or OSHA fines could make it difficult to be able to hire new employees or get new customers.

Working With EZ

Workers’ compensation isn’t just about protecting your employees, it’s also about protecting your business. Nobody wants to deny a legitimate claim. But if you encounter one of those rare cases it’s fraudulent, you should know you have rights as well. And remember, EZ.Insure is here to help if you have any questions about workers’ compensation insurance. Or any other commercial insurance for that matter. We will connect you with a highly trained licensed agent. Who will listen to all of your concerns and make sure you get the best policy. To get started, enter your zip code in the box below or call 977-670-3538 to speak with an agent today.

Virtually every employer has to carry workers’ compensation insurance. However, some state laws provide exemptions for particular types of employees and business structures. Only a few worker categories are occasionally exempt. This exemption also applies to certain business owners. However, even when workers’ compensation coverage is not required, it is almost always in the best interest of the employer to provide coverage. If an employee sustains an injury on the job the employer may be held responsible for medical expenses, ongoing therapy, and lost wages. 

Additionally, if you as the business owner are injured on the job, a workers; compensation policy can help pay for your medical expenses and compensate you for a portion of your lost wages. Your personal health insurance provider may deny your claim if your injury or illness is work-related, leaving you again responsible for these costs. Below we’ll look at the exemption laws in each state, if you’d like more information on the other workers’ compensation laws in your state, check out our state workers’ compensation guides here.

Alabama

Any business with 4 employees or less does not have to carry workers’ compensation in Alabama, whether they are full or part time doesn’t matter. Alabama employers do not need to carry workers’ compensation for farm laborers, domestic laborers, or casual laborers including temporary or part-time employees hired for only an hour or a day.

Alaska

Alaska businesses with one or more employees have to have workers’ compensation coverage unless the Alaska Workers’ Compensation Board has approved the business for self-insurance.

Owners and business executives are exempt if they are:

• Sole owners
• Partners
• LLC owners with at least 10% ownership interest in the company
• Executive officer or municipal, religious, or legally registered nonprofit organizations.
• Executive officers for for-profit corporations with at least 10% ownership.

As for employees who are exempt from coverage:

• Part-time babysitters
• Non-commercial house cleaning personnel
• People who are hired to help a farm with harvest
• Amateur event sports officials
• Entertainers under contract
• Commercial fishers
• Taxi drivers under specific contractual arrangements
• Anyone who has benefits through the Alaska temporary assistance program.
• Professional hockey players and coaches, as long as they are covered under a health insurance plan.
• Some real estate agents
• Anyone defined as a transportation network company driver.

Arizona 

There are only 4 exemptions from Arizona’s workers’ compensation. Independent contractors and casual laborers do not need to be covered. As well as any employee who voluntarily chooses to not have workers’ compensation coverage. The only owners who do not have to have coverage are sole owners who have no employees. Beyond that, any business owner with one or more employees needs workers’ compensation coverage.

Arkansas

Employers with fewer than three workers do not have to provide coverage unless the workers are:

• Agricultural farm laborers
• Domestic workers in a private home
• Gardeners, maintenance workers, remodelers who work in a private home
• Employees of non profit, religious, charity, or relief organizations
• Employees of newspapers, magazines, periodical vendose, sellers, or deliverers
• Real estate agents

California 

All employers have to carry workers’ compensation insurance for themselves and their employees. The only exceptions to this are sole owners who opt out of coverage for themselves, or employers who have approval to self-insure.

Colorado

Colorado employers with at least one employee have to have workers’ compensation coverage. The exemptions to this are:

• Casual maintenance or repair workers who performed less than $2,000 of work in a single year
• Commission based real estate agents and brokers
• Ski area volunteers
• Part time domestic, maintenance, and repair workers for private homes
• Drivers under a lease agreement with a common or contract carrier
• Federal and railroad employees covered by workers’ compensation under federal laws
• Some corporate officers and LLCs

Connecticut

Connecticut is another state that requires all businesses to carry workers’ compensation insurance with very few exceptions. The only employees that don’t need coverage are domestic workers who work less than 26 hours a week. Sole owners, corporate officers, and partners are allowed to opt out of coverage for themselves but they must have coverage for their employees.

Delaware

Farm laborers and household workers in a private home who earn less than $750 every 3 months do not need workers’ compensation insurance. Other than that every other business owner and employee needs to be covered.

Florida

Employers with four or more employees must carry workers’ compensation insurance, unless one of the following applies:

• Farm laborers, unless there are more than 6 full time employees, or 12 seasonal employees.
• Independent contractors

Georgia

The only exceptions are sole owners and partners in a partnership. Businesses with three or more employees have to carry coverage.

Hawaii

Any employer with one or more full-time, part-time, permanent, or temporary employees has to provide workers’ compensation coverage. Exemptions include:

• Sole owners
• Partners
• Corporate officers
• Domestic workers who earn less than $225 a year
• Some stockholders who own 25% stocks
• All stockholders with at least 50% stocks
• Commission based real estate agents

Idaho

Every employer has to provide coverage. Exemptions to this law include:

• Employees in a domestic household
• Casual employees
• Sole owners
• Partners
• Corporate officers
• Family who works for an employer who is a sole proprietor
• Real estate agents

Illinois

If you have a single employee, even a part-time worker, you have to purchase workers’ compensation insurance. Only sole owners, partners, corporate officers, and real estate agents are excluded.

Indiana

Exemptions for employees and owners for workers’ compensation insurance include:

• Sole owners
• Partners
• Corporate officers
• Independent contractors
• Real estate agents
• Casual employees
• Farm and agricultural employees
• Employees in a domestic household
• Railroad employees

Iowa

Every employer has to provide coverage. Exemptions include:

• Sole owners
• Partners
• Corporate officers
• Independent contractors
• Family employed by a relative for agricultural work
• Casual employees in a domestic household

It’s important to note that some of these exemptions only apply if the employee earns less than $1,500 a year. 

Kansas

All Kansas companies must have workers’ compensation insurance with only a few exceptions. Some agricultural workers do not need to be covered. Sole owners, partners, corporate officers, and independent contractors with no employees do not need workers’ compensation insurance.

Kentucky

For Kentucky businesses all employers must provide workers’ compensation insurance unless their employees are:

• Agricultural employees, or agricultural owners
• Less than two domestic employees who work less than 40 hours per week each
• Anyone working in exchange for aid (such as housing or food) instead of money for charity or religious organizations
• Certain religious organizations

Louisiana

Exemptions for workers’ compensation insurance in Louisiana are:

• Employees of private residences
• Employees of private unincorporated farms
• Musicians and performers
• Airplane crews who fly for crop dusting or spraying operations
• Uncompensated officers of board of directors of nonprofit organizations

Maine

Employers with at least one employee have to provide coverage. Exemptions include:

• Sole proprietors, partners, and officers of corporations
• Some domestic employees
• Some agricultural employees

Maryland

Employers with at least one employee have to provide coverage. Exemptions include:

• Sole proprietors
• Partners
• Officers of corporations
• Certain agricultural employees

Massachusetts

All employers must provide coverage. Exemptions include:

• Customers of an LLC
• Partners of a limited liability partnership
• Sole proprietors of an unincorporated business (employees must still be covered) have to carry insurance.
• Domestic service employees working less than 16 hours per week

Michigan

Employers who regularly employ one or more employees for 35 or more hours per week for 13 or more weeks in the 52 weeks prior must provide coverage. Exemptions include:

• Agricultural workers (fewer than three employees working less than 35 hours per week)
• Domestic workers (fewer than three employees working less than 35 hours per week).

Minnesota

All employers must provide coverage. Exemptions include:

• Sole proprietors, partners, and officers of corporations
• Employers subject to federal liability statutes
• Agricultural operations with some limitations

Mississippi

Employers with at least five employees have to provide coverage. Exemptions include:

• Sole proprietors
• Partners
• Officers of corporations
• Employers with five or fewer workers
• Domestic laborers
• Farm laborers
• Independent contractors

Missouri

Employers with at least five employees have to provide coverage. Exemptions include:

• Workers in the railroad, postal, and maritime industries covered by federal laws
• Farm laborers
• Personal servants in a private residence
• Occasional workers performed in a private household.
• Professional real estate agents
• Direct sellers
• Volunteers of an organization exempt from federal income tax
• Non-event-sponsor-employed sports officials or contest workers for interscholastic activity programs or amateur youth programs.

Montana

All employers must provide coverage. Exemptions include:

• Sole proprietors, partners, and officers of corporations
• Domestic or household employees whose typical responsibilities include house cleaning and yard work
• Casual employment
• Only those working for assistance or sustenance
• Officials of amateur athletic competition, such as a timer, referee, umpire, or judge.
• Real estate, securities, and insurance salespeople paid solely on commission with no minimum earnings guarantee
• Direct sellers
• Those who deliver single or multiple newspapers and have acknowledged in writing that they have no insurance coverage.
• Freelance correspondents who submit articles or photographs for publication are compensated for each submission but have not confirmed coverage in writing.
• Barbers and cosmetologists who have contracts with cosmetology salons.
• Petroleum land specialists
• Licensed jockeys participating in a horse race, from the time the jockey reports to the scale room until the jockey is weighed out after the race.
• Licensed trainers, assistant trainers, exercise persons, and pony persons on the premises of a licensed horse race meet.
• Non-Montana residents whose primary duties are not performed outside the state. The employer must adhere to the coverage requirements in the location where the employee resides or works.
• Officers or managers of a private, non-profit irrigation ditch company, water user cooperative, corporation, or organization.
• A minister who is ordained, commissioned, or licensed by a church or religious order.
• Individuals who provide companionship services or respite care to incapacitated individuals. The individual providing services or care must be directly employed by a family or legal guardian.
• Excluding air search and rescue volunteers, volunteer reserve auxiliary law enforcement, and volunteer firefighters, volunteer workers are defined as:
• Professional athletes who compete in contact sports for a team or club
• Personnel of freight brokers and forwarders
• A musician whose performance is governed by a written contract
• a few agricultural employees

Nebraska

Employers with at least one employee have to provide coverage. Exemptions include:

• Federal workers, railroad workers, independent contractors, and the majority of volunteers are exempt
• Domestic servants
• Agricultural laborers
• Sole proprietors, partners, and officers of corporations

Nevada

Employers with at least one employee have to provide coverage. Exemptions include:

• Employment associated with entities engaged in interstate commerce that are not subject to Nevada’s legislative authority
• Employment covered by private disability and death benefit plans comprising compensation payments of equal to or greater amounts than those provided in NRS 616 and in effect for at least one year prior to July 1, 1947.
• Temporary employees insured in another state who are brought into Nevada if extraterritorial coverage provisions are in effect with the other state.
• Casual employment in the construction industry (employment lasting less than 20 days with a total labor cost of less than $500), if the employment is not in the course of the employer’s trade, business, profession, or occupation.

New Hampshire

Employers with at least one employee have to provide coverage. Exemptions include:

• Sole owners
• Limited liability company (LLC) with three or fewer executive officers and no other employees.

New Jersey

Employers with one or more employees have to provide coverage, with the exception of those covered by federal programs.

New Mexico

Employers with at least three employees have to provide coverage. Exemptions include Sole proprietors. However, sole proprietors are counted as employees when determining whether a business employs three or more individuals.

New York

All employers must provide coverage. Exemptions include:

• Volunteers who provide their services to nonprofit organizations without compensation
• Ministers, priests, and rabbis duly ordained, commissioned, or licensed; sextons; Christian Science readers; and sects of religious orders
• Customers of supervised amateur athletic activities operated on a nonprofit basis, provided that such s are not otherwise engaged or employed by any person, firm, or corporation participating in such athletic activity Educators in a nonprofit religious, charitable, or educational institution
• Individuals employed in a nonmanual capacity by or for a religious, charitable, or educational organization.
• Persons receiving charitable aid from a religious or charitable institution who perform work in exchange for such aid, but who are not under an express contract of hire, are considered unpaid volunteers.
• People who are covered for specific types of employment under another workers’ compensation system, such as those employed in certain maritime occupations, interstate railroad employees, federal government employees, and others who are covered by federal workers’ compensation laws.
• The spouse and minor children of a farmer-employer, provided they are not under an express contract of employment.
• Certain foreign government and Native American Nation employees
• Provisions of the New York State General Municipal Law that protect New York City police officers, firefighters, and sanitation workers
• People, including minors, performing yard work or casual chores in and around a single-family, owner-occupied residence or a noncommercial organization’s property.
• Certain real estate salespeople who sign a contract with a broker stating that they are independent contractors are considered independent contractors.
• Certain media sales representatives who sign a contract stating they are independent contractors are considered independent contractors.
• Certain insurance agents or brokers who sign a contract stating they are independent contractors are considered independent contractors.
• Sole proprietors, partners, and certain corporate officers with no additional personnel providing essential business services.

North Carolina

Employers with at least one employee have to provide coverage. Exemptions include:

• Sole proprietors, partners, and officers of corporations
• Some railroad personnel
• Casual employees
• Domestic servants employed directly by the household
• When less than ten full-time, non-seasonal farm laborers are regularly employed by the same employer, they are considered farm laborers.
• employees of the federal government in North Carolina
• Those who sell agricultural products for their producers on commission or for other compensation, provided the product is prepared for sale by the producer.

North Dakota

There are no exceptions in North Dakota. All businesses must have workers’ compensation insurance.

Ohio

All employers must provide coverage. Exemptions include:

• Partnership Limited liability company that operates as a sole proprietor
• LLC serving as a partnership
• Directors of family farm corporations
• Individuals with no employees incorporated as a corporation
• A religious organization’s ordained or associate ministers

Oklahoma

All employers must provide coverage. Exemptions include:

• Independent contractors
• Some agricultural employees
• Certain providers of services administered by the Oklahoma Department of Human Services who are licensed and compensated on a commission-only basis
• Any employee of an employer with five or fewer employees who are all related to the employer by blood or marriage. Any employee of a tax-exempt youth sports league.
• Sole proprietors, partners, and officers of corporations
• Any individual who performs volunteer work and receives no remuneration other than meals, drug or alcohol rehabilitation therapy, transportation, lodging, or reimbursement for incidental expenses is considered a volunteer.
• Owner-operators of tractor-trailer trucks
• Drive-away sole proprietors

Oregon

Employers with at least one employee have to provide coverage. Exemptions include:

• Sole proprietors, partners, and officers of corporations
• Family-owned businesses with no employees in which multiple families are employed.
• leased employees
• Temporary employees

Pennsylvania

Employers with at least one employee have to provide coverage. Exemptions include:

• Federal workers
• Longshoremen
• Railroad employees
• Casual employees
• Some agricultural laborers
• The Workers’ Compensation Act does not apply to domestic workers Sole proprietors, partners, and corporate officers
• Executive officers for whom the Department of Labor and Industry has granted a religious exemption
• Real estate salespeople with a valid license or associate real estate brokers

Rhode Island

Employers with at least one employee has to provide coverage. Exemptions include:

• Sole proprietors
• Partners
• Officers of corporations
• Independent contractors

South Carolina

Employers with four or more workers have to provide coverage. Not a single exception exists.

South Dakota

Unlike most other states, South Dakota employers do not legally have to carry workers’ compensation insurance. To avoid civil lawsuits, however, the state encourages employers to have workers’ compensation coverage. 

Tennessee

Employers with at least five employees have to provide coverage. Exemptions include:

• Farm laborers
• Domestic laborers
• Sole proprietors, partners, and officers of corporations

Texas

Except for private employers under contract with the government, Texas employers are not required to carry workers’ compensation insurance.

Utah

Employers with at least one employee are required to provide coverage. Exemptions include:

• Sole proprietors, partners, and officers of corporations
• Independent contractors

Vermont

All employers must provide coverage. Exemptions include:

• Casual employees
• Participants in amateur sports
• Some agriculture employees
• Volunteers

Virginia 

Employers with at least three employees are required to provide coverage. Exemptions include sole owners. However, sole owners are counted as employees when determining whether a business employs three or more individuals.

Washington

All employers must provide coverage. Exemptions include:

• Certain executives of public corporations
• a number of independent contractors
• Volunteers

West Virginia

Employers with at least five employees have to provide coverage. Exemptions include:

• Domestic staff
• Casual workers
• Employees of religious institutions Athletes in professional sports
• Employers participating in federal programs

Wisconsin

Employers with at least three employees have to provide coverage. Employers with fewer than three employees who pay wages of at least $500 per calendar quarter must also carry workers’ compensation insurance. Exemptions include some farm laborers.

Wyoming

Employers with three or more workers must provide coverage. Employers with fewer than three workers who pay at least $500 in wages per calendar quarter have to carry workers’ compensation insurance. Exemptions include some farm workers.

Workers’ Compensation Made EZ

Most states require businesses to carry workers’ compensation insurance, which will not only protect your business but also your employees. Keeping your employees safe does not have to be an expensive endeavor for your company. There are numerous ways to promote safety routines and programs, all of which will help you reduce your workers’ compensation costs. If you use the best practices for claims management and follow them in a timely manner, your employees will be able to return to work as soon as they receive medical clearance to do so. Not only will production return to normal, but workers’ compensation costs will get cheaper as well. 

Come to EZ for free, instant quotes from one of our agents if you are looking for the best workers’ compensation policy. And if you already have workers’ compensation benefits but are looking for a better deal, we can assist you. Your EZ agent will be familiar with the local laws and able to guide you as you shop around for the best policy at the most affordable price. Enter your zip code in the box above or call us at 877-670-3538 to speak with one of our agents.