It’s hard to say which type of business insurance is most important for your business. They all cover specific things and keep your business protected in different ways. But there is one type of commercial insurance that you are most likely required by law to have if you have employees: workers’ compensation.
This type of policy covers you and your employee if they are hurt while working, or sick because of workplace conditions. Workers’ comp in nearly every state covers medical expenses, disability, rehabilitation, and death benefits. And while there is some uniformity in regard to the benefits available to injured workers across the country. There is considerable variation in the amounts and methods each state distributes. If you want to find out more about how workers’ comp works in your state, check out our state-by-state guide. Then talk to an EZ agent about what you need.
First, though, read on to find out more about how workers’ comp covers these four benefits (medical expenses, disability, rehabilitation, and death). So, you know exactly what to expect from your policy.
Medical Expenses
At its core, workers’ compensation covers medical expenses incurred by employees who get sick or hurt on the job. It will cover most medical expenses for most legitimate claims. Including bills that come from visits to the doctor, inpatient care, skilled nursing care, medication, diagnostic imaging, physiotherapy. And the cost of long-term supports like walkers and wheelchairs.
In some states, though, there’s no coverage for “alternative” therapies like biofeedback and massage. And it’s possible that one state may cover a treatment while another won’t. Additionally, in some states there are limits on certain treatments. For instance, the law might allow no more than twenty-four visits to a chiropractor or physical therapist.
In most cases, workers’ comp does not have spending caps, deductibles, or copayments. And workers will be eligible for benefits until they have made a full recovery from their injury.
Managed Care
A managed care organization (MCO) is a healthcare provider or group of healthcare providers that has a contract with an insurer or self-insured employer to provide managed healthcare services to enrolled workers. In many states, benefits through a managed care plan can be provided by employers or workers’ compensation insurers to get injured workers the care they need. In fact, insurers in some states legally have to offer this option to businesses.
Managed care plans are governed by a wide range of statutes. Typically, a plan will include some combination of the following:
Provider Networks – A network of medical professionals who have agreed to provide discounted services to members of an insurance pool or employee group. In some states, injured workers will have to receive care from in-network providers.
Utilization Management – This type of management is intended to ensure that the type of medical care that is provided to workers is necessary, appropriate, and efficient with regard to costs. Before carrying out particular medical procedures, providers might be have to get prior approval from the insurance company.
Pharmacy Benefits Manager – An administrator of a program that purchases prescription drugs whose job it is to limit spending. A pharmacy benefit manager (PBM) is responsible for establishing formularies, negotiating discounts with drug manufacturers, forming contractual relationships with pharmacies, and paying claims for prescription drugs.
Medical Care Management – This type of management provides supervising care to make sure that injured workers get the appropriate treatment they need. So, that they can get back to work as quickly as possible.
Disability
Disability benefits compensate an employee for a portion of the wages they lose while they are unable to work as a result of an injury on the job. For instance, if a construction worker breaks their leg in an accident. It is highly unlikely that they will be able to return to work until they have fully recovered. Because of the amount of time this will take, they will require financial assistance during this time when they cannot work.
“Disability” as it relates to workers’ comp has four distinct categories:
Temporary Total Disability (TTD) – To receive TTD benefits, your employee must have been injured so severe that they will not be able to return to work at all for a long time. For example, if a worker sustains an injury to their back and is subsequently unable to perform any duties for six weeks, but will then return to their regular responsibilities.
Temporary Partial Disability (TPD) – Your employee has a relatively minor injury that has only temporarily rendered them partially disabled. For instance, a worker breaks their arm while they are on the job and must work reduced hours. They’re able to still work just not to their full capacity.
Permanent Total Disability (PTD) – If your employee has an injury that will not heal and will be unable to generate income in the future by performing the kind of work they were doing at the time of the injury.
Permanent Partial Disability (PPD) – The injury your worker suffers might affect them permanently, like an injury that causes hearing loss, but they might still be able to work. The injury, though, might prevent them from earning as much income as they did before their injury.
Disability Payments
The severity of a worker’s disability will determine how much money they will receive from workers’ compensation benefits. In general, your employee’s average weekly pay prior to the injury is the basis for the calculation of benefits. This amount, though, might be subject to minimum and maximum limits, depending on your state. There will be a waiting period before benefits are provided, which is typically one week. If the disability lasts less than that period of time, your employee will not be eligible for benefits.
Typically, disability benefits are as follows:
Temporary Total Disability – With TTD, benefits will be paid while your employee is recovering. Typically, these benefits are calculated as a certain percentage of the worker’s average weekly wage. For example, if a worker whose normal weekly wage is $1,000 is unable to work due to a broken leg for a period of two months. They will get a total of $667 weekly over the course of the eight weeks.
Temporary Partial Disability – With TPD benefits, your worker will typically receive their normal pay in addition to a percentage of the difference between their normal pay and their reduced pay. This is the case when the worker receives compensation for work that they are able to perform. For instance, a worker who sustains an injury to their leg is unable to perform their regular job duties because those duties require them to stand. They typically make $1,000 a week. During the two months that it takes for their leg to heal, they are responsible for performing administrative work. This job only pays $500 each week. So, there is a difference of $500 per week between their regular pay and their current pay. They will earn $500 per week plus $333 (66.66% of $500). For a total of $833 per week while they are unable to perform their normal duties.
Permanent Total Disability – A worker who is totally and permanently disabled will typically receive compensation equal to 66.66% (or some other specified percentage) of their previous average weekly wage for the rest of their life. When an employee reaches the official retirement age in some states, the benefits they have been receiving will end.
Permanent Partial Disability – A permanent partial disability may be classified as either “scheduled” or “non-scheduled” in some states. Injuries on the schedule typically involve a specific limb, organ, or part of the body. A worker who suffers a permanent injury to a body part in the schedule can receive disability payments for a specific period of time. If an employee loses a finger on the job, for instance. They may be eligible for 45 weeks of disability pay at 66.66% of their regular wage.
Disability benefits for employees with a permanent partial injury not on a schedule are determined in accordance with applicable state law. Benefits may be calculated in accordance with the worker’s degree of impairment, loss of earning capacity, wages lost. Or some other factor, depending on the state.
Rehabilitation
The part of workers’ compensation that covers rehabilitation helps if something catastrophic happens to an employee that prevents them from working and requires long-term treatment for recovery. For example, if an employee has a history of mental breakdowns, such as after prolonged exposure to toxic stress. They may not be able to work for a time. But rehabilitation and therapy during this time may help them recover. Although they may no longer be able to return to your place of work.
Rehabilitation can also include a service called Transferable Skills Analysis, which can help the employee in these situations. The goal of this program is to assist participants in securing gainful employment that puts their acquired skills to use. Their benefits cover the cost of a case manager who will assist them in their job search.
Death
If an employee dies on the job, his or her dependents will receive workers’ comp death benefits. This protection is in place to help families deal with the monetary fallout of a loved one’s death. This type of coverage will help the deceased’s loved ones pay for funeral expenses. And help replace the income they would have otherwise received.
It’s important to be aware of the laws and regulations in your state before purchasing workers’ compensation insurance. It’s also vital that you stay well-informed on your insurance policies. So, that you can communicate effectively with your staff in the event of an accident.
Working With EZ
EZ.Insure knows that in order to succeed, businesses must have all the information possible. That’s why we’re here to answer all of your questions about the commercial insurance policies you need! But don’t worry, we know that your time and money are valuable. So, you won’t pay anything for our services. And you won’t have to worry about being inundated with calls from your agent as they answer your questions, help you compare plans, and sign you up when you’re ready. To start, either enter your zip code into the box below or call 877-670-3538 to speak with an agent. Thanks to EZ.Insure, getting insurance is a breeze.
Once you sign up for a health insurance plan, you are immediately expected to start monthly premium payments. Then, if you incur medical expenses such as lab work, you are expected to pay these expenses, contributing to your ‘deductible.’ A deductible is an amount you have to pay before your insurance starts paying a percentage. Then, once you are finally all caught up with your deductible, your insurance policy covers the rest of your claims, right? Well, kind of, unless your policy has a coinsurance clause.
Once your deductible is met, any insurance-covered procedure, treatment or service will result in a medical expense. This is called coinsurance. Your insurance company will pay a large portion of any bill (after your deductible is met), and you are responsible for the rest. There are different breakdowns for how the coinsurance is paid for.
Coinsurance is a great option for people needing a little extra help.
How It Breaks Down
The divisions in coinsurance policies are usually broken down into 70/30 or 80/20. What this means is the insurance company will pay 70% or 80%, and you will pay the remaining 30% or 20% out of pocket. The most common coinsurance breakdown is 80/20.
This will only apply once your deductible is met. If you have a $1500 deductible, then you must pay this off first before activating the coinsurance.
Now, let’s use an example. If your medical bill is $2,000 and you have a $1,000 deductible, then the portion of the bill that the coinsurance will apply to is $1,000. With a 20% coinsurance, you will pay $200 extra. In total, the $1,000 deductible plus the $200 remaining of the coinsurance will equate to $1,200 out of pocket.
Now if your deductible was already met and you had that same procedure that was $2,000, then you would have to pay 20% of it. The sum total of $400 out of pocket, since the insurance company paid $1,600 of the service.
Out-of-Pocket Maximum
Now, to throw a wrench into things, health insurance companies offer plans with an out of pocket maximum- but this will work in your favor if you have coinsurance. Once you reach your out of pocket maximum, then the insurance company will pay for any following services 100%.
For example, if you have a $5,000 out of pocket maximum, then the $1,000 deductible you paid goes towards that. This leaves you with only $4000 left to pay. Every 20% or 30% you pay in coinsurance goes towards your out of pocket maximum.
If you have surgery that costs $20,000, then you will have to pay a 20% coinsurance of $4,000. Once you pay that off, including the previous $1,000 deductible, then you can not be charged for anything further out of pocket. The out of pocket max will have been satisfied and the insurance company must pay any following services fully.
Think of the money you’ll save by using this insurance method–paying completely alone could be devastating.
Because policies are renewed annually, once the new year begins, then your deductible restarts, and you will have to meet that price again. Some people have to deal with coinsurance, while others just have to pay their deductible and the insurance company will pay the rest.
In order to find a plan that meets your budget, and needs, speaking with an agent will help. They can help guide you in the best direction, and explain to you thoroughly how much everything will be. You can discuss with them coinsurance, and if you would like a plan that has one or doesn’t. To speak to one of our highly trained agents in your area call 888-350-1890, or email us at replies@ez.insure. Or to get instant quotes, enter your zip code in the bar above. Health insurance has so many different variables. Let us make it more simple and easy for you.
Seeking for advice for your new business? EZ.Insure provides not only ease with insurance, but also these simple guides. Reading them should arm you with the knowledge you’ll need to navigate the business world, like what our policies cover. Curious about more than just a Business Owner’s Policy? See our Business Insurance Masterlist and our Beginner’s Guide to Worker’s Compensation. Here, we’ll take a look at what our Business Owner’s Policy (BOP) covers, application times, and costs.
Want to start your workday with a smile? Think of the ways you set yourself up for success like coverage.
What is a Business Owner’s Policy?
So, what defines a BOP? One of the most important types of coverage, or at least the most useful for the business owner, is this policy combining both liability and major property insurance. With the combination, both policyholder and insurance company can benefit. The choice of what you actually want to combine is up to you. Here are your options:
General liability
Property liability
Business Income/Interruption
Cyber insurance
The above coverage types extend protection should any property damage, bodily harm, or income loss happen to your company. No one ever wants these types of things to happen, but it is always better to be prepared just in case.
Without a Business Owner’s Policy, you take the financial brunt of any misfortune happening on your company property, including cyber theft. Take for instance if while at your businesses someone slips on a cracked floor and breaks an ankle, if you do not have a business owners policy, and a lawsuit ensues, you will be responsible for any reparations, plus the loss of when you have to shut down for repairs.
When Can You Apply?
The short answer is now! There is no open enrollment for a Business Owner’s Policy. However, you may ask your agent about special offers, especially if they are time-dependant With EZ.Insure, your agent will make sure to get you the best policy for exactly what you need. The best time to apply is when you feel you need coverage.
New products? If you’re moving up in business, you might consider new coverage.
If you feel you are ready for a Business Owners Policy the next step is to reach out to an agent to have any questions answered and get a quote for different types of coverage. You can reach an EZ.Insure agent at PHONE NUMBER. Before you call, write down what you think will be right for your business. If you hold most of your information online, we would suggest adding cyber liability insurance, or, if your business is mostly physical property and equipment, property liability would be best. Taking a small amount of time to take note of your assets will make your application process smoother.
What Is Not Covered?
A Business Owner’s Policy does cover quite a bit, but there are exceptions. Worker’s Compensation and Professional Liability are not covered in a BOP but are solid policies to hold. Remember, Worker’s Comp is mandatory in most cases, but Professional Liability is not. While these are not included in the BOP, be sure to do your research if your company has a high risk for malpractice suits. People make mistakes, but certain professions like doctors need extra protection with insurance.
What Are the Costs of a Business Owner’s Policy?
The average cost ranges between $30 to $200 per month. Of course, this will vary based on your needs. Ask your agent to help keep costs down. Also, keep in mind that while this may seem like an extra bill per month, the median cost of just one business lawsuit is $54,000. That’s the price of a good car. Can you afford a surprise purchase like that? To make matters worse, millions of cases pass through U.S. courts annually. Do you like those odds?
Talk to your friends in the business. What advice could they give you about their own coverage?
The process can be easy enough, especially with an agent on your side. They will have the most up to date information about what level of coverage your company really needs to keep you safe, but not overspending.
EZ.Insure is here to help. Your agent will answer any questions you have, compare different plans for you, and even sign you up when you’re ready, free of charge and without having to worry about being hounded by endless calls. To get started simply enter your zip code in the bar above, or you can speak to an agent by emailing replies@ez.insure, or calling 888-350-1890. EZ.Insure makes the entire process easy, and quick.
Taking the plunge with a new business? You’re in luck. It’s never been a better time with support all over the place. As a new business owner, you may have legal advice, a business plan, and employees already, but don’t undervalue insurance when it for added security. Do not overlook the benefits of peace of mind.
Planning for unforeseen disasters now can save you headaches later.
You may not know all the important insurance coverages, or why exactly you’d need them. We’ve got a guide for you here with the necessities for a smooth launch.
And if you’re thinking specifically about group health insurance, we’ve got all the information on that over here.
Types of Insurance for Your New Business:
Worker’s Compensation Insurance
This coverage pays for medical care and replaces lost wages for the worker affected.
This is required insurance coverage. (Except in Texas)
Insurance cost is averaged to about $2 for every $100 in payroll.
Unemployment Compensation Insurance
This will guarantee some wage to your employees after their job is lost.
This is required insurance.
Insurance cost varies by state.
Disability Insurance (Required in Some States)
This covers your employees if an illness or injury causes them to miss work.
Rhode Island, Hawaii, New Jersey, New York, and California require this.
Insurance cost will be about .25%- .5% of payroll.
General Liability Insurance
If someone else is injured on your property or from a business service, this covers that situation.
This is not required coverage.
Average liability coverage will come to around $500,000 per year but can be lessened or increase by your business’ risk level.
Commercial Property Insurance
This covers your physical property and spaces that belong to your business. (Including weather, vandalism, or theft)
This is not required coverage.
Average insurance cost is about $1500 per year.
Professional Liability Insurance
This is also known as Errors and Omissions insurance. You’ll need this for higher risk businesses such as lawyers or doctors.
This is not required insurance.
Average insurance cost is about $1350 per year.
Product Liability Insurance
This coverage protects you from faulty merchandise. If you operate with a manufacturer and/or packagers, this can cover you in case they make a mistake.
This is not required insurance.
The cost will be about .25￠ for every $100 in retail sales.
Employment Practices Liability Insurance
This coverage protects you in cases of sexual harassment lawsuits or otherwise.
This is not required insurance.
These policies have wider ranges due to many factors such as employee number, turnover, and type of business. The range will be from $800-$3000 per year.
Key Person Insurance
This insurance type covers your business in the event that the business owner or another key personnel member dies or becomes disabled.
This is not required insurance.
Less than $1000 per year
Other Insurance Policies to Consider
Business Vehicle Insurance
Covers vehicles used for the business
Directors and Officers Liability Insurance
Covers the directors and officers of non-profit businesses in lawsuits claiming they mishandled their business
Business Identity Insurance
Covers cases of identity theft, even going so far as to notify your customers for you should you have their information
Terrorism Insurance
Covers cases of terrorism affecting your business. Check to make sure it is not already bundled with your other policies.
Unexpected things happen. Don’t get caught unawares and lose your hard-earned profits.
Of course, we hope you never have to take advantage of these types of insurance. However, when it comes down to it, it’s best to keep everyone covered. Whether you’re a home-based business or a larger one, all will benefit from the support. And like before, it’s never been a better time to do so with all the specialists available.
EZ.Insure offers you another helping hand. Your agent will answer any questions you have, compare the plans for you, and even sign you up, free of charge. To get started simply enter your zip code in the bar above, or you can speak to an agent by emailing replies@ez.insure, or calling 888-998-2027. EZ.Insure makes the entire process easy, simple, and quick.
