AASCIF 2012 Super October 2 –5

AASCIF 2012 Super ConferenceOctober 2nd – 5th

Measuring S&H's Contributions within the

OrganizationHereInitial Conversation and FeedbackKEMI:• Policyholder retention• Value‐added• Agency relationship• Underwriter decision making• Auditing• Claims• Internal advice


OrganizationHereInitial Conversation and FeedbackWCF—Minnesota• Value agency relationships• Value of addressing “early symptom reporting and intervention measures”

• Value of outreach activities• Environmental stewardship• Policyholder injury reporting and management systems

• Underwriting pricing decisions based on LP risk ratings; credit verification


OrganizationHereInitial Conversation and FeedbackSAIF—Oregon• “Targeted” accounts• Healthcare/Zero‐lift study• SIIM4 ® ‐‐safety in motion• Agency surveys• Loss Prevention: corporate social responsibility


OrganizationHereCASE STUDY• Costs for 2011 visits compared against total costs

• 2011 Policyholder Touches• Utilize as of Year End 2011 numbers• Top 50 Account Evalution• Recapture Accounts• Policyholder Retention


OrganizationHereCASE STUDY• Targeted groups• Success Stories• Stretch for Safety• Ergonomic Interventions• Kudos• Open Seminar• Losses by Cause 2006 to 2011

BEST PRACTICES: SESSION 1Here

FAR OUT MAN!

http://apod.nasa.gov/apod/ap120305.html

http://apod.nasa.gov/apod/ap120305.html

BEST PRACTICES: Loss Control Consultation meeting follow‐up documentation and safety plans.

HereFeature• One document that encompasses both meeting follow‐up documentation and safety plans.

• Safety plan items are prioritized based on type• Multiple drop down boxes to assist with the tracking of types of injuries and status

Benefits• consolidated form ensures all safety plan items addressed at each consultation

• current status of items is maintained and easily available.

Microsoft Office Word Document

BEST PRACTICES: Industry Safety Associations

Feature• Supporting seven safety associations that represent 16 rate codes.• non‐profit organizations • Safety associations deliver safety related training, programs and advice that

support employers and workers in addressing health and safety issues.

Benefits• Since 2004 the rate codes covered by safety associations have reduced their

collective injury rate by 36% • By comparison, rate codes not covered by safety associations dropped by 22%

during the same period.• Average premium rate for rate codes covered by safety associations has dropped

by 35% • Rate codes not covered by safety association’s saw a 15% drop in their average

premium rate during the same period.

BEST PRACTICES: Understanding WCB Booklet

Feature• simple plain language approach to explaining some keys

employers should know about WCB as well as basic information about safety and claims management/return‐to‐work.

• intended for small and new employers, but is being used by employers of all sizes and industries.

Benefits• Can be made available to anyone who would like one.• received very positive feedback from employer’s employer

associations.•

BEST PRACTICES: : Agricultural Safety Seminars

Feature• 26 free half‐day seminars in 17 cities throughout the state between November and March• 2,109 attendees in 2011‐12. • 2012‐13 to have seven Spanish sessions• focus is on providing agricultural owners, operators, supervisors, and foremen training on

topics relating to safety and health, as well as safety leadership• 2011‐12 our seminars focused on these topics:

– Safety Committees and Safety Meetings– ATV and tractor safety– Chain saw and hearing protection– Safety leadership

– 2012‐13, seminars will focus on these topics:– Forklift safety– Understanding and complying with the Worker Protection Standard– Practical solutions for pesticide safety– Turning employees into safety leaders

• Content is developed and delivered by two Ag experts: SAIF employee….contractor who works extensively in the Ag community

• Spanish sessions are delivered by a native speaker.. works very closely with our English presenters

BEST PRACTICES: : Agricultural Safety Seminars

Benefits• Ability to reach a large population of Ag accounts through one

venue rather than multiple onsite visits • SAIF brand and marketing advantage is strengthened : responsive

and caring ; a marketing advantage for potential new business• frequency rate has declined over the 18 years we have offered

these seminars • see and hear stories of changed work practices from farmers and

growers • receive high marks (an average score of 4.65 out of 5.0 for content

quality, educational benefit, and effectiveness of presenters• attendance has grown over the past five years by a total of 48%.

BEST PRACTICES: Managing Risk Booklet

Feature• Implementing Job Hazard Analysis, Risk Assessments, and Daily Task

Planning Tools.

Benefits• Pre‐planning both routine and non‐routine/hazardous tasks

Best Practice Supporting Materials/information:• Training Guide with Definitions, Hazard Evaluation essentials, Instructions

for Completing a Job Hazard Analysis, Instructions for Completing a Risk Assessment, and Instructions for Completing a Daily Task Plan. There is a power point with sample forms.

BEST PRACTICES: Servicing Small Policyholder’s

Feature• looking at trends by SIC/NACIS code for accounts under a premium

threshold of $15,000• Each month we do a short analysis• send identified accounts a letter with a safety meeting topic that

addresses this area and information /how to easily access our website/online safety materials

• target about 500 accounts each month with the small business mailing project.

Benefits• able to touch a large number of accounts that are having accidents that

we would not normally touch unless a regulatory required visit came into the mix.

Best Practice Supporting Materials/information:•

BEST PRACTICES: “Preparing for Retiring Staff”

Feature• Restructuring Career Path Opportunities• Attracts younger employees• Creates a more robust organization• Creating and Promoting a Succession Culture• Encourages promoting from within• Encourages hiring at base level of organization• Prioritizes preparation for promotion as part of continuous learning• Setting Up An Effective Intern/Trainee Program• “Outreach” To College/University Students• Professional Presentations –“What Young Professionals Need To Know That Cannot Be Learned in School”• Informational Presentations to College Based Professional Societies –“A Day in the Life of a Safety

Consultant”• Senior Project Opportunities• Internship/Co‐op Program

Benefits•

Best Practice Supporting Materials/information:•


Prospect Account

GunpowderSaftey_101.wmv


High Tech / Low Touch* quarterly e‐mail communications

Schools Tactical Approach Tracking* Major loss source

Schools Best Practices and Tactics database* Major loss source by department

* control tactics, needs and leadership aspects/needs.Education System* are building major loss source‐based “educational systems”

BEST PRACTICES: Right ATTIRe

Feature• Work model with focus on Right:

– Account• Utlizing spreadsheet accounts in territory with parameters

– to produce Priority number» Premium» Class code» Loss frequency/severity» E‐Mod

– Targeted classes– Touch

• Focus on account activity– File review– Telephone survey– Risk assessment/evaluation– Services

» LP activity based» Consultative based

– Time• Appropriate and in line with touch• Considerate

BEST PRACTICES: Right ATTIRe

Feature• Work model with focus on Right:

– Information• Reporting process: report types• Quality assurance • Correspondence

– Results • Recommendations follow‐up• Services delivered as promised• testing metrics looking at frequency and severity (with a cap) rate reductions

and comparing the account to themselves before and after

Benefits• systematic approach to assure the right accounts are provided LP

attention inline with corporate strategies• Help to define focus to address services to promote meaningful,

purposeful and impactful LP account activity

Pinnacol Health Risk Management Study

September 2012

Confidential Draft. Do not reproduce, cite, or share without permission of Pinnacol Assurance and Colorado School of Public Health.

Agenda

1. Pinnacol background

2. Quick overview of the HRM program

3. Long‐term research goals and approach

4. Preliminary results

5. Next steps

6. Discussion


Pinnacol Background

• Pinnacol is Colorado’s leading provider of workers’ compensation insurance

• The company serves nearly 55,000 policyholders across the state, protecting nearly one million workers


The Pinnacol HRM Program• Comprehensive wellness program provided free of charge to 30,000 Pinnacol covered lives

– HRA

– Feedback

– Unlimited coaching

– Broad array of online and interactive tools

• Up to five years duration (2011 ‐ 2016)

– Entrants after 2011 will have fewer than five years


Long‐Term Research Agenda

• Determine impact of wellness on:

– Health status

– Productivity

– Workers’ compensation costs

• Control group from nonparticipating policyholders matched by geography, industry, size and hazard classification


Short & Medium‐Term Research

• Contribute to the meager supply of data linking health risks and behaviors to workers’ compensation claims

– Duke University study is the primary current study, others are dated and limited in applicability to “Main Street” small businesses

• Identify other findings and opportunities along the way


Current Status of HRM Study• Approximately 30,000 lives (fluid due to disenrollment,

growth within participating companies, and new companies)– Approximately 300 policyholders– Size ranging from group of 1 to several thousand

• Most are in their first year, although 40% are in their second year and a few are approaching their third HRA cycle

• Control group is being established• Focus is shifting from recruitment to sustained engagement


Preliminary DataA very preliminary look at:• Health Risk Assessment (HRA) data• Workers’ compensation data

Analysis prepared in April 2012 by the Pinnacol Research Advisory Committee (RAC) with:

• Colorado School of Public Health• Colorado State University


Important to Note

• This is a “first look” at a partial dataset• Results are expected to change with further analysis• Each analysis has significant limitations (interpret with caution)

• Association does not equal causation– Bivariate rather than multivariate analysis


Methods Overview• HRA data includes: study years 1 & 2• HRA data excludes: Year 2 HRA data for those participants who completed a survey in both years

• Workers’ compensation data (2005‐2010)• Descriptive statistics ‐ all variables• Simple correlations ‐ outcome variables:

– Number of Workers’ Compensation Claims– Total Gross Compensation– Temporary Total Disability (TTD)

• Bivariate analysis rather than multivariate


Health Risk Assessment Data

Health Risk Assessment Data

(5/1/2010‐1/20/2012)

N =8943

Study Year 1

N =4245

Program Year 1

N=7778

Study Year 2

N=4698

Program Year 2

N=1165

Study Years 1 & 2

N=636


Workers’ Compensation Data

Workers’ Compensation Data

(2005‐2010)

Policyholder Claims

N =13,014

Policyholders

N= 208

HRA Participant Claims (Total)

N=2,127

HRA Participants w/

claim(s)

N=1,491Confidential Draft. Do not reproduce, cite, or share without permission of Pinnacol Assurance and Colorado School of Public Health.

Risk Overall Wellness Score

Risk Category ScoreCaution, High

Risk(Poor)

0 – 19

Needs Improving(Fair) 20 – 59

Doing Well(Good) 60 – 79

Excellent 80 – 100


Workers’ Comp Data Summary• Female HRA participants filed more workers

compensation claims during 2005-2010 • The majority of claims filed by HRA

participants were medical only claims• In most cases, the categories with the highest

frequency of claims, were not those with the most total days lost (TTD claims), or with the highest gross totals paid (as of end of calendar year, so no reserves)


What types of health conditions and behaviors are associated with previous

workers’ compensation claims?


Risks That Impact Incidence AND Cost Of Claims

• Less than 7 hours of sleep a day• Obesity• Self‐reported high blood pressure• Diabetes


Sleep Hours Frequency Claims (mean) 95% CI Total Gross amount paid on claim (2005-2010)Mean 95% CI

6.9 hours or less 835 0.24 0.19-0.29 494.7 297.10-692.32

> 7 hours 7472 0.17 0.16-0.18 212.6 171.38-253.81

P-value <0.005 <0.0001

Sleep


Underweight Normal Overweight Obese

N (#) 126 3296 2884 2001Mean Workers’ Compensation Claims

0.08 0.14 0.19 0.22

SD 0.37 0.49 0.65 0.67P-value <0.0001Mean Gross Compensation ($)

34.69 174.67 263.99 329.91

SD 283.90 1540.03 2105.83 2360.85P-value <0.05Mean Lost Days TTD No significant difference in means detected.

Obesity (BMI)


Normal BP High BPN (#) 6955 1352Mean Workers’ Compensation Claims

0.17 0.23

95% CI ($) 0.16-0.18 0.19-0.26P-value <0.001Mean Gross Compensation ($)

209.00 405.25

95% CI ($) 166.76-251.26 265.39-545.11P-value <0.001

Self Reported High Blood Pressure


Diabetes History No History of Diabetes

N (#) 309 6221Mean Workers’ Compensation Claims

.33 .18

95% CI .24-.41 .16-.19P-value <0.0001Mean Gross Compensation ($) 517.95 235.18

95% CI 183.47-852.42 185.09-285.26

P-value <0.05

Diabetes (Personal Health History)

Note‐ The HRA asks two diabetes questions. Both yielded similar results.Confidential Draft. Do not reproduce, cite, or share without permission of Pinnacol Assurance and Colorado School of Public Health.

Risks That Impact ONLY Claims Incidence

• Alcohol consumption• Not wearing a seatbelt 100% of the time• Inadequate exercise• High cholesterol


Weekly Alcohol Use Claims (2005-2010)N (#) Mean Claims SD P-value

No Alcohol Use 3049 0.21 0.65 <0.0001

Moderate Alcohol Use 4970 0.16 0.54

Excessive Alcohol Use 288 0.22 0.73

Moderate

Excessive

Alcohol Consumption


Seat Belt Usage N (#) Mean Claims 95% CI P-value

Wear Seat Belts 6665 0.17 0.16-0.18 <0.005Do not always wear Seat Belts 1642 0.22 0.19-0.25

Seat Belt UsagePercent o

f tim

e Seatbe

lt Worn


Inadequate Exercise

Adequate Exercise

N (#) 2256 6051

Mean Workers’ Compensation Claims

0.20 0.17

95%CI 0.18-0.23 0.16-0.18

P-value <0.05

Mean Gross Compensation ($)

No significant difference in means detected

Exercise

Note‐ Adequate exercise defined by CDC guidelines, for adults, age 18‐64. Confidential Draft. Do not reproduce, cite, or share without permission of Pinnacol Assurance and Colorado School of Public Health.

Normal Cholesterol High Cholesterol

N (#) 6757 1550

Mean Workers’ Compensation Claims

0.17 0.22

95% CI 0.16-0.18 0.19-0.26

P-value <0.001

Mean Gross Compensation ($) No significant difference in means detected.

High Blood Cholesterol

Note‐ The HRA asks two cholesterol questions. Both yielded similar results.


A Surprise or Two

• Smoking had no impact on:

– Frequency of claims

– Cost of claims

– Duration of lost time

• Initial data run showed a small impact


Implications

• First data to validate our assumption that health risks and risky behaviors likely impacts workers’ compensation incidence and costs

• Conceptually, this could provide the basis for premium adjustments based on health profile or participation in wellness activities

• Unprecedented in workers’ compensation


Impact on Study• The data is reinforcing the relationship between safety and health risk management

– Sleep, alcohol consumption, and seat belt usage are all components of safety programs

– Pinnacol’s safety team will be incorporating the HRM message in their safety sessions

– Pinnacol’s HRM team now incorporates the safety message with their HRM policyholders

– We believe “HRM is the new safety”…Confidential Draft. Do not reproduce, cite, or share without permission of Pinnacol Assurance and Colorado School of Public Health.

Limitations

• The data does not tell us how to address or minimize these risks, just the potential value in doing so

• The long term study and the control group is designed to help answer the solutions aspect of the equation


Limitations

• Biggest drawback is that this data is not adjusted for other factors such as age, gender, presence of chronic conditions etc.

– The RAC is currently doing a series of multivariate analyses to determine other factors that might be impacting these results

– Suggestions from the group?


Discussion


Thank You to Our Sponsors

Documents

AASCIF 2012 Super October 2 –5