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Financial solvency - must provide certified audited financial reports to prove the company can meet the financial obligations of self insurance
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Application to the Self Insurers Guarantee Trust Fund and the State Board of Workers' Compensation. Application fee is $500. (non refundable)
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Must pay an initial assessment of $4000 and annual assessments of $1000 - $4000 based upon annual losses
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Provide security deposits to secure future claims in the case of insolvency. The security may be: Irrevocable letter of credit or Surety Bond
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Security may be claimed by the Self Insurers Guarantee Trust Fund in cases of insolvency. The security will be used to pay workers compensation obligations of an insolvent member of the fund.
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Dissatisfaction with insurance company performance
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Increased control of claims process
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Reduce cost of workers compensation
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Employee dissatisfaction with claim handlers of insurance companies
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More direct contact with injured employees
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Must have operations in Georgia
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Must be financially solvent
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Audited financial reports
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Commitment to long term self insurance
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Application to self insurers Guarantee Trust Fund and the State Board of Workers Compensation
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Establish appropriate claims organization, i.e. TPA or self administration
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Commitment to timely payment of benefits
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Compliance with the Georgia workers compensation law
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Decide whether claims will be administered internally or externally
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If claims are to be handled internally, ensure that staff is qualified and equipped for the job
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Third party administrators (TPA) are available to provide claims handling services for a fee
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Most companies should enter the self Insurance experience with the help of a reputable TPA
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Establish and fund bank accounts to assure that checks will be honored
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File reports with the State Board of Workers' Compensation in a timely manner
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Benefits payments must be made in accordance with the Georgia workers' compensation laws
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Benefit payments must be drawn on a Georgia depository
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Employers should provide the best medical treatment available for their injured employees
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Employers may utilize a panel of physicians, a conformed panel, or an approved medical care organization (MCO)
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Panel of Physicians - Must consist of at least four qualified physicians. The Panel must include one Orthopedic Surgeon, a Minority Physician, and two other properly qualified physicians. No more than two may be Industrial Clinics. Employees must chose a physician from the panel for treatment of their Workers' Compensation injury. Employees may make one change of physicians from the panel without approval. Some employers believe the Panel of Physicians provides more control of the medical treatment because of the restrictions on the number of Physicians
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Conformed Panel - Must include at least ten physicians. Employees may make one change. This is considered a compromise for employers who are not satisfied with the Panel of Physicians and are not ready for the use of an MCO
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MCO - Must be approved by the State Board of Workers Compensation. MCO's offer a much larger choice of treating physicians from many disciplines. Employees may make one change within the MCO