Best Practices 

Best Practices for Self Insurers becoming Self Insured.

Self insurance is a privilege that must be earned, not a right of every employer. Employers in Georgia have the privilege to become self insured if they meet the following qualifications:

Companies who self insure must be committed to long term self insurance.
If properly managed, companies may:

Recommended Thresholds for Self Insurance.
Acceptance is made on a case-by-case basis after a thorough review. The following are recommended qualifications. All applications will be considered.

General Guidelines

Reasons to Consider Self Insurance

Requirements for Self Insurance

Claims Administration

GWCA - Self insured companies should become a member of GWCA.
Our organization provides services in the following areas

Medical Treatment
Financial solvency - must provide certified audited financial reports to prove the company can meet the financial obligations of self insurance
Application to the Self Insurers Guarantee Trust Fund and the State Board of Workers' Compensation.  Application fee is $500. (non refundable)
Must pay an initial assessment of $4000 and annual assessments of $1000 - $4000 based upon annual losses
Provide security deposits to secure future claims in the case of insolvency.  The security may be:  Irrevocable letter of credit or Surety Bond
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.
Improve control of workers compensation claims
Reduce overall cost of workers compensation claims
Improve relations with injured employees
Gain more enthusiastic support of safety efforts
150 or more employees
$250,000 or greater workers compensation premium
$1,500,000 annual payroll
Financial solvency
Viable safety program
Dissatisfaction with insurance company performance
Increased control of claims process
Reduce cost of workers compensation
Employee dissatisfaction with claim handlers of insurance companies
More direct contact with injured employees
Improved cash flow
Must have operations in Georgia
Must be financially solvent
Audited financial reports
Security provisions
Commitment to long term self insurance
Application to self insurers Guarantee Trust Fund and the State Board of Workers Compensation
Establish appropriate claims organization, i.e. TPA or self administration
Commitment to timely payment of benefits
Compliance with the Georgia workers compensation law
Decide whether claims will be administered internally or externally
If claims are to be handled internally, ensure that staff is qualified and equipped for the job
Third party administrators (TPA) are available to provide claims handling services for a fee
Most companies should enter the self Insurance experience with the help of a reputable TPA
Establish and fund bank accounts to assure that checks will be honored
File reports with the State Board of Workers' Compensation in a timely manner
Benefits payments must be made in accordance with the Georgia workers' compensation laws
Benefit payments must be drawn on a Georgia depository
Legislative Advocacy
Educational Seminars
Case Law Reviews
Workers Compensation
New Member Information
Employers should provide the best medical treatment available for their injured employees
Employers may utilize a panel of physicians, a conformed panel, or an approved medical care organization (MCO)
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
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
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