You may know your way around the world of workers’ compensation (WC) pretty well, or well enough to get by. What about Wrap-Up coverage? US&LH v. State Act? Experience Mods? Stop Gap coverage? Volunteer endorsements? Ghost policies? WC v. Employer’s Liability (EL)? Multiple risks on a single policy? No worries, I will do a brief overview so you know more about each of these, well enough for you to get by or know enough to talk about it or how to ask questions about them.
Wrap-Up Coverage
Wrap-up insurance is a liability policy that acts as an all-encompassing insurance protecting contractors and subcontractors. Owner-controlled insurance is set up by the owner of a project for the benefit of the builder or contractor to cover all listed contractors. Larger construction companies often have this in place for added liability protection. Policies with wrap-up coverage are typically for very large construction companies or for very large projects. A few carriers are leery of writing policies for contractors who are required to have wrap-up coverage.
USL&H
This stands for Longshore and Harbor Workers’ Compensation Act. This is essentially WC for employees working on or around navigable waterways. Think ocean, but not limited to. Employees in the ocean need USL&H coverage since the State Act is not intended for that exposure. But not all risks with this exposure are required to carry WC. USL&H is only required for commercial vessels or personal vessels over 65 feet in length. This is for work done over navigable bodies of waters but can include work on bridges, docks, or other structures. More info: Here. Few carriers offer USL&H, but a few will include incidental or even IF ANY USL&H. Omega can entertain risks with USL&H endorsement with a minimum of 8 month’s prior WC and $5,000 minimum premium.
Experience Mods
Most states use NCCI to promulgate the experience modification (mod) for each risk. Each carrier submits loss data to NCCI for each policy holder they write. Once the premium is $10,000 or higher and the risk has 2-3 years of loss data, NCCI then calculates a mod factor which is simply a multiplier. This can be a debit or credit based on the losses v. premium. All risks start with the multiplier of 1.00 which does not change the premium. Risks with poor loss history often have a debit mod which is anything above 1.00. It is typical to see mods of 1.15, 1.29, 1.38 or similar. I once saw a mod as high as 2.99 which is extremely rare. In non-NCCI states like NY, CA, NC, they have their own state program doing the same as NCCI. For larger risks, it makes sense for the owner to participate in safety and drug-free programs as well as return-to-work programs. Also, if a carrier offers a deductible, it may help the policy holder to mitigate having higher debit mods which saves them from higher premiums in the long run. Some larger contractors will not allow construction companies who have a high mod to work with them.
Stop-Gap Coverage
A stop-gap endorsement is an endorsement that is primarily used to provide employers liability coverage for work-related injuries arising out of exposures in monopolistic fund states (fund workers’ compensation policies do not provide employers liability coverage). The monopolistic states are ND, OH, WA, WY. This means WC is only available from the state fund for each state.
Volunteer Endorsements
Risks with a great deal of volunteers will sometimes ask for an endorsement to cover volunteers. Since the volunteers are not paid, and WC is based on payroll, then they would only be covered for the medical portion of a claim resulting in an injury which happened while the employee volunteered for the policy holder. Most carriers will not offer this endorsement.
Ghost policies
This term is most often used to refer to a minimum premium or “IF ANY” policy where no one is covered since there are no employees and owners are exempt. Why would the risk want the WC policy? If they hired a sub-contractor and there was an injury resulting in a WC claim, what if their certificate of WC was invalid? This policy would most likely pick that exposure up. Most carriers will not entertain these policies, but there are a few who do. Omega writes these for HOAs and Condo Associations, and it also includes volunteer endorsement meant to cover officers.
WC v. Employer’s Liability (EL)
Employer’s liability insurance is a coverage that helps pay a business owner’s costs related to a lawsuit resulting from an employee’s work-related injury or illness. Without employer’s liability insurance, you’d have to pay for these legal costs out of pocket, which can get very expensive. Workers comp has three parts. Part 1 is Workers’ Compensation which covers the medical expense for an injury and if needed the indemnity (partial wages while out of work). Part 1 has no stated limits. Part 2 is Employers’ Liability which is separate coverage for liability for the owners of the company. Part 2 has standard or statutory limits of $100,000/$500,000/$100,000 (Each Accident/Disease-Policy Limit/ Disease-Each Employee) or they can elect to increase limits on part 2 to either $500,000/$500,000/$500,000 or $1,000,000/$1,000,000/$1,000,000. Part 3 is the other covered states. Employer’s Liability Insurance usually covers all types of employer’s liability claims unless the policy specifically excludes them. However, some claims are more common than others. While very rare compared to WC claims Employer’s Liability lawsuits typically involve one or more of the following four claims: Third party over actions, Loss of consortium, Dual-capacity suits, Consequential bodily injury. When these claims happen, Employer’s Liability Insurance can cover your business’s:
- Legal defense fees
- Settlements
- Damages or judgments
- Other court costs
Multiple risk on a single policy: Yes, multiple entities can be on a single WC policy. This is only available for combinable risks. Combinability is reached when one owner holds majority ownership in all entities. Often an ERM-14 form is required for NCCI to make official combinability determination. Combining multiple risks can be beneficial since they are more likely to develop an experience mod, but if they develop a debit mod then it would affect all combined entities.
Disclaimers: The above explanations are experience-based opinions. There are always exceptions. For further understanding of these aspects of WC send me a request and I will try to point you in the right direction for more official information.