TASB Risk Management Fund
INSIDERM

The Value of Workers' Compensation Coverage

May 29, 2018 Amanda Beck

female patient wearing green shirt

The Fund helps employees get back to work after injury or incident, including teachers back in their classrooms to deliver quality education to Texas students. We’re there every step of the way to help your employees get the care they need without unnecessary costs.

A long history

The story starts in 1974 when a new Texas law required school districts to purchase workers’ compensation coverage, but traditional carriers didn’t rush to take on the schools’ risk. TASB leaders recognized members’ need and that the law allowed governmental entities to come together to pool risk. The TASB Workers’ Compensation Self Insurance Fund was created and although the name has changed, it has been serving Texas public education entities in this capacity ever since.

Experts who care

Like most TASB employees, workers’ compensation adjusters care deeply about members. Each year, they help more than 10,000 injured employees navigate through every step of the claim and recovery process so that they can return to work quicker and feeling better. They rely on an in-house team of licensed review agents, registered nurses, and a board-certified physician to provide expert guidance on complicated claims. With more than 250 years of combined medical experience, this utilization review team ensures injured employees receive care appropriate to their injury or occupational illness.

While there are countless examples of workers’ compensation team members positively impacting the lives of our members, one recent example is the difference Workers’ Compensation Adjuster Stephanie Carby made helping an injured police officer at Austin Community College get the treatment and support he needed.

“She cared about me, and so did her boss and her boss’ boss. That just shows how awesome [TASB] has been…I can’t believe how lucky I am to have people in my corner,” Austin Community College Police Officer Chris Hernandez said.

The hard work and dedication of the workers’ compensation team has not gone unnoticed. For six consecutive times, the program has been recognized as a High Tier performer by the Texas Department of Insurance for top speed and efficiency in operations.

Superb quality and cost-effective service

The Fund belongs to the Political Subdivision Workers’ Compensation Alliance, a medical provider network consisting of five risk pools. The Fund’s partnership with the Alliance helps ensure that workers receive timely medical care from qualified health care providers who share common goals—providing quality care, treating according to nationally recognized treatment guidelines, and returning injured employees to work.

The Alliance has consistently received high scores in the Texas Department of Insurance Network Report Card compared to other networks and non-networks. Some of the accolades the Alliance received recognition for in 2018 Network Report Card include:

  • Highest satisfaction in care
  • Lowest average number of prescriptions per injured employee
  • Second lowest average professional costs

Pharmacy benefits

Medication plays a major role in the recovery of injured employees. The Fund partners with Optum to manage pharmacy benefits for the Workers’ Compensation program. For employees who are injured at work, this partnership means they do not have to wait until the claim processes to receive medication. Members receive a first fill card that allows employees to fill a prescription immediately, at no cost to them. There are more than 4,500 Optum retail pharmacies across Texas, so no matter what part of the state they live in, prescriptions can be quickly and easily dispensed.

Optum also works with treating medical providers to reduce the unnecessary use of opioids, which is not always the best option for pain management, and can result in longer recovery periods and additional costs. Over the past five years, Optum has seen a declining trend in use and cost of opioids.

On average, Fund member prescription claim costs are 40 percent less than those without a network – $145 compared to $233.

Training and prevention

The benefits to participating in the Fund’s Workers’ Compensation program aren’t limited to the claim process. A dedicated TASB training coordinator helps members navigate the complex rules specific to school districts so you know which forms to fill out and how.

Experts from TASB provide training via webinars and in person throughout the year, including at Members’ Conference. Because workers’ compensation goes hand-in-hand with other human resources topics, Risk Management Services staff collaborate with TASB HR Services professionals to offer a comprehensive approach.

Members also receive access to a custom online training program provided by SafeSchools to help you prevent employee injuries before they happen. We have handpicked courses on 11 of the most common injury types that are provided at no cost to fully-funded and aggregate deductible members. Those who are Administrative Services Only can purchase those and other courses from the library at a substantial discount.

Data and reporting

One way to prevent and mitigate injuries and ultimately claims is by training staff; another way is to gather and analyze data. That’s why we provide a number of self-service reports available online to members of the Workers’ Compensation program. Members can look at data from claims as recent as the day before and slice and dice the information to understand what trends are happening in their organization. Workers’ compensation reports can show the frequency and severity of issues. For example, reports outline if there are certain types of injuries more prevalent than others, what type of job classifications are most at risk, and which campuses see more injuries.

If you’re interested in finding out more about Workers’ Compensation coverage, including which funding option is right for your organization, contact your marketing consultant.

Tagged: coverage, "the Alliance", "workplace safety"