The Fund helps employees get back to work after an 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.
Superb quality and cost-effective medical care
The Fund belongs to the Political Subdivision Workers’ Compensation Alliance, which achieves better health and return-to-work outcomes at lower costs.
Compared to claims filed without a network, Fund member:
- Employees return to work 60 percent quicker after injury (14 weeks compared to 35)*
- Medical costs are 20 percent less per claim ($1,958 compared to $2,469)*
- Prescription costs are 40 percent less per claim ($145 compared to $233)*
*according to the 2017 Texas Department of Insurance Network Report Card
In addition, the Fund partners with OptumRX, a leading pharmacy benefits management company, to save costs on medication and reduce the unnecessary use of opioids.
Expert claims service and utilization management
When member employees suffer an injury at work, dedicated case managers help get them to a medical professional quickly. They become an integral part of the recovery process by staying in touch with the injured employee and team of medical professionals.
An in-house team of licensed utilization review agents, registered nurses, and board-certified physician with more than 250 years of combined medical experience reviews cases to ensure proper treatment.
Employee training and resources
Comprehensive coverage includes training to prevent injuries before they happen. Members have access to digital resources like articles on the InsideRM blog, forms in the member library and the online training with the SafeSchools courses. Throughout the year, Member Solutions hosts webinars on a variety of workers’ compensation topics, and many of the sessions at Members’ Conference cater to workers’ compensation professionals.
Compliance and high tier performance
The Fund stays current on regulations to ensure claims are adjusted timely and properly. The Workers’ Compensation program has been designated a High Tier performer by the Texas Department of Insurance for speed and efficiency every year since the rating’s inception in 2007.
Flexible funding options
Select the funding option that meets your needs, whether you participate in the pool as a fully-funded or aggregate deductible member, or need an administrative services only (ASO) plan. You can discuss coverage options with a marketing consultant or by calling 800.482.7276.