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. The Workers’ Compensation program offers benefits such as loss prevention services, training opportunities, and school emergency management services geared towards helping you protect students and employees.
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, 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
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.
Injured employees can now receive medical care using telemedicine. This benefit is available at no additional cost to Fund members. There is reduced missed work/productivity because there is no travel or wait time for employees to see medical providers.
Fund members can work with Concentra or RediMD to offer telemedicine as an option for injured employees to receive medical care for minor no lost time claims or follow-up appointments.
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, we host 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 plan. You can discuss coverage options with a marketing consultant or by calling 800.482.7276.