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Experience Modifiers What They Are and Why There’s Nothing Wrong with a 1.0 Eric Bourquin, Vice President of Safety Services Texas Mutual Insurance Company

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Page 1: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

Experience ModifiersWhat They Are and

Why There’s Nothing Wrong with a 1.0

Eric Bourquin, Vice President of Safety ServicesTexas Mutual Insurance Company

Page 2: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

Understanding Experience Rating

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2

Page 3: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

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Experience rating and modifiers

Understanding

Page 4: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

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Experience rating and modifiers

Experience rating formula

Understanding

Page 5: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

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Experience rating and modifiers

Experience rating formula

Ways to control your experience modifier

Understanding

Page 6: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

What is the purpose?Comparative analysis:• Used to modify premium• Based on individual account experience

Creates incentive to promote health and safety:• Reduce number of losses through safety• Encourage savings through return to work

programs

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Page 7: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

What is experience rating?

It is a formula that:Evaluates your claim experience, adjusted for the amount of payroll you have in each class codeCompares your company’s claim experience to expected claim experience within your industryResults in an experience modifier

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Compares an employer’s actual losses against the expected losses within their industry

Page 8: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

Experience modifier

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An experience modifier is a factor used in premium

calculation.

It is calculated based on your claim experience

during the last 3 completed policy years.

Page 9: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

3 Years for experience rating

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2018-192014-15 2015-16 2016-17 2017-18

Used to calculate for new period

New

Used to calculate the current

Current 2013-14

Page 10: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

How is the experience rating calculated?

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The formula in simple terms:

= E-ModActual LossesExpected Losses

Page 11: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

What does this mean for you?

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A multiplier of 1.00 represents an average risk

Standard Premium

Experience Modification Factor

Modified Premium

$50,000 X 1.00 = $50,000

Page 12: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

What does this mean for you?

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A multiplier of 1.00 represents an average riskA multiplier less than 1.00 – called a credit mod

Standard Premium

Experience Modification Factor

Modified Premium

$50,000 X 1.00 = $50,000$50,000 X 0.80 = $40,000

Page 13: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

What does this mean for you?

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A multiplier of 1.00 represents an average riskA multiplier less than 1.00 – called a credit modA multiplier greater than 1.00 – called a debit mod

Experience Modification Factor

Modified Premium

$50,000 X 1.00 = $50,000$50,000 X 0.80 = $40,000$50,000 X 1.20 = $60,000

Page 14: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

Risk Information

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Page 15: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

Risk Information

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Page 16: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

Final Emod Factor

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Page 17: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

Controlling your experience rating

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Prevent accidents

and injuries

Page 18: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

Controlling your experience rating

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Contain claimcosts

Page 19: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

Prevent accidents and injuries

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• Develop and implement an Injury & Illness Prevention Program

• Train employees on safety topics• Investigate accidents & near misses

Page 20: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

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Management commitment Analysis Record-

keeping

Safety & health training

Audit/ inspection

Injury and Illness Prevention Program

Page 21: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

Accident investigation

New employee orientation

Refresher training

Remedial training

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Injury and Illness Prevention Program

Page 22: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

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Prevent accidents & injuries:Training resources

Page 23: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

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Prevent accidents & injuries:Accident investigations

• Gather facts• Analyze information

to determine root cause

• Develop corrective actions

Page 24: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

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Containing claim costs

Page 25: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

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Containing claim costs

Report claims to your carrier immediately

Page 26: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

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Containing claim costs

Report claims to your carrier immediately

Implement a return to work

program

Page 27: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

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Containing claim costs

Report claims to your carrier immediately

Implement a return to work

program

Communicate proactively with

all involved parties

Page 28: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

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Containing claim costs

Report claims to your carrier immediately

Will allow the carrier to:• Arrange for appropriate

medical treatment• Prevent payment delays• Refer claims for

investigation as needed

Page 29: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

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Containing claim costs

Implement a return to work

program

Before an injury:• Develop policies and

train employees• Assess job tasks• Prepare documents

Page 30: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

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Containing claim costs

Implement a return to work

program

After an injury:• Send documents to

the doctor• Discuss RTW

opportunities• Make RTW offer

Page 31: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

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Containing claim costs

Communicate proactively with

all involved parties

• Stay in contact with the claim adjuster

• Stay in contact with the treating physician

• Stay in contact with the injured employee

Page 32: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

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SummaryExperience modifiers are:• Based on comparative experience• A part of premium calculation• A reflection of loss experience

You can manage your experience modifier through:• Effective safety programs• Return to work options• Communication

Page 33: Experience Modifiers - tdi.texas.gov · Results in an experience modifier 7 Compares an employer’s actual losses against the expected losses within their industry. Experience modifier

Questions?


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