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IN

SIDE

Fall 2017

Pennsylvania Resort Creates a Company Culture of Family and Safety

Inside this Issue

New Silica Rule to Improve Worker Safety, Impact Bottom Line

Physical Medicine: A Major Cost Driver in Workers’ Compensation Claims

400 Quarrier StreetCharleston, WV 25301

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ON THE COVER John S. Kiesendahl, President and Chief Executive Officer of Woodloch Pines Inc.

InSide BrickStreet is produced and published for BrickStreet Insurance policyholders and agents.

Copyright© 2017 by BrickStreet Insurance. All rights reserved.


INSID

E

Fall 2017


Inside this Issue


Physical Medicine: A Major Cost Driver in Workers’ Compensation Claims

IN

SIDE

Table of Contents

Gregory A. Burton and David L. Kaufman

Welcome3

Return to Work Impacts E-Mod12

Stretches Poster16

Expansion Update14

BrickStreet Completes HM Casualty Conversion

19Woodloch Pines resort found the perfect partner for managing workers’ compensation claims in a hands-on way with BrickStreet.


FEATUREDSPOTLIGHT

20 New Silica Rule to Improve Worker Safety, Impact Bottom Line

Industry Advancing Technology

26

Physical Medicine:A Major Cost Driver in Workers’ Compensation Claims

24

Jack Grimm, Insurance Management Company

AGENT SPOTLIGHT

3

Last fall in my Inside BrickStreet welcome message, I spoke of the BrickStreet acquisition of HM Casualty and how rewarding it is to lead our company’s continued growth.

This year, I’m proud to say, has been even bigger and better. In October 2016 we announced the intent to affiliate through a joint venture with Motorists Mutual Insurance Co., and we were granted approval from all necessary regulatory agencies to do so in April. At that time, I transitioned from being BrickStreet’s CEO to Motorists Insurance Group’s Executive Chairman. My title change is only that; my dedication to BrickStreet, the unique and innovative 360° model and the superior customer service that agents and policyholders have come to expect has not wavered and never will.

I want to take this opportunity to introduce Dave Kaufman, CEO of Motorists Insurance Group, for those of you who do not yet know him. Dave is a knowledgeable and skilled insurance expert; a great resource who I am proud to now call my colleague.

Dave started his career as an actuary, and joined Motorists in 1986. For more than 30 years he has served in a number of leadership roles, becoming president and CEO in 2013. Dave serves on several industry boards, including the American Association of Insurance Services, NAMIC Property and Casualty Conference Board, TrustedChoice.com and more. He also is involved in the Columbus community as a board member of the Ronald McDonald House, Columbus Partnership and the Chamber of Commerce.

As the two of us have begun working together, so have many of our teams. Although our products and services remain specific to each company, and each company’s risk appetite remains unchanged at this time, our goal is to provide an all-lines solution. We started offering solutions like this in August, as we began marketing joint products through our co-appointed agencies in Illinois, Pennsylvania and West Virginia; just a few weeks later, we successfully bound our first cross-sold policy. I am confident this is only the beginning of our combined success. We will continue to enhance and streamline our processes for future phases and both short- and long-term solutions to benefit everyone.

This is an integration of two truly great companies, and the future has never looked so bright.

GREGORY A. BURTONExecutive Chairman

Motorists Insurance Group

DAVID L. KAUFMAN Chief Executive Officer

Motorists Insurance Group

4 www.brickstreet.comInSide BrickStreet Magazine • Fall 2017


The charming Woodloch Pines resort in the Pocono Mountains of Pennsylvania is the kind of place where the staff (that fluctuates between 500 and 1,200) plans and performs a show each year to raise money for a crisis fund to help one another in times of trouble.

Owned by the Kiesendahl family, it’s the kind of place where a handwritten thank-you note from an owner goes a lot further than any stale, packaged corporate gesture. And it’s why Woodloch Director of Risk Management Kimberly Kenthack knew BrickStreet was the only partner to resonate with the entire resort family.

“I was trying to find a carrier to understand that you can’t just come in here and talk to our management and tell them what they’re doing wrong and call it a day,” Kenthack said. “You have to be here, shoulder to shoulder, elbow to elbow, getting your hands dirty, saying let’s do this together.”

Woodloch, in business since 1958, features golf, more than 400 rental and privately owned homes, a lake for water skiing and boating, zip lines, a six-sided rock climbing wall, indoor and outdoor pools, bumper cars, go-karts, snow tubing, ice skating and nightly entertainment.

When Kenthack, a dentist by trade, arrived at Woodloch seven years ago, she was looking for something to occupy her time and her mind. The company employs countless people with hidden pedigrees and talents, even a millionaire working in the entertainment department just because he loves it. Despite her initial hesitation to accept a position in risk management, she began with workers’ compensation claim reviews.

“I was so frustrated; we were having these reviews two times a year and nothing was changing from review to review,” she said. “At that time, workers’ comp was handled through human resources, and


so I was expressing my frustration, but no one was eager to bring it over to risk management.”

As the third generation of the Kiesendahl family became more involved, a desire for fresh ideas became apparent. Kenthack said she was confident she could make a change, but things moved slowly. When workers’ compensation switched hands from the HR department to risk management in February 2015, her first big change was to find a new carrier— one that would become part of the family.

“A lot of carriers will focus on just your management level; they’re not going to come in and focus on the employee level. I wanted somebody that was going to pay attention to everybody across the board,” Kenthack said. She knew her teams better than any carrier or adjuster could, so she was looking for a carrier to empower her to allow those relationships to fix things.

By the time she spoke with Safety & Loss Control Consultant Brian Crebs from BrickStreet, she had already been unimpressed by 10 other loss control consultants. But she quickly made up her mind and suggested the family go with BrickStreet.

“BrickStreet has empowered us and given us the resources to clean up our books and control the claims, and not be nonexistent or not involved in the process. They really are true team players.”

The fun, creative approach Woodloch took to connect with employees—from a monthly safety poster contest with staged and hilarious staff photos, to giant, silly sunglasses for catching staff in the act of working safely—fit directly in line with BrickStreet’s philosophy for behavior-based safety and positive reinforcement of safety behaviors.

“We don’t just do trainings and have people show up; we hand the landscaper a cold Gatorade and say, ‘Thank you for wearing your ear protection; now what about your eye protection?’” Kenthack explained. “We grab the other end of the picnic table and we talk about the proper way to lift and move things.”

Crebs said an accident investigation and claims reporting program, including benchmarks for timely reporting and thoroughness, was implemented in 2015, along with extended training for upper management and supervisors to explain fully the workers’ compensation system—from roles and responsibilities to the advantages of light duty.At the end of the 2015 policy year, BrickStreet Account Manager Terina Grossnickle reported Woodloch had gone from experiencing just shy of $800,000 in losses annually (resulting from 300 or so claims with nearly 1,000 Temporary Total Disability days on average) down to $300,000 in losses (across 101 claims and 519 Temporary Total Disability days).

“A lot of carriers will focus on just your

management level; [BrickStreet] paid

attention to everybody across the board.”

- Kimberly Kenthack


“Within the first year Brian and I were able to cut our losses over $400,000, and all of a sudden it started looking believable,” she said.

Kenthack said when the employees know the team cares about each person, it’s important for all of them to return to work after an injury.

“Not only are we paying attention, but we’re calling. We care about you and we want you back; so now they’re eager to get back to work,” she said. “We can do anything as far as light duty restrictions.”

In 2016, Kenthack received even more resources, including Woodloch Health and Safety Coordinator, T.J. Walsh. Kenthack describes him as the heart and soul of Woodloch’s safety culture, crafting it into something that goes beyond her wildest dreams.

“He’s a natural, and he deals with all the concerned parties with a level of tact and true concern that is contagious,” Crebs said.

Walsh, who was first hired at Woodloch as an Emergency Medical Technician (EMT) in 2011, began monitoring employees and facilitating the information flow with physicians and claims analysts in his new position. He began to follow

up on corrective actions from investigations into accidents, injuries and hazardous conditions. As an EMT, he often was the first point of entry into the workers’ compensation system at Woodloch, and he was motivated to make it better.

“The biggest highlight for me, not even two years into this now, is the rapport we’ve been able to create, from the supervisor level down to team members,” Walsh said. “The fact that I can walk around the property and it’s not, ‘Oh, darn, here comes the safety guy,’ but people are starting to show off where they’re trying to improve.”

While Crebs says Walsh breathes life into safety at Woodloch, Walsh says Crebs helps to connect to employees on every level. “The way BrickStreet fits into our program and into what we’re trying to do—really and truly, every aspect of BrickStreet and every person we interact with at BrickStreet is in line with what we want to do,” Walsh said.

Walsh highlighted the timely communication employees now get from BrickStreet, which cuts down on the potential for frustration. And he said the claims adjusters move so quickly, any potential problems are usually solved before they have a chance to develop.


“The whole degree of service fits into our being a family resort and running this program with compassion,” Walsh said. “It’s helped us to reach our goals.” Weaving a culture of safety throughout such a sprawling and varied business isn’t easy, with departments ranging from entertainment and activities to housekeeping and kitchens to maintenance. But Walsh said management buy-in and listening have gone a long way.

“I think the biggest surprise has been that people want to get involved with this if you give them the opportunity to,” he said. “If you make employees stakeholders in their success, they have a vested interest, and Brian recognized the need to make it employee-driven.”

Walsh spends time walking the grounds and interacting with every single staff member he sees.

“When we do our haunted hayrides, that’s a big production. I might drive around with candy bars for all the actors and remind them to be safe tonight or thank them for building everything safely,” he said.

A broker change in 2016 brought another fresh set of eyes to the Woodloch team in the form of the Seltzer Group and East Coast Risk Management, but the Woodloch family requested BrickStreet and the service team remain in place.

Both Frank Dumbleton, broker with the Seltzer Group, and Stacey Cheese, East Coast director of claims for Seltzer and vice president of risk solutions, agreed the positive changes at Woodloch have been the result of a true team effort.

Cheese said while Crebs and Walsh worked on the culture shift at Woodloch, she helped to close old claims while outlining processes and procedures that could help going forward. The 40 or 50 open claims Woodloch had when the new broker came on board was unusually large, but the number was whittled down quickly.

“Every person we interact with at BrickStreet is

in line with what we want to do.”

- T.J. Walsh

8 www.brickstreet.comInSide BrickStreet Magazine • Fall 20178 www.brickstreet.comInSide BrickStreet Magazine • Fall 2017


“Employees talk to other employees about the status of their claims so we started to shine in changing the culture in the event of workplace injuries as to how employees are going to be treated,” she said.

As Dumbleton put it, they stepped into a situation where lingering issues were hanging over the resort. “Frankly, now they’re in the position where they can attack the new stuff and they don’t have to spend much time on anything hanging out there,” he said. Cheese said many of the situations were not the result of anyone abusing the workers’ compensation system, but rather employees who were never educated on the system.

“You have to keep that momentum going, though,” Cheese said. “And that is exactly what Woodloch is doing, with constant training and education.

“Everybody is staying proactive, and that’s why you’re not seeing a lot of the lingering old claims. We are working together for the good of all, and it’s showing in those results. It’s truly a team effort.”

Dumbleton said Woodloch is on a deductible program, so it pays the first large piece of any claim, which gives the company a significant financial motivation to limit those claims. However, he’s seen Woodloch operate from a moral motivation to do what’s right. “They just want to take care of their staff, but not at the expense of taking advantage of them,” he said.

Both Dumbleton and Cheese agreed the relationships have led to better all-around service.

“Our involvement in this account has built respect, relationships and a comfort level,” Dumbleton said. Cheese added that they work in unison, which generates better results.

“This client understands and feels they have a real opportunity to control their risk and the claim,” Dumbleton said. “They get it, that they have a say in this, and they’re willing to spend the time to control that. Not all customers believe that, and so this client has a greater opportunity to succeed because they do believe it and they’re willing to spend the time on it.”

At the end of the 2016 policy year, Woodloch had just $30,000 in losses, 66 total claims and 60 Temporary Total Disability days, with no open claims for the 2016 policy year and just two open claims remaining from 2015.

So far in 2017, Walsh and Crebs have elevated their conversations and plans to add different angles and different voices to the company’s safety training, from a revamped orientation and employee onboarding process to even more on-the-ground safety. Lunch and learn programs, walk-up mini training sessions and safety refreshers have been the latest additions, but Walsh continues to rely on the classic methods, too.

“I walk around, find people while they’re working and ask what they’re up to, and that’s where we get a lot of ideas,” Walsh said. “It’s the concept that employees will solve problems for us if we just talk to them.”

They’re not above a little culinary bribery, either. Walsh recently suggested a hot dog cookout for the maintenance team after a stretch with no injuries.

“It does two things,” Kenthack explained. “If I can have one housekeeper drive by and see an employee eating a hot dog, every housekeeper will know within half an hour and they’ll all want to know why they didn’t get a hot dog.”

“The whole degree of service fits into our being a family resort and running this program with compassion. It’s helped us to reach our goals.”

- T.J. Walsh

“This client understands and feels they have

a real opportunity to control their risk and

the claim.”

- Frank Dumbleton


Walsh said the key to Woodloch’s success has been the tremendous amount of support the owners have provided. “Any crazy idea or request for training—we all look at it as a marathon instead of a sprint, and they’ve been behind us 100 percent,” Walsh said. “It’s easy to pay lip service to a problem, but they took it personally and did something about it, and they did it in a real way.”

BrickStreet would like to thank Woodloch Pines resort for the use of photography.

“I can’t think of a better word than empowered; BrickStreet

has empowered us.”- Kimberly Kenthack

Kenthack said the company culture has always been one of family, but now it’s family and safety, so it’s safe to say BrickStreet is officially part of the family. She adds that the BrickStreet partnership runs so deep, Crebs not only knows all the housekeepers’ names, he even knows their children’s names and nicknames.

“I can’t think of a better word than empowered,” she said. “BrickStreet has empowered us.”


Continuing BrickStreet’s commitment to technology, we upgraded StreetConnect this July with a new interface and enhanced features.

StreetConnect, BrickStreet’s online policy management portal, offers a variety of self-service tools such as training documents and video tutorials, claims reporting and more for policyholders. In addition, StreetConnect allows agents to submit new business, process renewal business, and view policy and claims information and agency reports.

The online portal now boasts an improved appearance, along with more user-friendly accessibilities. User feedback and available technology upgrades made this the ideal time to update StreetConnect. After its launch, BrickStreet held training sessions to teach StreetConnect users about the array of new features and how to use them properly.

The way technology is consumed in today’s society is more fast-paced and efficient than it has ever been. StreetConnect is staying on course with tech trends by now being mobile friendly to all its users and accessible on Mac computers, cell phones and tablets.

StreetConnect Advancements

Notable improvements were made to the Alerts feature during the update. The new types of alerts are all now readily available to agents and include audit, endorsement request processed, payment posted and payment reminder. Adjustments and customizations also can be made within the Alerts feature. They can be tailored to an agent’s entire book of business or down to the risk location level. New Quick Quote functionality is available for evaluation purposes for agents as well.

Also, claim numbers are now immediately available and we’ve added a feature allowing exportable PDFs to make information sharing much more convenient.

The new Occupational Safety and Health Administration (OSHA) Recordable feature presents insureds a screen to complete the necessary fields for the OSHA 300, 300A and 301 reports. Under the Policy Documents tab, the application allows users to print items to be sent to OSHA. Finally, new reports are now available for both insureds and agents.

For more information or to access the training videos, contact your BrickStreet representative or log in to StreetConnect.

The way technology is consumed in today’s society is more fast-paced and efficient than it has ever been.


Did you know that employers without a return-to-work program, or employers who offer limited (or no) modified or alternate work, may pay more for workers’ compensation insurance?

Even with the safest, most reliable workplace safety program, accidents still happen. On-the-job accidents not only can be expensive, but can cause companies to increase operating expenses to pay for higher workers’ compensation insurance premiums. How can you prevent this from happening in your workplace? You can prevent or lower indemnity and manage your experience modification factor (e-mod) by implementing and maintaining a return-to-work program for your employees.

What is indemnity?

In the insurance world, indemnity serves to restore the insured to the same financial condition as before a loss. In workers’ compensation, indemnity entails the payments being made to an injured employee whose injury or illness occurred while working.

The payment of lost wages, or indemnity, along with medical bills is what creates workers’ compensation costs. For most employers, indemnity equates to approximately 50 to 60 percent of this cost.

Getting your employees back to work as soon as they’re medically able helps reduce the overall cost of claims and ultimately helps improve your company’s e-mod.

What is an e-mod?

A company’s e-mod describes the credit or debit that is applied to the workers’ compensation premium. Therefore, the lower your e-mod, the lower your premium.

Ruth Ann Gilpin, senior technical coordinator at BrickStreet, said experience ratings provide a tremendous financial incentive for employers. “Your e-mod is a reflection of losses,” she said. An experience rating provides a financial incentive for employers to reduce losses and encourages employers to return employees to work as soon as possible. The e-mod transformation doesn’t happen overnight; but over time, if an employer consistently reports claims timely and implements return to work, they have been able to lower their e-mod to 1.0 or less.

“If your company takes a hands-off approach and is not proactive in return to work, costs can continue to escalate and impact your company’s overall profitability,” adds Gilpin. “Controlling the claims costs ultimately reduces premium costs.”

Return to Work Impacts E-Mod

“Controlling the claims costs ultimately reduces premium costs.”- Ruth Ann Gilpin


A company is granted an e-mod based on its workers’ compensation claims experience by industry and size. The National Council on Compensation Insurance calculates e-mods using payroll, number of hours worked and accidents, utilizing statistics from the past three full policy years. The industry average e-mod is 1.0, and the goal is to be at or below this average.

What is the correlation between indemnity and your e-mod?

The longer indemnity continues to be paid, the potential increases that your e-mod will escalate, resulting in higher premiums and associated costs.

Gilpin adds, “Modification factors that are greater than 1.0 indicate the past losses were worse than expected, and surcharges may be added to premiums because of this.”

The most effective and controllable way to have a favorable impact on these costs is to implement a return-to-work program. Studies show employees who stay off work with a job-related injury for more than twelve weeks have less than a 50 percent chance of ever returning. If lost time reaches a year, the chance of successfully returning to work drops to 10 percent.

One benefit of a return-to-work program is it allows workers who are unable to perform their usual job duties because of an injury or illness to return to work in a temporary, or light duty, capacity while they recover.

Employees could return to their current positions with modifications or be placed in alternate positions until they are medically able to fulfill their original job duties. Not allowing, or not having a position for, an injured employee to return to work will result in higher claims costs and potentially a higher e-mod.

As an employer, managing these costs by keeping injured employees involved and working while they heal will help decrease your e-mod and dollars lost, and reduce both direct and indirect costs associated with lost wages and injuries. In addition, when a company provides a return-to-work program, productivity, turnover rates and morale can be positively affected.

So, lower your cost of risk and protect your company’s e-mod by promoting a positive work environment and staying proactive with a return-to-work program.

When a company provides a return-to-work program, productivity, turnover rates and morale can be positively affected.


Expansion at BrickStreet means stretching across new territories while staying firmly rooted where it all began.

Because things began in West Virginia, working with border states is both frequent and familiar —five states surround it at every angle, including Pennsylvania. In response to feedback from our agency partners, particularly those agents in Pennsylvania, BrickStreet has become licensed in New Jersey and is now quoting submissions with New Jersey exposure without the need to leverage our Argonaut partnership. This will ensure our current and future policyholders with New Jersey exposures will be able to experience seamlessly the BrickStreet 360° service that no other company can match—giving policyholders direct access to what they need and helping to make workplaces and employees safer every day.

The decision to become equipped to write New Jersey exposures works in concert with BrickStreet’s acquisition of Highmark’s workers’ compensation book in 2016. The company is now quoting for New Jersey exposures with effective dates of Jan. 1, 2018, and thereafter.

“BrickStreet is a stable, profitable, competitive company fully equipped to expand while maintaining the business activities already in our footprint,” said Greg Burton, now executive chairman of Motorists Insurance Group.

Iowa and Georgia, nestled among states where BrickStreet had already been actively writing, also were added to the BrickStreet footprint in 2017.

EXPANSION UPDATE:New Jersey Joining BrickStreet’s Widening Footprint

The company has continued to spread its roots in the south and across the Mississippi River, to build the regions serviced by the Charlotte, North Carolina, and Naperville, Illinois, offices. This year’s expansions are just the latest in BrickStreet’s steady and methodical growth, which started in 2009 with service in Kentucky. But to ensure the value of the franchise, BrickStreet partners only with a limited number of agencies for the states in which it writes business. This guarantees the ability to maintain one-on-one relationships that provide the best client service and support.

Because of the affiliation with Motorists Insurance Group, Michigan and Wisconsin are the next states where BrickStreet intends to have a presence, once approved. The current success Motorists has seen in the two states has generated a great deal of optimism for BrickStreet’s potential. The affiliation has created a new, super-regional carrier now ranked among the top 20 mutual companies in the United States, which includes more than 1,450 employees, 10 offices writing in 29 states, premiums of nearly $1.2 billion, a surplus of nearly $1.55 billion and assets of $4.5 billion.

“We are always proud to add new areas to our service map,” Burton said. “Thanks to the forward-thinking vision of those who helped shape BrickStreet more than 10 years ago, we’re enjoying watching this company grow—with the ultimate goal of improving and ensuring workplace safety across the United States.”


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Conversion is complete for HM Casualty, which BrickStreet Insurance acquired from Highmark in 2016. And that means BrickStreet is now a major player in the Pennsylvania market.

“We’re using all BrickStreet systems at this point,” said T. Kirk Aguirre, BrickStreet vice president. “Active information has been converted.”

Policy migration is complete, meaning billings and commissions are now being processed from BrickStreet systems. In addition, archival and current data have been converted to BrickStreet’s StreetConnect portal.

With the acquisition, BrickStreet continues to grow as a leading provider of workers’ compensation insurance in the region.

“BrickStreet can offer former HM customers the ability to write different classifications of business,” Aguirre said. “Our product offerings are unique in that market, and our account manager approach is a good model for customers in that area.”

The move placed BrickStreet as the Keystone State’s third largest workers’ compensation carrier. It’s been a perfect fit, both regionally and culturally. BrickStreet has a growing presence on the East Coast, and HM had been emphasizing outcomes for years.

“The acquisition has allowed us to expand our footprint in Pennsylvania,” Aguirre said. “It moved us from a smaller player to a top-five player in the state.”

HM Casualty now operates as a wholly owned subsidiary of BrickStreet, meaning it is similarly situated in BrickStreet’s corporate structure to NorthStone Insurance, SummitPoint Insurance and PinnaclePoint Insurance. In 2018, the subsidiary will become AlleghenyPoint Insurance.

After assuming existing contracts with HM’s agent base, BrickStreet secured updated contracts where needed. “We want to solidify our position in Pennsylvania, maintain the market share and grow,” Aguirre said.

The Northeast Team operates out of One PPG Place in downtown Pittsburgh. The office, which opened in February, is a modern, open-concept design with a beautiful view in the heart of one of the country’s most vibrant cities. For more information about the Pittsburgh office, or about opportunities with BrickStreet in Pennsylvania, contact your local agent or BrickStreet representative.

BrickStreet Completes HM Casualty Conversion

“[The acquisition has] moved us from a smaller player to a top-five player in the state.”- Kirk Aguirre


The Occupational Safety and Health Administration (OSHA) has begun requiring measures to prevent workers from breathing in “respirable crystalline silica,” and employers should understand the impacts.

Silica is found in many materials including glass, marble countertops, paving, concrete and automotive bonding adhesive. Working with these materials can cause silica particles to be released into the air, at which point they can be inhaled.

Workers who inhale very small crystalline silica particles are at increased risk of developing serious —and often deadly—silica-related diseases. These tiny particles—known as “respirable” particles —can penetrate deep into workers’ lungs and cause silicosis, an incurable and sometimes fatal lung disease.

“The controls are good because they’re designed to limit exposure to silica,” said Thomas Withrow, safety and loss control technical coordinator with BrickStreet. “But employers should understand the financial ramifications and the time needed to ensure employees are protected.”

OSHA’s rule is designed to curb lung cancer, silicosis, chronic obstructive pulmonary disease and kidney

disease in America's workers. The rule consists of two standards: one for construction and one for general industry and maritime. OSHA estimates the rule, once its effects are fully realized, will save more than 600 lives and prevent more than 900 new cases of silicosis each year. The final rule is projected to provide net benefits of about $7.7 billion annually to employers.

“Silica is found in so many materials, and that’s why these regulations affect so many industries,” Withrow said.

According to OSHA, about 2.3 million workers are exposed to respirable crystalline silica in workplaces, including two million construction workers who drill, cut, crush or grind silica-containing materials such as concrete and stone, and 300,000 workers in general industry operations such as brick manufacturing, foundries and hydraulic fracturing, also known as fracking.

Many employers have been protecting workers from harmful exposure to respirable silica for years, using widely available equipment that controls dust with water or a vacuum system. However, Withrow said, they still should be well-acquainted with the new rule.


“Silica is found in so many materials, and that’s why these regulations affect so many industries.” - Thomas Withrow



Key provisions include: • Reducing the permissible exposure limit

(PEL) for respirable crystalline silica to 50 micrograms per cubic meter of air, averaged over an 8-hour shift (from 250 micrograms per cubic meter).

• Requiring employers to use engineering controls (such as water or ventilation) to limit worker exposure to the PEL, providing respirators when engineering controls cannot adequately limit exposure, limiting worker access to high exposure areas, developing a written exposure-control plan, offering medical exams to highly exposed workers, and training workers on silica risks and how to limit exposures.

• Providing medical exams to monitor highly exposed workers and give them information about their lung health.

• Providing flexibility to help employers— especially small businesses—protect workers from silica exposure.

Standards in the final rule took effect last year, and the compliance deadline for construction was Sept. 23, 2017. The compliance schedule also includes general industry and maritime, and fracking on June 23, 2018. For fracking specifically, engineering controls require compliance by June 23, 2021.

The U.S. Department of Labor (DOL) first highlighted the hazards of respirable crystalline silica in the 1930s after a wave of worker deaths. The DOL set standards to limit worker exposure in 1971, when OSHA was created. However, the standards gradually became outdated, as workers were exposed to silica in new industries such as stone countertop fabrication and fracking.

A full review of scientific evidence, industry consensus standards and extensive stakeholder input provided the basis for the final rule, which was proposed in 2013.

Changes are substantial and include enhanced employer flexibility in choosing how to reduce levels of silica while maintaining or improving worker protection.

“It’s going to mean extra precautions and extra time,” Withrow said. “The changes are all aimed at reducing illness and disease. They’re added measures to make sure employees are safe.”

For most activities, employers will have to ensure that silica dust is wetted down or vacuumed to prevent workers from breathing it in.

Employers are required to limit access to high exposure areas, provide training and provide respiratory protection when controls are not enough to limit exposure. For example, they might retrofit Plexiglas on tractors to enclose employees or provide respiratory equipment – as well as ensure workers are physically fit enough to breathe through that equipment. Employers also must provide written exposure-control plans and measure exposures in some cases.

In addition, employers are required to offer medical examinations to highly exposed workers. Workers who find they have an illness, such as lung disease, can use that information to make employment or lifestyle decisions to protect their health.

BrickStreet offers resources that help explain the new rule and how businesses can comply, including the SafetySource online course program and safety videos streaming at www.brickstreet.com. Also, BrickStreet’s safety and loss control consultants are available to answer questions and provide detailed explanations.

Additional information on OSHA’s silica rule can be found at www.osha.gov/silica.

“They’re added measures to make sure employees are safe.” - Thomas Withrow

“The controls are good because they’re designed to limit exposure to silica.”- Thomas Withrow


Working in the insurance industry wasn’t a career goal for Jack Grimm, senior client adviser with Insurance Management Company (IMC) in Erie, Pennsylvania. But when he discovered a career path that would blend communication, analytics and negotiating, he knew he’d found his niche.

As a young man about to graduate from Penn State University, Grimm kept his career options open, looking for something to keep his days varied while applying all his skill strengths. “My mother was an agent, so I had a little insurance in the blood,” he said.

Grimm’s job search led him to a position as an underwriter in 1988 for a national insurance company. He said he learned the product and how to make it work, but he quickly realized he wanted to refine and hone his skills even further.

“I wanted to do something a little different and be on the firing line, engaging with the client and problem solving with the client at a variety of levels,” he said.

Grimm started working with IMC in 1993, and the learning hasn’t stopped. “We’re always learning,” he said. “To be successful, you have to be a student of the business. There is a constant requirement to anticipate as opposed to react to client needs, and to be aware of emerging trends. That applies to workers’ compensation, liability, property— you have to be aware and constantly studying.”

IMC has been in business for 84 years. IMC is known for its team-based approach to working with clients through collaborative meetings to identify exposures, vulnerabilities and solutions— which may be why the company has found such a successful partnership with BrickStreet and its 360° model.

IMC had worked with HM Insurance Group, a Highmark company, for several years before BrickStreet acquired the workers’ compensation

business in 2016. Grimm said the transition from HM Insurance Group to BrickStreet was seamless.

“Partnering with a company like BrickStreet that has risk-control resources helps our clients achieve the goal of keeping employees safe,” Grimm said. “BrickStreet doesn’t look at agents and brokers as a necessary evil; I feel like they look at us as partners striving to achieve a common goal.”

The IMC team works only with commercial, industrial and institutional clients, so the business is focused on larger commercial accounts. “Because of that, I have to be a student of general liability, property, directors and officers, the whole gamut of liability and property coverage as well as workers’ compensation,” Grimm said. “The job requires you to be on your game all the time.”

Grimm said his clients also tend to be buyers who understand workers’ compensation losses are not just the cost of doing business, but that a safe workplace helps to improve the quality of what’s being produced as well as production, so it all works together.

Not unlike his own workplace’s priority, Grimm described BrickStreet as client-focused. “I think they deliver on the promise of meeting and exceeding client expectations,” he said. “I believe they’re compassionate in managing claims but aggressive when they need to be.” Grimm said all the information BrickStreet provides to clients in terms of trends and loss-run reports is excellent.

“The underwriting is responsive, creative and thoughtful, and the claims folks are personable,” he said. “At its core, everything is a relationship business, and BrickStreet does a very good job of fostering relationships. I feel very comfortable recommending BrickStreet to my clients because I know they’re going to get the job done.”

AGENT SPOTLIGHTJack Grimm, Insurance Management Company


Grimm has been in the business long enough to point out that not every claim is going to have a positive resolution, but he said the key is to avoid surprises.

“I think it goes back to the service model of communication,” he said. “I think BrickStreet has helped us do an excellent job of avoiding surprises. You need good communications protocol between the claims adjuster and the client—everybody is on the same page; you may not like the answer, but it’s not a surprise.”

Grimm says the philosophy that served him well in the early days of his career and helped him to advance is the same practice he still follows. “What I’m doing today in terms of education is the same as what I did in 1993. You just have to be able to learn, read, think, critically analyze and communicate,” he said.

He describes the benefits of a relationship with BrickStreet similarly. “It’s about being nimble, responsive and engaged with the client,” he said. “If you’re not adding value, you become a commodity, and we strive as an agency to add value; that’s what BrickStreet does as well. If it’s just about price, you live by the sword and die by the sword.”

Grimm counts his happy marriage and three children among his career highlights, but he also earned the designation of Associate in Risk Management in 2010 and has presented at the University Risk and Insurance Management Association national conference.

To reach IMC and Grimm, call 814.452.3200 or visit www.imcerie.com.

“BrickStreet doesn’t look at agents and brokers as a necessary evil; I feel like they look at us as partners striving to achieve a common goal.”- Jack Grimm

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Physical medicine plays a large role in workers’ compensation claims due to the nature of the injuries that are typically covered. Sprains and strains, as well as soft-tissue injuries, are common in the workplace; many times physical therapy is the best way to quickly and effectively treat these types of injuries. Physical therapy also plays a major role in recovery following surgical procedures to assist injured workers in getting back to their best functional performance levels. It serves as a way to condition patients to help reach pre-injury physical demand levels. Therapists are instrumental in objectively evaluating physical capabilities, which assists treating physicians by providing reliable information that allows a confident release to return to work.

Because of the importance of physical medicine in workers’ compensation claims, insurance carriers must diligently monitor the focus. Too often, physicians may prescribe more physical therapy even though there is little evidence the previous treatment was beneficial to the patient. The treating physician may not know what else to do for the claimant, the claimant may be reluctant to attempt a return to work and requests more therapy, or the treating provider may leave the decision up to the therapist, so another round of therapy is ordered. This wastes time and money on a treatment modality that does little to get the injured worker

PHYSICAL MEDICINE:A Major Cost Driver in Workers’ Compensation Claims

back to pre-injury physical capabilities. Over-utilization can sometimes occur at the treatment facility, particularly if state rules do not restrict the number of modalities a provider can bill for in a day.

Insurance carriers must be mindful of treatment modalities that have not been deemed appropriate by Official Disability Guidelines (ODG), such as dry needling or iontophoresis. Dry needling refers to the practice of using solid needles for therapy, without an injectable liquid, used in the context of acupuncture, trigger point injections or percutaneous needle tenotomy. The injured area is repeatedly needled under ultrasonic guidance to disrupt pathological tissue and induce bleeding. Theoretically, this is supposed to turn a nonhealing chronic injury into an acute injury with potentially enhanced healing capability.

Dry needling is not recommended by ODG because this treatment is unproven, and more evidence-based, peer-reviewed research should be conducted.

Iontophoresis is commonly used by physical therapists and occupational therapists for the application of anti-inflammatory medications through the skin by repulsive electromotive force. Iontophoresis is a physical process in which ions flow diffusively in a medium driven by an applied electric field. In other words, the anti-inflammatory medication is applied to the skin, and an electric


The 360° model allows BrickStreet to readily identify over-utilization as well as the use of questionable modalities.

current is run through it. ODG does not recommend this treatment due to the limited evidence for effectiveness. Both iontophoresis and dry needling are commonly billed with a more generic billing code, which makes them much harder to identify. Careful interpretation of the actual medical documentation is crucial to identifying, and ultimately denying, these procedures for payment.

The 360° model allows BrickStreet to readily identify over-utilization as well as the use of questionable modalities. In addition to nurse case managers and adjusters, who review the therapy reports as they are submitted, our medical billing department consists of trained and certified billing and coding experts who can catch things others may not. Any questionable treatment or suspected over-utilization of therapy services can be sent to BrickStreet’s Office of Medical Management (OMM). The OMM is staffed by physicians with varying backgrounds and expertise, including an emergency room physician, a family practitioner, an occupational medicine physician and a chiropractic physician. The assigned nurse case manager or claims adjuster can request reviews.

The OMM also monitors all active physical therapy claims with state-of-the-art analytics. This assists in identifying over-utilization trends, as well as billing of questionable modalities. Whenever these issues are identified, the assigned nurse case manager and claims adjuster are notified the claim in question has fallen outside BrickStreet’s best practices.

Managing physical therapy must be a central part of any carrier’s medical cost containment strategy. Physical therapy is an important treatment modality, but, left unchecked, can get out of hand quickly. BrickStreet employs a full 360° attack on over-utilization of physical therapy and questionable treatments.


We all are connected 24/7, and the technologies we use continue to advance at a rapid pace. Within the workers’ compensation industry, organizations like the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH) are ensuring the latest equipment and applications are available to protect workers on the job.

Both NIOSH and OSHA have released new products this year to make protecting employees and reporting injuries more effective and efficient. On Aug. 1, OSHA launched a new electronic Injury Tracking Application, or ITA, which allows employers to submit required injury and illness data on OSHA Form 300A online.

To ensure information is secure, the ITA is accessible on the OSHA website and provides three options for data submission:

• Users can enter information manually into a web form;

• Users can upload a CSV file to process single and/or multiple worksites at once; or

• Employers utilizing automated recordkeeping systems can use an Application Programming Interface to transmit data electronically.

Per OSHA’s recordkeeping requirements, companies with 250 or more employees in the industries covered by OSHA’s recordkeeping regulations are required to submit occupational injury and illness information to OSHA on forms 300, 300A and 301. Organizations with 20-249 employees in certain high-risk industries also must submit information using Form 300A. With the ITA, OSHA can further streamline the data received from companies submitting Form 300A.

In June, OSHA announced a notice of proposed rulemaking to extend the Form 300A deadline from July 1, 2017, to Dec. 1, 2017, to allow employers time to become familiar with the new electronic reporting system. Covered organizations must submit their completed 2016 Form 300A by Dec. 1. Information from 2017 will be required by July 1, 2018. Beginning in 2019, and in the years following, companies will be required to submit Form 300A by March 2. More information about the ITA and reporting requirements is available at www.osha.gov.

Industry Advancing TechnologyEarlier this year, NIOSH announced the release of a new mobile application designed to help employers and employees protect against hearing loss. The free mobile app is available for iOS devices and helps measure sound levels in the workplace.

The concept for the app was developed in 2014, after research indicated most sound-measuring applications did not provide adequate functionality and accuracy to calculate occupational noise levels. NIOSH partnered with app developer EA LAB to create the Sound-Level Meter, or SLM. The NIOSH SLM measures exposure on a level similar to professional noise-gauging instruments.

The app is designed to:

• Raise awareness of the work environment;

• Help workers recognize potential hearing hazards;

• Be a research tool to help collect noise-exposure data; and

• Promote hearing health and loss prevention efforts.

While this app is not meant to replace professional sound-measuring equipment, it is a helpful supplemental tool for hearing loss prevention in the workplace. The Centers for Disease Control and Prevention (CDC) recommend employers and workers interested in assessing noise levels more accurately use a calibrated external microphone with the app.

More information about the NIOSH SLM is available on the CDC website (www.cdc.gov). NIOSH also has created a demonstration video, which is available to view on YouTube (https://youtu.be/zk07tLj_SDs).

Safety always should be the number one priority in the workplace, and the new technological developments described herein are helping to make it easier for employers to keep safety top of mind while staying current with regulations to achieve that goal. Technology is helping the workers’ compensation industry, and all industries, become better equipped to reduce injuries and create a safety-focused workplace culture.



Industry Advancing Technology

P R O V E N R E S U L T S .

50% Since instituting yearly safety training classes with BrickStreet, HospiceCare has seen a 50 percent reduction in claim frequency over the past three years.

Through our premier team structure, services and technology, we focus on keeping your employees safe by fundamentally improving your business culture — working with your team to reduce injuries and mitigate risk to positively impact your bottom line. BrickStreet is proud to not only help improve workplace safety at HospiceCare, but also serve as a partner to help them reach their full potential in the communities they serve.

www.brickstreet.com / 1.866.452.7425

“WORKING WITH BRICKSTREET... WE TRAIN OUR EMPLOYEES TO WORK SAFELY.” – Larry Robertson

Executive Director HospiceCare


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