floridaupdate to the florida workers’ compensation health care provider reimbursement manual...
TRANSCRIPT
![Page 1: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/1.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved.
Florida
January 1, 2018 Workers Compensation Rate FilingActuarial Analysis
Jay Rosen, FCAS, MAAADirector and Senior Actuary
![Page 2: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/2.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved.
Current NCCI Voluntary Market Loss Cost/Rate Level Changes (%)
Excludes Law-Only Filings
-16
.3
-16
.2 -14
.0
-13
.3
-13
.0 -10
.9
-10
.7
-10
.3 -9.8
-9.4 -8
.7
-8.4 -7.9
-7.8
-7.8
-7.6 -6
.4
-6.1
-5.8 -4
.6
-4.5
-4.3 -3
.0
-1.0 -0.5
-14
.1
-13
.9 -12
.8
-12
.7
-12
.6 -11
.3
-9.3 -7
.9
-7.6 -6
.2
-3.0 -1
.7
1.1
OK NM CT OR AL NH MD IN CO TN NC IL NV WV LA UT FL IA AR AK VT MT TX KS NE AZ SC MS ID KY RI ME DC MO HI SD GA VA
Approved Pending
2
Reflects the most recent experience filing in each jurisdictionDue to the timing of the individual loss cost/rate filings, the figures shown may include changes from prior filing seasons
![Page 3: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/3.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved. 3
Component Impact
Change in Experience, Trend and Benefits –7.8%
Change in Production and General Expenses 0.0%
Change in Taxes and Assessments –0.4%
Change in the Profit and Contingency Provision –1.0%
Change in Loss-Based Expenses –0.5%
Offset for the Change in the Expense Constant +0.3%
Proposed Overall Average Rate Level Change –9.3%
FloridaJanuary 1, 2018 Rate Filing
![Page 4: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/4.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved. 4
Component Impact
Change in Experience, Trend and Benefits –7.8%
Change in Production and General Expenses 0.0%
Change in Taxes and Assessments –0.4%
Change in the Profit and Contingency Provision –1.0%
Change in Loss-Based Expenses –0.5%
Offset for the Change in the Expense Constant +0.3%
Proposed Overall Average Rate Level Change –9.3%
Experience, Trend and Benefits
![Page 5: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/5.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved.
Filing Methodology
5
Calculation Methodology
Experience Period Most recent two full policy years
Loss Development Average of the results produced by the paid and paid plus case loss aggregations
Three-year average link ratios
![Page 6: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/6.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved.
The most recent two full policy years of financial data is used as the filing’s experience period
Filing Methodology—Experience Period
Policy
Year
2014
1/1/14 1/1/15 12/31/16 1/1/191/1/181/1/16 12/31/19
Policy
Year
2018
Policy
Year
2015
Financial data valued
as of year-end 2016
Supreme Court decisions
effective April and June 2016
6
![Page 7: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/7.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved.
Filing Methodology
7
Calculation Methodology
Trend Reviewed historical changes in:- Claim frequency and severity- Loss ratios
Indemnity: Selected –3.0% per yearMedical: Selected –0.5% per year
The selected trend factors recognize the current high degree of uncertainty associated with financial data loss experience that has yet to fully emerge in the post-Castellanos environment
![Page 8: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/8.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved.
Florida Lost-Time Claim Frequency(Frequency per Million on On-Leveled, Wage-Adjusted Premium)
8
12
14
16
18
20
22
24
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Policy Year
Florida claim frequency hasfallen 19% since 2011
Based on financial data
![Page 9: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/9.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved.
Florida Average Claim Severity ($ ‘000s)
9
10
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Policy Year
The lost-time claim severity figures are in excess of wage trendBased on an average of paid and paid plus case financial data at current benefit level and developed to ultimate
Medical
Indemnity
![Page 10: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/10.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved.
Florida Indemnity and Medical Loss Ratios
0.2
0.3
0.4
0.5
0.6
0.7
0.8
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2018Projected
Policy Year
10
Medical
Indemnity
Based on an average of paid and paid plus case financial data at current benefit level and developed to ultimate
![Page 11: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/11.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved.
Florida Indemnity and Medical Loss Ratios
0.2
0.3
0.4
0.5
0.6
0.7
0.8
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2018Projected
Policy Year
11
Medical
Indemnity
Based on an average of paid and paid plus case financial data at current benefit level and developed to ultimate
![Page 12: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/12.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved.
Update to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual
Effective July 1, 2017
Component Impact
Physician –0.2%
Hospital Outpatient –0.1%
Impact on Medical Costs –0.1%
Overall Impact on WC System Costs –0.1%
12
The estimated impact is based on data provided by the Florida Division of Workers’ Compensation
![Page 13: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/13.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved. 13
Component Impact
Change in Experience, Trend and Benefits –7.8%
Change in Production and General Expenses 0.0%
Change in Taxes and Assessments –0.4%
Change in the Profit and Contingency Provision –1.0%
Change in Loss-Based Expenses –0.5%
Offset for the Change in the Expense Constant +0.3%
Proposed Overall Average Rate Level Change –9.3%
Florida Expense Provisions
![Page 14: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/14.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved. 14
Component Impact
Change in Experience, Trend and Benefits –7.8%
Change in Production and General Expenses 0.0%
Change in Taxes and Assessments –0.4%
Change in the Profit and Contingency Provision –1.0%
Change in Loss-Based Expenses –0.5%
Offset for the Change in the Expense Constant +0.3%
Proposed Overall Average Rate Level Change –9.3%
Florida Expense Provisions
![Page 15: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/15.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved.
Expense Provisions—Profit and Contingency
15
Provision Methodology
Profit andContingency(P&C)
Based on the results of NCCI’s Internal Rate of Return (IRR) model:
“Dynamic” estimate: 1.38%
Selected provision: 2.0%
“Static” estimate: 2.80%
• The selected provision reflects the merits of the two individual approaches
• It is expected that selecting a P&C provision approximately midway between the two estimates will provide year-to-year stability in this filing component
![Page 16: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/16.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved. 16
Component Impact
Change in Experience, Trend and Benefits –7.8%
Change in Production and General Expenses 0.0%
Change in Taxes and Assessments –0.4%
Change in the Profit and Contingency Provision –1.0%
Change in Loss-Based Expenses –0.5%
Offset for the Change in the Expense Constant +0.3%
Proposed Overall Average Rate Level Change –9.3%
Florida Expense Provisions
![Page 17: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/17.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved. 17
Component Current Proposed
Loss Adjustment Expense (LAE) 21.3% 20.7%
Expense Constant (EC) $200 $160
• LAE includes costs associated with the handling of WC claims
• The EC, together with the expense provision included in the manual rate, provide for insurer expenses
• The proposed reduction in the EC is intended to affect a more equitable distribution of premium and expenses across risk sizes and is being implemented in a premium-neutral fashion
Expense Provisions—LAE and Expense Constant
![Page 18: FloridaUpdate to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual Effective July 1, 2017 Component Impact Physician –0.2% Hospital Outpatient –0.1%](https://reader036.vdocument.in/reader036/viewer/2022062607/603467b6e633912c0877d847/html5/thumbnails/18.jpg)
© Copyright 2017 National Council on Compensation Insurance, Inc. All Rights Reserved. 18
Component Impact
Change in Experience, Trend and Benefits –7.8%
Change in Production and General Expenses 0.0%
Change in Taxes and Assessments –0.4%
Change in the Profit and Contingency Provision –1.0%
Change in Loss-Based Expenses –0.5%
Offset for the Change in the Expense Constant +0.3%
Proposed Overall Average Rate Level Change –9.3%
FloridaJanuary 1, 2018 Rate Filing