Employees’ Compensation’s Pressing Reckoning with COVID-19 Presumption Legal guidelines : Threat & Insurance coverage

With the end of the COVID-19 pandemic, employee executives are wondering how the assumptions will last.

As the one-year mark of the COVID-19 pandemic has come and gone in the US, vaccine distribution continues to rise and hopes for a return to normal are growing.

Even if things return to normal, a likely permanent change in the compensation industry has begun. The coincidence of COVID-19-related suspicions in many states is of paramount importance to worker executives, many of whom fear slippery slopes.

An NCCI COVID legislation dated February 2021 report Lists 28 states with a specific bill, law, or regulation related to COVID that have an impact on employee compensation.

Many of these are presumptions that require employee compensation to cover the COVID treatment. In the second and third quarters of 2020 in particular, workers’ organizations tried to keep up.

“Compliance and regulatory updates are always of the utmost importance, but COVID has put this in the spotlight and critical of efforts that were already important,” said Matthew Zender, SVP of Employee Compensation Strategy for AmTrust.

“From our point of view, what changed the most was how fluid it was. In some cases, we received multiple updates in different states every day, trying to create a medium that would allow for adequate absorption of this fluid data and ensure that we not only absorb it, but also respond to it in a manner that is with the intent of language agreed. So it was an extremely intellectually interesting time. “

Now that activity has slowed down significantly, AmTrust is one of the companies looking to the future looking to see what impact this new guesswork will have on the industry in the years to come.

“I think whenever you create a new standard or area for compensability, it is reasonable to ask if this is a standard that is now being applied to successive outbreaks in other areas. When that door is open, will other things find their way? “Zender put up.

“I think this is one of the reasons the industry was concerned about letting these COVID suspicions get into the system. It’s not because the industry didn’t feel it could help. Most people in the industry felt that we should help to the extent that we should help. The problem is, where does that end? We have an industry where there were no such claims for a hundred years, and now we have these kinds of claims. “

Communicable Disease Reporting: The New Normal?

Indeed, the COVID-19 pandemic has set a new precedent for an industry that has not treated communicable diseases in more than a century.

Phil Walls, clinical director of myMatrixx

There are many questions about how this precedent could be used. Steven Davis, One Call’s chief legal officer, believes the guesswork could rise, but doubts it will expand to the extent that communicable diseases, more common and less effective in nature, will be part of that growth.

“Every time you have something new, like presumption laws related to the coronavirus, there are always concerns about the slippery slope,” said Davis.

“The states that passed presumption laws did so carefully. I’m not overly concerned about the addition of a barrage of guesswork. However, now that we have the precedent, the more likely we will see other guesses in the future. “

As for the kind of suspicions that could emerge after the pandemic, Davis also doubts that there will be a fight against the exclusion of typical seasonal diseases: “I don’t expect a panacea like the flu or the common cold. I think the assumptions in the future will be industry specific. “

He added that possible industry-specific guesswork would be similar to the cancer guesswork for firefighters, but could become granular, such as a certain manufacturing process tied to a specific condition.

Phil Walls, clinical director of myMatrixx, believes the potential for communicable diseases to spark additional guesswork is highly likely. “At least I think other communicable diseases can be taken as a guess for certain defined workers,” he said.

“Unlike accidental needlestick exposure where the risk of HIV infection is a direct consequence, the development of COVID or any other communicable disease can likely be related to a job or occupational role, but the contraction of the disease can rarely be direct attributed to exposure at work. Hence the need for guesswork is obvious, but application to communicable diseases can have unintended consequences. “

A wave of new editions

Regarding other permanent changes that could create suspected COVID, Walls voiced the data suggesting higher pharmacy costs are on the horizon.

“We are seeing customers begin to approach 90 and even 100% generic fill rates for the traditional drugs used for employee compensation,” he said. “Development of new drugs like molnupiravir [an oral medication in development that can block transmission of COVID] can potentially lead to even more expensive branded drugs for a period of time. “

However, medication is just the beginning.

Matthew Zender, Senior Vice President, Toilet Product Manager, AmTrust Financial Services

A Research assignment WCRIB estimates that the cost of making a conclusive COVID guess for key critical infrastructure workers in California is “$ 2.2 billion to $ 33.6 billion, with an approximate median estimate of $ 11.2 billion, or 61% of the estimated annual rate Total costs of total workers “. Compensation system from the effects of the pandemic. “

While the ongoing cost of treating COVID patients is a major industry concern as the pandemic has subsided, positive, lasting change may emerge.

Michele Tucker, Vice President of Enterprise Comp Operations at CorVel, noted that the exponential growth of guesswork in 2020 led to a better focus on how employee compensation can be an essential aid as opposed to an obstacle.

Tucker went on to explain that CorVel went through a change just before the COVID hit in January 2020 to reduce controversial perception in the claims process, and COVID became a way to test the theory.

“In general, I think there is a good opinion that COVID and employers take responsibility when there is exposure in the workplace,” she said.

“I think that would have happened of course. In our experience, the preponderance of employers was open-minded and took a sensible approach early on, even without changes to the law.”

Davis agreed with Tucker’s opinion, noting that “guesswork remains,” along with additional safety measures such as workplace distancing, hygiene and a focus on mental health that have received near constant attention during the pandemic.

“These guesses are tremendously convenient for those on the front lines, and I think there is a tremendous opportunity for those who might be more skeptical to come up with creative solutions,” he said.

As is usually the case in major industries, fundamental change will drive workers to come up with these creative solutions, and the companies that do so will see more value in health dollars and patient outcomes.

The role that COVID conjectures must play in this constant pursuit of innovation remains to be seen, but many consider it unwise to sit on our laurels after the crisis is over.

As Zender put it, “This is a defining time for the industry. Before COVID-19, there were many near misses. It’s part of nature, these things will happen again. ” &

Nina Luckman is a New Orleans-based business journalist primarily focused on the employee compensation industry. For the past several years, Nina has been the editor of the Louisiana Comp Blog, a news site she started in 2014 under the auspices of a group’s auto insurance fund. She can be reached at [email protected]