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Workers' Comp. FAQs
Billing
How often do you bill?
For a new member, your first bill will be for two months of premium. You will then receive a monthly bill. Your Workers' Compensation premium is due by the 10th of every month.
How does my premium differ from the rest of the members?
Even though all members have the same rates, it is your individual payroll and your experience modification factor that determines your premium.
What is an experience modification factor?
An experience modification factor is a rating that recognizes the differences among individual insureds with respect to safety and loss prevention. It does this by comparing the experience of individual insureds with the average insured in the same classification. The differences are reflected by an experience rating modification, based on individual payroll and loss records for three years, which may result in an increase, decrease, or no change in premium.
Experience modifications are determined on an annual basis and are effective for a period of 12 months.
Experience modifications are determined on an annual basis and are effective for a period of 12 months.
If my payroll has changed, can I get my billing revised?
Yes. If you have a significant change in payroll, we will be happy to revise your premium. We also send out a self-audit at the end of the second quarter. By reporting your payroll for the first six months, we hope to avoid large additional premiums due or large refunds at the end of the year.
OSHA
Reporting Fatalities and Severe Injuries:
Who is required to report fatalities and severe injuries?
All employers under OSHA jurisdiction must report these incidents to OSHA, even employers who are exempt from routinely keeping OSHA records due to company size or industry.
What am I required to report under the new rule?
Employers now must call OSHA’s local office at 603-225-1629 or 24-hour hotline 800-321-6742 to report the following work-related incidents:
- Fatalities (within 8 hours)
- Inpatient hospitalizations of one or more employees (within 24 hours)
- Amputations (within 24 hours)
- Losses of an eye (within 24 hours)
BECOME A MEMBER OF THE TRUST.
Rebates
What is a rebate?
Rebates are a refund of premium based on your annual premium and loss history. Rebates are distributed on an annual basis, usually in May. Rebates may be distributed from any fund year.
Who determines the rebate?
An outside vendor does a complete actuarial analysis. The actuary determines the surplus based on a 99 percent confidence level and then makes a recommendation to the Board of Trustees. The Board of Trustees then votes on the amount of the return.
How is a rebate calculated?
The WCT uses a two-step formula to calculate individual participant rebates:
Step 1: Audited Premium - Administrative Expenses - Incurred Losses = Eligible Balance
Step 2: Eligible Balance x Return Percentage x Premium Return = Current Rebate
Using the above formula, rebates are allocated among those members with a positive balance, and members with a negative balance receive no rebate. Rebates distributed to a fund year are completed independent of all other years. So, if you have had one bad year, it doesn't mean you will not get a rebate for other fund years.
Step 1: Audited Premium - Administrative Expenses - Incurred Losses = Eligible Balance
Step 2: Eligible Balance x Return Percentage x Premium Return = Current Rebate
Using the above formula, rebates are allocated among those members with a positive balance, and members with a negative balance receive no rebate. Rebates distributed to a fund year are completed independent of all other years. So, if you have had one bad year, it doesn't mean you will not get a rebate for other fund years.
Can rebates be transferred?
No. Rebates cannot be transferred to a succeeding corporation unless the sale includes assets and liabilities or the transfer is between family members (i.e., parent to child).
If I am no longer in business, am I still eligible for a rebate?
Members must be actively engaged in an automotive-related business within 120 days of the board approval of the rebate to be eligible.
If I am no longer a member of the WCT, am I eligible for a rebate?
No. Former members are not entitled to receive any rebates approved by the Trustees pursuant to the Trust Agreement.
General
What are the employer's responsibilities when an employee is injured on the job?
Contact the Nurse Case Manager at NHADA at 800-852-3372 regarding the medical provider selection. If the injury requires emergency medical care, direct the employee to the nearest New Hampshire hospital. Complete the "Employer's First Report of Occupational Injury or Disease" (Form 8WC) no later than five (5) days after employer knowledge of any occupational injury. Complete the "Employer's Supplemental Report of Injury" (Form 13-WCA) if the employee's work-related injury or illness results in a disability of four (4) or more calendar days or when the employee returns to work. The employer shall complete and file the Wage Schedule (76WCA) to include twenty-six (26) weeks of gross wages on all claims involving disability of 14 days or longer. When an employee is released to return to work with restrictions, the employer shall provide temporary alternative duty within the restrictions outlined by the medical provider.
When does the NHADA WCT begin making indemnity payments to the injured worker?
The law allows twenty-one (21) days from the date NHADA received the "First Report of Occupational Injury or Disease" (Form 8WC) to determine whether medical and investigative evidence substantiates that the injury arose out of and in the course of employment.
Is there a waiting period before indemnity payments are paid?
There is a three-day waiting period unless the disability continues for fourteen (14) days or longer. However, if the employee returns to work, light-duty, within five (5) days of sustaining the injury, the employee shall be paid from the first date of injury.
How are indemnity benefits reimbursed to the injured employee?
The employee is reimbursed 60 percent of his/her average weekly wage [AWW = average of gross earnings (26 weeks prior to the date of injury)].
What other benefits does an employee receive?
Payment of reasonable, necessary, casualty related medical bills as long as treatment occurs within the State-mandated managed care provider network; reimbursement of mileage at the rate established by the State of NH; reimbursement of prescription medication.
If questions arise regarding a potential or existing claim, who do I call?
Call the Claims Department at NHADA at 800-852-3372.
How long does an employee have to report a work-related injury?
The employee has two years from the date of injury to report a claim.
If an employee's Workers' Compensation claim is denied, what can the employee do?
An employee whose case is denied may request a hearing in writing within eighteen (18) months of the date of denial with the New Hampshire Department of Labor, 95 Pleasant Street, Concord, NH 03301.
The NHADA WCT Loss Prevention Department provides us with safety glasses. Do you also provide hearing protection?
No. We suggest you contact NHAD Services at 800-852-3372.