SELF-INSURANCE
WHO ARE WE?
WHAT DO WE DO?
WHAT HAPPENS WITH OUR RECEIVABLES?
5/7/2015
Self-Insurance
• What we will cover today
• What is Self-Insurance?
• Requirements to be self-insured
• Application process
• Documents
• Flow of funds (accounting process)
5/7/2015
Who Are We?
• Self-Insurance has 5 basic units
• Program Compliance (compliance audits)
• Penalty Adjudicators (set penalty amounts)
• Claims Adjudicators (Regulate firms & their TPAs)
• Resource for TPAs and firms managing claims, handles disputes, allowance &
wage orders, as well as re-openings.
• This section includes our pension adjudicators who determine if a pension is
appropriate. The pensions are set by State Fund Pension Benefit Specialists.
• Training (create & hold training sessions for TPAs & firms)
• Certification Services (Money related activities, new
certifications, inactivate or decertify firms)
5/7/2015
Self-Insured requirements
• WAC 296-15-021
• Business in WA for minimum 3 years prior to application
• Written accident prevention program
• Total assets worth at least $25M
• Positive earnings (current year & 2 of the last 3)
• Current liquidity of 1.3 to 1
5/7/2015
Application process
• WAC 296-15-021
• Process applications the quarter after the application is received
• Application is reviewed as well as all submitted documentation
• Surety requirement is set
5/7/2015
Documentation needed
• WAC 296-15-021
• Application
• 3 years Audited financial statements
• List of all WA locations
• Copy of accident prevention program
• Submit $250.00 application fee
5/7/2015
Flow of Funds
5/7/2015
Self-Insurance
Certification Services
• Type of Documents associated with Funds
• Required documents
• Quarterly reports
• Debit Memos (bills)
• Credit Memos (usually refunded)
• Pension payments
• Penalties
• Out of State Audit expenses
• Other miscellaneous Assessments and fees
• Surety for claims costs (Bond, Escrow, LOC)
5/7/2015
Quarterly Reports
• Sent the 15th of the month after the quarter end
• Due May 22, August 22, November 26, and Feb 22
• Firms send the reports with payment to:
• PO Box 24442, Seattle, WA 98124
• The Cashiers office receives Quarterly report with Payment
• We process the report with payment which includes:
• Auditing for errors
• Matching payments with reports
• Imputing in LINIIS which is transferred to ARC
5/7/2015
Quarterly Reports
5/7/2015
Flow of Quarterly Report
Assessments
5/7/2015
Self-Insured
Employers
Self-Insured
Employees
Self-Insured Quarterly
Accounting
• Input each firm in LINIIS/SIHR
• Screen One
5/7/2015
Self-Insured Quarterly
Accounting
• Input each firm in LINIIS/SIHR
• Screen Two
5/7/2015
Self-Insured Quarterly
Accounting
• LINIIS Transfers debt to ARC
• Analyst releases funds thru LINIIS/SIRP or ARC
• If there are debts still owed or credits we send Debit
memos or credit notices to firm
5/7/2015
Self-Insured Quarterly
Accounting
• LINIIS/SIRP SCREEN
5/7/2015
Self-Insured Quarterly
Accounting
• ARC SCREENS
• Balance screen
5/7/2015
Self-Insured Pensions
• Bonded Pensions
• Automatically input into ARC when the M4020 report is run
each quarter
• Firms have more than one bonded pension
• We list each Pension on the firm’s billing
• Most of our firms pay each pension separately
• ARC separates each pension payment due in the system but
not on the statement
5/7/2015
Self-Insured Pension “M”
report”
5/7/2015
Self-Insured ARC Statement
5/7/2015
Self-Insured ARC Balances
5/7/2015
Self-Insured Pension Billings
5/7/2015
• Pension billings sent around the 14th of the month after
quarter ends
• Pensions are automatically input into the system on
our end
• Self-Insurance sends bills to firms due to billing cycle
Self-Insured Manual Input
• ARC Screen Example
• Manual input screens
• Used for Penalties, Interest, Out of State Audits, 2nd injury pensions,
Cash funded/lump sum pensions, 3 month deposits, and pension
funds that remain undetermined.
5/7/2015
Self-Insurance Suppresses ARC
• ARC SUPPRESSION
• SCREEN
• We suppress all firms with ARC debt which do not owe other parts
of the agency
• Before the 10th of every month
• On the 12th or 13th of the month we un-suppress the firms ARC
statements
• Prevents confusion of our firms
• However, if information is input after the suppression takes place, the firm will
receive a billing statement causing frustration and confusion for them.
• Our billing cycles are different than State Fund
5/7/2015
Self-Insurance
• Payment options
• Mail a check to the PO Box
• ACH
• Wire transfer
We prefer they mail a check with the report or bill. However,
for those firms who have asked to send funds via ACH or
Wire, we request they let us know 24 hrs. in advance so we
can alert the cashiers office.
5/7/2015
Self-Insurance Lock boxes
• Payments mailed should go to the following PO
Boxes:
• Quarterly reports
• PO Box 24442, Seattle WA 98124-0442
• Debit Memos (bills)
• PO Box 84186, Seattle WA 98124-5486
• Pension payments
• PO Box 84186, Seattle WA 98124-5486
• Out of State Audit expenses
• PO Box 84186, Seattle WA 98124-5486
• Other miscellaneous Assessments and fees
• PO Box 84186, Seattle WA 98124-5486
• Penalties
• PO Box 44892, Olympia WA 98504-4892
5/7/2015
QUESTIONS
5/7/2015

Power Point

  • 1.
    SELF-INSURANCE WHO ARE WE? WHATDO WE DO? WHAT HAPPENS WITH OUR RECEIVABLES? 5/7/2015
  • 2.
    Self-Insurance • What wewill cover today • What is Self-Insurance? • Requirements to be self-insured • Application process • Documents • Flow of funds (accounting process) 5/7/2015
  • 3.
    Who Are We? •Self-Insurance has 5 basic units • Program Compliance (compliance audits) • Penalty Adjudicators (set penalty amounts) • Claims Adjudicators (Regulate firms & their TPAs) • Resource for TPAs and firms managing claims, handles disputes, allowance & wage orders, as well as re-openings. • This section includes our pension adjudicators who determine if a pension is appropriate. The pensions are set by State Fund Pension Benefit Specialists. • Training (create & hold training sessions for TPAs & firms) • Certification Services (Money related activities, new certifications, inactivate or decertify firms) 5/7/2015
  • 4.
    Self-Insured requirements • WAC296-15-021 • Business in WA for minimum 3 years prior to application • Written accident prevention program • Total assets worth at least $25M • Positive earnings (current year & 2 of the last 3) • Current liquidity of 1.3 to 1 5/7/2015
  • 5.
    Application process • WAC296-15-021 • Process applications the quarter after the application is received • Application is reviewed as well as all submitted documentation • Surety requirement is set 5/7/2015
  • 6.
    Documentation needed • WAC296-15-021 • Application • 3 years Audited financial statements • List of all WA locations • Copy of accident prevention program • Submit $250.00 application fee 5/7/2015
  • 7.
  • 8.
    Certification Services • Typeof Documents associated with Funds • Required documents • Quarterly reports • Debit Memos (bills) • Credit Memos (usually refunded) • Pension payments • Penalties • Out of State Audit expenses • Other miscellaneous Assessments and fees • Surety for claims costs (Bond, Escrow, LOC) 5/7/2015
  • 9.
    Quarterly Reports • Sentthe 15th of the month after the quarter end • Due May 22, August 22, November 26, and Feb 22 • Firms send the reports with payment to: • PO Box 24442, Seattle, WA 98124 • The Cashiers office receives Quarterly report with Payment • We process the report with payment which includes: • Auditing for errors • Matching payments with reports • Imputing in LINIIS which is transferred to ARC 5/7/2015
  • 10.
  • 11.
    Flow of QuarterlyReport Assessments 5/7/2015 Self-Insured Employers Self-Insured Employees
  • 12.
    Self-Insured Quarterly Accounting • Inputeach firm in LINIIS/SIHR • Screen One 5/7/2015
  • 13.
    Self-Insured Quarterly Accounting • Inputeach firm in LINIIS/SIHR • Screen Two 5/7/2015
  • 14.
    Self-Insured Quarterly Accounting • LINIISTransfers debt to ARC • Analyst releases funds thru LINIIS/SIRP or ARC • If there are debts still owed or credits we send Debit memos or credit notices to firm 5/7/2015
  • 15.
  • 16.
    Self-Insured Quarterly Accounting • ARCSCREENS • Balance screen 5/7/2015
  • 17.
    Self-Insured Pensions • BondedPensions • Automatically input into ARC when the M4020 report is run each quarter • Firms have more than one bonded pension • We list each Pension on the firm’s billing • Most of our firms pay each pension separately • ARC separates each pension payment due in the system but not on the statement 5/7/2015
  • 18.
  • 19.
  • 20.
  • 21.
    Self-Insured Pension Billings 5/7/2015 •Pension billings sent around the 14th of the month after quarter ends • Pensions are automatically input into the system on our end • Self-Insurance sends bills to firms due to billing cycle
  • 22.
    Self-Insured Manual Input •ARC Screen Example • Manual input screens • Used for Penalties, Interest, Out of State Audits, 2nd injury pensions, Cash funded/lump sum pensions, 3 month deposits, and pension funds that remain undetermined. 5/7/2015
  • 23.
    Self-Insurance Suppresses ARC •ARC SUPPRESSION • SCREEN • We suppress all firms with ARC debt which do not owe other parts of the agency • Before the 10th of every month • On the 12th or 13th of the month we un-suppress the firms ARC statements • Prevents confusion of our firms • However, if information is input after the suppression takes place, the firm will receive a billing statement causing frustration and confusion for them. • Our billing cycles are different than State Fund 5/7/2015
  • 24.
    Self-Insurance • Payment options •Mail a check to the PO Box • ACH • Wire transfer We prefer they mail a check with the report or bill. However, for those firms who have asked to send funds via ACH or Wire, we request they let us know 24 hrs. in advance so we can alert the cashiers office. 5/7/2015
  • 25.
    Self-Insurance Lock boxes •Payments mailed should go to the following PO Boxes: • Quarterly reports • PO Box 24442, Seattle WA 98124-0442 • Debit Memos (bills) • PO Box 84186, Seattle WA 98124-5486 • Pension payments • PO Box 84186, Seattle WA 98124-5486 • Out of State Audit expenses • PO Box 84186, Seattle WA 98124-5486 • Other miscellaneous Assessments and fees • PO Box 84186, Seattle WA 98124-5486 • Penalties • PO Box 44892, Olympia WA 98504-4892 5/7/2015
  • 26.