1 Public Safety, Finance, and
Strategic Support Committee
Workers’ Compensation
Program Annual Report
Human Resources Department
September 21, 2023
Item: d(4)
Presenters: Jennifer Schembri, Director of Human Resources/ Director of Employee Relations
Kelli Parmley, Asst. Director of Human Resources
Eric Fortes, Division Manager
2 Recommendation
Accept the annual report on the City’s efforts
to contain workers’ compensation costs and
reduce claims for the Workers’ Compensation
Program by focusing on wellness, health, and
safety through the end of Fiscal Year 2022-
2023.
3 Open Claims as of June 30, 2023
The total number of open claims has decreased by
approximately 4% since June 30, 2022, when the open
claim inventory was 2,575.
Claim Type Number of Open
Claims as of 6/30/2022
Number of Open
Claims as of 6/30/2023
Indemnity 1,458 1,363
Medical Only 81 95
Future
Medical 1,036 1,033
Total 2,575 2,491
4 Workers’ Compensation Total Claims Cost
Department
2022-2023
Budget
(Adopted)
2022-2023
Budget
(Modified)
2022-2023
Actuals
Fire $8,500,000 $10,000,000 $9,711,838
Police $8,950,000 $8,950,000 $8,621,573
PRNS $1,450,000 $1,000,000 $866,304
DOT $500,000 $500,000 $457,846
Others $1,500,000 $1,250,000 $1,059,012
Public Works (GS) $600,000 $850,000 $770,369
General Fund Totals $21,500,000 $22,550,000 $21,486,942 Special Funds Total $2,007,500 $2,065,500 $1,322,203
All Funds Total $23,507,500 $24,615,500 $22,809,145
5 General Fund - Workers’ Compensation
Settlements 2022-2023
Fire Police PRNS DOT PW Others Total
Workers’
Compensation
Settlements
$712,586 $1,237,165 $161,620 $36,112 $4,383 $276,208 $2,428,073 6 AON Actuarial Study - Projected Ultimate
Losses Changes through June 30, 2023
Claim Period Projected
Ultimate
Losses as of
6/30/2019
Projected
Ultimate
Losses as of
6/30/2023
Change Percentage
Change
FY 13/14 $22,737,000 $21,685,000 ($1,052,000) -5%
FY 14/15 $23,306,000 $23,370,000 $64,000 0%
FY 15/16 $32,335,000 $33,654,431 $1,319,431 4%
FY 16/17 $21,253,000 $23,603,000 $2,350,000 11%
FY 17/18 $27,254,000 $29,484,000 $2,230,000 8%
FY 18/19 $32,115,000 $24,155,000 ($7,960,000) -25%
FY 19/20 $36,122,000 $28,254,000 ($7,868,000) -22%
FY 20/21 $37,950,000 $35,654,000 ($2,296,000) 6%
FY 21/22 $39,870,000 $40,454,000 $584,000 2%
FY 22/23 $41,888,000 $42,431,000 $543,000 1%
Total $314,830,000 $302,744,431 ($12,085,569) -3.8%
7 Intercare Staffing as of June 30, 2023
Claim Type
Number of Open
Claims as of
6/30/2023
TPA Employee
Type
Number of
Staff
Average
Caseload
Indemnity,
Medical Only,
Future Medical
2,491 (b)
Senior Claims
Examiner 10 136.3 (a)
Future
Medical/Medical
Only Examiner
4 258 (a)
Clerical and
Support Staff 5 0
Total 19
(a) Average does not include clerical
staff
(b) Claims totals do not include Information Only claims 8 TPA Performance Measures Jul 1, 2022 – Jun 30, 2023
Cycle Time Performance
Total Possible
Categories
Audited
Total "Yes" Total "No" Total "N/A" Overall Audit Percentage Score
Prior Audit Percentage
Score through 6/30/22
Adjuster Technical Audit Performance
Summary 2,104 1,389 54 661 97.4% 97.5%
Quality Performance Total Claims
Audited Total "Yes" Total "No" Total "N/A" Overall Audit Percentage Score Prior Audit Percentage
Score through 6/30/22
Three-point contacts - Timely completion of 3
Point Contacts. (Pass/Fail) 263 235 20 8 92% 95%
Causation Analysis - Timely causation decision
within 90 days. (Pass/Fail) 263 224 8 31 97% 96%
Plans of Action - Plan of Action in claim notes
every 90 days. (Pass/Fail) 263 234 5 24 98% 93%
Benefits Payments - Timely and accurate
payment of benefits (Pass/Fail) 263 112 5 146 98% 100%
State Compliance Performance Total Claims
Audited Total "Yes" Total "No" Total "N/A"
Overall Audit Percentage
Score
Prior Audit Percentage
Score through 6/30/22
Temporary Disability payment compliance
263 138 0 125 100% 100%
Permanent Disability & Death benefits payment
compliance 263 138 0 125 100% 100%
Subsequent indemnity payment compliance
263 138 0 125 100% 100%
Agreed Medical Examiner/ Qualified Medical
examiner notices compliance 263 170 16 77 94%
96%
9 Workers’ Compensation Program - Other
• Monthly/Quarterly Claims Reviews
• Quarterly WC Liaison Meetings
• Workers’ Comp 101 Supervisor Training
• Firefighter and Police Fastlane Program
10 Safety Management System
Health and Safety Program
11 Safety, Health and Wellness Update
• Safety Officers
• Safety Scoreboard
• Citywide Safety Committee Meetings
• Ergonomics Program
• Wellness
12 Conclusion and Follow-up
• Focus on safety and injury prevention
• Workers’ Compensation expenditures for Fiscal Year
2022-2023 finished below the Adopted Budget by
$698,355
• Restructure of City Safety Officers will promote
employee engagement and culture of safety
• Continued focus on settlements to further reduce
Projected Ultimate Losses and open claim inventory
13 Discussion and Questions