Montana Self Insurers’ Association
Who We Are
We are some of Montana’s largest employers and employer groups. We are also professionals who work with those employers to provide medical and rehabilitation services, claims management expertise, and legal advice. We are your supermarkets, we are construction and mining companies, we are your hospitals and other health care providers, we are your schools and, in some instances, we are your cities, towns, or counties. Montana self-insured organizations employ over 108,000 people in Montana.
Some of us are taxpayer funded organizations striving to be better stewards of taxpayer funds. Others of us are private businesses, some Montana only companies, other large national companies employing our many of our fellow citizens. Generally, whether a private or public entity, we have found by self -funding, meaning we don’t buy insurance for our workers’ compensation…we pay all of the direct costs when one of our own is injured at work, there is an increased interest in actively embracing and applying a culture of safety. The understanding and correlation of a proactive safety culture to both direct and indirect financial benefits for the employer and the employee motivates us to try to “do better”.
When an injury occurs, because that employee is part of us, we work hard to minimize the impact to their life and their family. We are directly invested in making sure they get prompt medical treatment and in finding ways to get them back to their families and their lives. We do this ourselves, rather than delegating it to an insurance company. We have learned over the last century that we are better stewards for our employees, their families, your taxes, and our money as a result.
As required of all employers by law in Montana, we specifically guarantee statutory benefits to our workers should they get hurt on the job. We pay their benefits out of our own pockets – there is no insurance company in between our employee team members and the employers. The State of Montana analyzes and monitors our financial situation to make sure we can pay the benefits to our injured workers and provides a level of oversight to make sure we are paying claims timely, correctly and treating our employees fairly under the law. Self-insurance is a different way of handling the risk. We own our results.
Typically, in any state system, statistics support the idea that self-insurers do the best job in managing the workers compensation system. Within self-insured programs, both the number of injuries and the number of days lost due to a work-related injury are typically lower than those reported by standard insurance carriers. This contributes to a reduction in our overall workers’ compensation costs. Do not be confused – we provide the same benefit levels as any other insurance carrier as required by Montana law.
Some larger employers have found it more palatable to purchase coverage from an insurance company, rather than expending the time, effort and resources to manage their workers compensation exposures on their own. There is nothing wrong with that approach and it works well for many employers. For us our member organizations, however, the self-insured approach works better. In many ways we are competition to insurance carriers. Through the marketplace, we challenge each other to work harder to do our best within the confines of the law for people who could not go home after their shift because they got hurt at work.
Are we perfect? Not hardly, we are all human. Consider, however, when we insure ourselves, it is our employee, our production and your services to our customers that are in jeopardy. We have a direct investment in and accountability for making an accident as minimally disruptive as possible for our co-worker and their family, for our business partners and our customers.
MONTANA SELF INSURERS’ ASSOCIATION
Why We Are Here
Having that vested interest in making sure our employee receives prompt and appropriate medical treatment returns to their family and life as quickly as possible, means we have that much more of an interest in how effectively and efficiently the Montana workers’ compensation system operates. Unnecessary bureaucracy, needless waste and delays serve no one – least of all our injured employee or their family. Needles waste, fraud and abuse cost you and cost us money – and do not help our injured employee.
- We will advocate to make the system work as efficiently and fairly as possible.
- We will support systems and business partnerships to make sure benefits paid are paid timely and appropriately.
- We will support the ideas behind the Montana workers’ compensation system. The law says the system is not designed to make someone whole – it is to enable and engage people recover from their injuries and return to their lives after an accident at work.
The workers compensation system will not fix your life, and for some accidents there are lifetime issues. Permanent total disabling injuries are just that – permanent and total. Those are the most expensive claims in any workers compensation system. However, if someone is able to work, is able to have a productive life, the workers’ compensation system is not designed, and should not function to keep them away from their life, family or work. A stated objective of the system is to return the worker to work as soon as possible after the worker has suffered a work-related injury or disease.
Workers’ compensation benefits in Montana provide payment for reasonable and necessary medical treatment for injuries that occur at work and provide replacement wages, if the medical recovery requires time loss from work, up to 66 2/3% of the State Average Weekly Wage. Montana in this area is very similar to other states.
Workers’ compensation benefits are not taxed. Workers’ compensation medical benefits have no co-pay nor deductible and balance billing by your medical provider is prohibited. That means the injured worker has no out of pocket costs for their medical treatments for their accepted workplace injuries.
The more any state system moves away from those concepts – for example increasing wage loss benefits closer to actual wages, strange incentives can be created. If someone can earn almost as much while out on workers’ compensation, what incentive have we provided for them to return to work? Where those away from work are given incentives to not return to work, costs in the workers’ compensation system increase.
Some questions to ask yourself:
- Why should we continue to require full medical documentation be provided when both the injured worker and employer agree, in writing, benefits need to continue?
- Why should the employer be fully responsible when someone outside employment causes injuries to their workers? Specifically, if a drunk driver runs a light and broadsides one of our trucks, the workers’ compensation system requires the employer to provide benefits, without recompense against the drunk driver. Why is that fair?
- In this day of electronic signatures and virtual work-spaces, why do we require only live signatures for so many workers’ compensation documents?
By themselves, these are not significant issues within the system. They do however represent the kind of common-sense ideas and approach the Montana Self Insurers’ Association and our members think about.