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MONTANA SELF INSURERS' ASSOCIATION

July 2025 UPDATE

  • MSIA Business & Annual Meeting 
  • Proxy statement
  • Governor’s Conference – Billings - Sept 3 - 5
  • 2025-26 Dues 
  • CMS Webinar on WC MSAs
  • Welcome New MSIA Member - FIGUR8

MSIA Business & Annual Meeting 

  • Proxy statement
  • Governor’s Conference – Billings – Sept 3 - 5

The MSIA Business & Annual Meeting is on Wednesday, September 3, starting at 8:15a at the Doubletree in downtown Billings and issponsored by Browning, Kaleczyc, Berry & Hoven and Definiti Comp Solutions /Definiti Rx. 

Our guest speaker this year will be Dr Claire Muselman of Drake University. The Muselman presentation is sponsored by Midland Claims Service/Industrial Injury Claims.

This meeting is for ALL members - if you cannot join us, please provide your proxy below for quorum purposes.

At the Business meeting we will go through the Annual Members Issues Survey results, our financial results, budget and we will elect Board members. Three seats on the Board are up for election, including the Chair and two at large seats. Any employer member is welcome to serve on the Board. If you are interested in one of the seats, please contact the MSIA office.

Dr. Claire Muselman returns to Montana and the Governor’s Conference as the MSIA guest speaker this year. To say that Muselman has significantly impacted the insurance industry is an understatement of her work. Muselman is an Assistant Professor of Practice in Leadership, Human Resources, and Organizational Behavior at the Zimpleman College of Business and Co-Director of the Master of Science in Leadership program at Drake University. Muselman has pioneered transformative initiatives such as the Workers' Recovery Unit, the Workers' Compensation Center of Excellence, and the Transitions, inspiring innovation and change. Muselmans’ focus on emphatic, emotionally intelligent leadership fosters well-being and growth, reflecting her commitment to educating future leaders. She is also a personal friend of MSIA.

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I, ______________________________(your name), representing _______________________________________  (MSIA Member) hereby provide my PROXY for quorum purposes only to the MSIA Board of Directors to conduct the Business Meeting scheduled for September 3, 2025. 

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MT Governors Conference – Billings – Sept 3 – 5 You won’t want to miss this year’s Conference!

This year’s Conference, with the theme of Making Work Comp Work, has a powerful line-up of speakers – 

  • Dr. Tyrone Spears with the City of Los Angeles talking about successful return to work
  • Dr. Gary Franklin, Medical Director for WA Dept of Labor & Industry – likely talking about opioids in the system and new changes at the CDC
  • Dr. Jennifer Jutte, Associate Medical Director at the WA DLI – talking about their PTSD treatment guidelines
  • Dr. Lisa Fitzpatrick with XcelABLE – talking about FCEs (an MSIA Member)
  • Amy Rolando with Minworx Health talking about medical innovation (an MSIA Member)
  • Brian Holmes talking about Listening, Influencing and Persuading
  • James Benham – talking about Insurance, Technology and Innovation
  • Bob Wilson with WorkersCompCollege.com talking about Innovation & AI (MSIA Friend)
  • Amanda Frickle – MT AFL/CIO – a leader on public policy issues in Montana

We’ll also get a perspective on the legislative session just ended in April from Nick Mazanec with MSF, a Workers’ Comp Court Case Update from Judge Lee Bruner and a PT panel discussing the new changes permitting PTs to be Treating Physicians under MT WC law from Sam Schmidt and Lorena Petite Payne of APTA-MT.

This really is a conference you don’t want to miss – starting with Muselman at the MSIA meeting!

2025-26 Dues  

Last month MSIA sent out the initial notice regarding annual dues. Some members are on a January dues cycle – if you received this UPDATE individually, you are on the January cycle and need not pay at this time. However, most of our members are on the July fiscal year cycle. Annual Dues for most members are due by July 31. 

Your Board of Directors has kept the dues levels the same – again! While the cost of EVERYTHING else has gone up, MSIA dues have not changed. We have attached a copy of the 2025-26 dues schedule and ask that you make payment as quickly as possible. Many members have already taken care of this – and if you are one of them – thank you. If you are not sure if your company has paid, or if you are not sure if you are on the January dues cycle,, please feel free to contact us at any time. 

If paying by check, please make payment to MSIA and return to our mailing address, below. We also offer credit card payment through the website, Montana Self Insurers' Association – hit the ‘Join Now’ button in the upper right corner of the page. For EFT/ACH or Venmo payments, please contact us.

MSIA increased our credibility again this year in the Capital as an honest broker and a subject matter expert on workers’ compensation in the state. As a result, we have been able to build a business coalition that works to support initiatives to improve the WC marketplace and to oppose proposals to expand coverage or provide additional benefits. As a result of MSIA efforts, for example, the Montana system continues to buck the national trend by continuing to require a physical injury to qualify for emotional disability benefits within the system. The MSIA position is there are better avenues to address these issues. Thanks to our efforts, the Governor vetoed legislation that could have significantly increased system costs. MSIA also was the lead opponent to the proposals to overturn the choice of provider and to eliminate the benefit caps in the current system. MSIA will be leading the efforts to work with others to explore ways to make our system work better. 

MSIA has done the same thing nationally as well. Our work with the Workers’ Compensation Research Institute, the National Council of Self Insurers, UWC Strategies at the federal level, and our contacts at NCCI and the California Workers’ Compensation Institute have served us well. The MSIA relationship with WorkersCompensationCollege.com lead MT to be the first state to recognize their course work as meeting the standards for state licensing. MSIA continues as a leader nationally, and a voice to turn to regarding smaller state systems. MSIA’s influence does not stop at the state’s borders.

CMS Webinar on WCMSAs

In June, the Centers for Medicare and Medicaid Services (CMS) hosted another webinar on WC Medicare Set Asides (WCMSAs). A Medicare Set-Aside is required as part of the settlement process when:

  • the injured worker is already Medicare eligible, 
  • the settlement is estimated to cost over $25,000 OR there is a reasonable expectation the injured worker is within 30 months of expected Medicare eligibility or Social Security disability rating, and 
  • the total settlement is at least $250,000. Under the Medicare as Secondary Payer law, Medicare is prohibited from paying for medical services that should be the responsibility of another party (Employers in the case of a WC injury). Benefit providers are required to protect Medicare’s interests in that situation.  

If the injured worker is represented, at least their attorney should be aware of the need to protect Medicare’s rights under the settlement. Regardless – it is incumbent on the benefit payers – to make sure those rights are protected. Improper protection can result in potentially future liabilities for employers and injured workers. Improper expenditures or improper funding of an MSA could result in Medicare denying benefits in the future. Medicare has the right to deny benefit payments where they think the funds have been spent inappropriately. However, that is the injured workers’ responsibility. 

A number of MSIA members have provided a recap of the event and more detailed information on what was covered. This was an Introduction to WCMSAs, so the messages were more basic, than would be regarding many of the technical issues on the topics.

Much of the presentation reiterated the information in the CMS WCMSA Reference Guide, but there were a few points of the presentation that stood out: 

  1. CMS issued a reminder that $0 WCMSAs will no longer be accepted effective July 17, 2025. However, the parties to the settlement are still responsible for protecting Medicare’s interest. If the parties feel a zero is appropriate, they should evaluate their claim using the criteria laid out in Section 4.2 of the WCMSA Reference Guide to confirm if an MSA is not needed. Additionally, even if no MSA is prepared in the case, the Responsible Reporting Entity (employers) will still need to report a zero dollar MSA amount for Medicare beneficiaries as part of their Section 111 reporting.
  2. Submissions of an MSA for approval by CMS remains voluntary. Once approved by CMS it provides some assurance that Medicare will not seek additional funds from the employer once those funds are depleted. 
  3. There are no statutes or regulations requiring submission of an MSA to CMS even if a case meets the workload review threshold, so failing to submit does not violate any code. However, the responsibility to protect Medicare’s interest does not go away – you remain responsible. Often, it is in your best interest to submit. 
  4. Since MSAs are not required to be submitted, non-submit MSAs may also be used to protect Medicare’s interests. The benefit payer remains responsible for reporting non-submit MSA amounts for Medicare beneficiaries through Section 111 reporting and CMS will use that information reported to coordinate benefits on a claim. 
  5. MSA funds, whether submitted or not, are required to be used appropriately (for covered future medical treatments) and an annual attestation of the MSA funds spent are required. If CMS approves the MSA, Medicare will resume payments once the set-aside funds are appropriately exhausted. If those funds are not used appropriately, Medicare may deny payment for medical expenses. This is an issue for your injured workers – who are the beneficiaries.

CMS advised they will not issue verification letters stating that a WCMSA is not necessary and that effective July 17, 2025, they will no longer accept or review WCMSA proposals with a zero-dollar ($0) allocation. 

MSAs are complex – reporting, calculating, apportionment of funds are detailed processes. There are a number of MSIA members who are experts and we cannot more highly recommend you contact them for additional information and professional expertise regarding CMS and WCMSAs.

Welcome New Member -- FIGUR8 

We’re excited to share that FIGUR8 has joined the Montana Self Insurance Association (MSIA) as a new member. Born out of a groundbreaking collaboration between MIT, Mass General Hospital Orthopedics, and the Boston Red Sox, FIGUR8 was created to bring precision, objectivity, and speed to musculoskeletal (MSK) injury evaluation and recovery. Today, our advanced movement analysis technology delivers clinically validated insights that help employers, providers, and claims professionals make faster, more informed decisions. As a member of MSIA, FIGUR8 looks forward to partnering with Montana’s self-insured community to reduce costs, accelerate return-to-work, and improve outcomes for injured workers across the state.

FIGUR8’s technology platform enables users to have a full picture view regarding joint motion and muscle function during dynamic activities, using movement as a biomarker to improve MSK health. For more information contact Scott Sexton at Scott.Sexton@figur8tech.com or 612-309-0110