Montana Self Insurers' Association

October 2026 Update

MSIA Annual Meeting – Bill Zachry - Hard Stops, Guardrails & Ethics with A.I.

The MSIA Annual Meeting guest speaker, Bill Zachry, Executive Director of CompSense and former Group VP of Risk Management for Safeway/Albertsons provided us with Hard Stops, Guardrails & Ethics with A.I.: Designing Systems That Produce Safer Outcomes. If only based on the headlines, AI deployment is advancing faster than governance – and the gap between the two is where losses happen. A.I. is very likely already operating in our own systems, if not on purpose than through our employees using it personally or through our partners’ systems.

As risk managers, we know that some risks can be managed and some risks must be prevented. Hard Stops are what the system must never do; Guardrails are what remains as permitted, constrained and monitored. Ethics is whether the purpose and use is acceptable. With A.I., stopping at the ethical questions or conclusions, means governance has failed.

Zachry provided a run-down of the 12 HAL Laws – what A.I. must provide:

Protection of Human Life
No Autonomous Resolution of Forced-Choice Scenarios
Prevention of Harm
Protection of Rights and Livelihood
Integrity of Information
Accountability Cannot Be Delegated
Validation Before Deployment
Required Deferral of Authority and Validity
Protection of Human Dignity
No Operation Without Demonstrated Compliance
No Self Preservation Override
Operational Intervention Authority

When something goes wrong – and it will - while we may want to blame A.I. Systems, they do not bear consequences - - people do. So, we need to make sure we understand what the machine is doing, how it is doing it and what the results are expected to be, To maintain that control, we must audit, use outside audits, surprise audits and then confirm those results. While we may think our systems are ‘containerized’ they are only containerized as of when you last checked.

MSIA members will receive a copy of Zachry’s presentation, as well as the research paper behind it as well as access to our Meeting Minutes and financial results.

Rising Medical Solutions 13th Annual WC Benchmarking Study – Next-Gen Claims Differentiators

How High Performers Operationalize Strategy – Execution and Strategy

The annual Rising Medical Solutions Workers’ Compensation Benchmarking Study is a national research program examining the complex issues impacting claims management. Rising Medical Solutions (an MSIA member) has been behind the study since its’ inception 13 issues ago. Each year, the study highlights the differences between higher performing organizations and the run-of-the-mill organizations. Given the consistency of the study, there is a high credibility level with the study.

What makes a difference?
How do they achieve it?
What are the key take-aways to make your organization one of the higher performers?

These and other questions are answered every year.

Higher performers are defined by a claim closure ration of 101% or higher; lower performers are below 100%. Merely closing claims is not a true differentiator – they must be closed with a high level of quality, so they do not generate regulatory action, litigation, or re-openings. “Organizations are not differentiated by priorities alone. Stronger outcomes emerge when people, processes, technology and culture are aligned to execute them effectively.” It is execution as well as strategy.

Higher performing organizations are not necessarily managing less complex claim inventories – quite the opposite, according to the study. They are more likely to report higher concentrations of active indemnity claims. It’s one thing to talk a good game – or to have the right plans in place – and it is quite another to execute properly. This years’ findings emphasize that it is a good strategy combined with execution that makes a difference.

For example, A.I. is important – no questions about that. Higher performing operations invest in implementation plans that rely heavily on engaging front line staff in the design, pilot programs and create feedback loops that must be closed, before program launch. Their programs and changes are made with a level of consistency and end-user input and support. That’s where culture comes in to play. The expectation at the front line level is that their input would be pursued and valued. And, organizational leadership demonstrates their dedication to listening to what the people who do the work are telling them by removing or designing alternative solutions when work performance roadblocks are identified.

Based on the study:

They Choose Better: Higher performers rely more heavily on frontline insight and operational data to identify improvement opportunities, prioritize investments, and select high-value initiatives.
They Reduce Friction: Higher performers are more effective at identifying operational pain points and designing solutions that reduce administrative burden, simplify workflows, and improve day-to-day claims execution, contributing to stronger gains in staff efficiency.
They Drive Adoption: Higher performers actively engage frontline staff throughout implementation, using pilot programs and feedback loops to test, refine, and improve solutions before scaling them across the organization.They are also significantly more likely to foster innovation and change adoption through leadership behavior modeling.
They Build Strength: Higher performers invest more heavily in workforce development, knowledge transfer, leadership readiness, and organizational capabilities that support ongoing improvement and future performance.

A more in depth discussion of the study and the findings can be obtained through this link to the recorded Webinar held in August, 2025 Benchmarking Study Webinar. As well, you can request a copy of the full study here: Rising Medical – WC Benchmarking Study

WCRI – Mental Health Claims in Workers’ Compensation: A Multistate Analysis

Montana remains one of about a dozen states that does not provide workers’ compensation coverage for ‘mental-mental’ claims. There must be a physical component to emotional injuries for coverage in our workers’ compensation system (a physical-mental injury).

This topic will be one of the key issues MSIA works on during the upcoming legislative session. We were able to convince the Governor to veto a bill last session which would have, for the first time, permitted PTSD claims for first responders. Part of our issue was Court expansion of the limitation to first responders, unknown costs and unknown outcomes of adding more people into the system, based on experiences not necessarily related to their work – but based on childhood experience, other life-factors and an unknown treatment protocol which may never result in MMI.

One of the study authors, Sebastian Negrusa was a speaker at this year’s Governor’s Conference in West Yellowstone.

From the Executive Summary:

Despite [the interest in mental health claims], relatively little is known about the frequency of these conditions, the industries in which they occur, the care they receive, and their associated costs and disability outcomes.(emphasis added) This study addresses these gaps by providing an overview of mental health claims from 2015 to 2024. The analysis focuses on claims in which the primary occupational injury is a mental health condition, such as post-traumatic stress disorder (PTSD), adjustment disorders, other stress reactions, anxiety disorders, or depressive disorders. It does not examine claims in which a physical injury is the primary injury and a mental or behavioral health condition subsequently develops or is treated.

Our findings characterize the experience of workers in general rather than the experience in each state. The substantial state variation in claim frequency may reflect not only differences in workplace risk exposures but also state approaches in terms of reporting, compensability, and adjudication of these conditions. We recognize that state features may play a key role in shaping the claim outcomes considered in this study.

Mental health claims were infrequent, but their frequency increased in recent years. They accounted for 0.3 claims per 100 paid claims overall and 0.5 per 100 claims with more than seven days of lost time.

From 2015 to 2024, mental health claim frequencies increased by 47 percent for overall claims and 40 percent for claims with more than seven days of lost time.
Frequency varied across states. California had the highest frequency (1.1 per 100 claims). Frequency was considerably lower in all other states, but interstate variation remained considerable.
Frequency was higher among longer-tenure workers, higher-wage earners, and women.
Frequency and trends varied across industries.
“Clerical and professional” workers had the highest frequency, but little change over time.
Frequency increased substantially in health care, public safety, and transportation.
About 40 percent of mental health claims involved more than seven days of lost time.
PTSD, stress-related conditions, and anxiety were the most frequent conditions.
Medical care provided for mental health conditions included the following:
Psychological diagnostic evaluations and psychotherapy.
Drugs: Sertraline (Zoloft), trazodone (Desyrel), escitalopram (Lexapro), alprazolam (Xanax).
Mental health claims had substantial medical and indemnity costs.
Per-claim medical payments for mental health claims with more than seven days of lost time were lower than for all claims with more than seven days of lost time ($8,923 vs. $13,125 at 12 months, and $13,316 vs. $16,814 at 24 months).
Indemnity bene�it payments were higher ($14,250 vs. $9,822 at 12 months, and $21,206 vs. $16,013 at 24 months).
Temporary disability duration averaged 19 weeks at 12 months and 26 weeks at 24 months.

MSIA is a member of WCRI. For more information regarding the study and the details, please contact our office.

WCRI Free Webinar – What’s Driving Medical Payment Growth – 10/15 @ Noon MDT

WCRI is hosting a free 30 minute Webinar on 10/15 at noon (MDT), regarding their medical payment findings from their CompScope™ Medical Benchmarks, 2026 Edition which reviews the results from 27 study states (Montana is not included).

Medical costs are increasing, of course at different levels across the states, owing to individual state system processes. “Understanding the factors behind these trends is important, as many of the same forces are likely to continue shaping medical costs in the years ahead,” said Sebastian Negrusa, WCRI VP of Research. The webinar will address key questions, including:

· How did changes in prices and utilization contribute to recent changes in medical payments per claim?

· What other factors may have contributed to growth in medical payments per claim across most states?

The Webinar is free, but space is limited. Advance registration is required. Each registrant will get a copy of the presentation deck. Register here: WCRI - What’s Driving Medical Payment Growth?

Welcome New MSIA Member – Weyerhaeuser

For more than a century, Weyerhaeuser has been growing trees and making forest products that improve lives in fundamental ways. We manage our millions of acres of forests on a continuous and fully sustainable cycle. We are responsible stewards of our land for multiple uses, including recreation, conservation, economic development and different forms of renewable energy. And the wood products we make are used to build homes where families are sheltered and raised.

Our vision: Working together to be the world’s premier timber, land, and forest products company. We manage the most sustainable, versatile resource on earth: forests. Weyerhaeuser are experts at using trees to make products people need, and we do it the right way so our forests will last forever.

Weyerhaeuser makes this happen by focusing on five core values of our business: Safety: It’s first on our list for a reason. We always start with safety, no exceptions. Integrity: We do the right thing, the right way, for the right reasons. Citizenship: The communities where we live and work are important. We help them thrive. Sustainability: Since 1900, we’ve balanced the needs of today with the needs of tomorrow. Inclusion: We want a workplace where everyone feels welcome, heard, and excited to grow and develop. We’re proud of what we do and how we do it, and we invite you to learn more. Contact Lisa Wysocki Lisa.Wysocki@Weyerhaeuser.com or 206-539-4449