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MONTANA SELF INSURERS' ASSOCIATION

September 2022 Update

  • MSIA Business & Annual Meeting – Sponsored by Browning, Kaleczyc, Berry & Hoven and Definiti Comp Solutions/Definiti Rx
  1. Agenda
  2. Proxy Statement
  3. Annual Member Survey
  4. Guest Speaker – Dr. Greg Vanichkachorn, Mayo Clinic – CE Credit!
  5. Special Guests – WorkersCompCollege.com
  • MSF Board Declares $30 Million Dividend
  • 5-Year Kids Chance Commitment
  • Governor’s Conference – Missoula – 9/28 – 30 - You Will Want to Attend!
  • WCRI White Paper – A Primer on Behavioral Health Care in Workers’ Compensation

MSIA Business & Annual Meeting – Sponsored by Browning, Kaleczyc, Berry & Hoven and Definiti Comp Solutions/Definiti Rx

  1. Agenda
  2. Proxy Statement
  3. Annual Member Survey
  4. Guest Speaker – Dr. Greg Vanichkachorn, Mayo Clinic – CE Credit Available
  5. Special Guests – WorkersCompCollege.com

The MSIA Business & Annual Meeting, Sponsored by Browning, Kaleczyc, Berry & Hoven and Definiti Comp Solutions/Definiti Rx, will start at 8:30a on Wednesday, September 28 at the Missoula Hilton Garden Inn. The MSIA Annual Meeting, starting at 9a, and our guest speaker, Dr. Greg Vanichkachorn of the Mayo Clinic, is on the Governor’s Conference agenda. Our Annual Meeting is the first item on the Conference agenda.

Our Business Meeting agenda, starting at 8:30a, will cover:

  • Introduction and adoption of 2021 Business & Annual Meeting Minutes
  • Financial Review
  • 2023 Budget Proposal and Adoption
  • Annual Issues Survey Review
  • Bylaw Amendment Review
  • 2020-21 Board Amendments
  • Additional Changes From the Floor?
  • Old Business/New Business
  • Tax Status
  • Conflict of Interest Statement for Board Members
  • Board/Officer Election (staggered terms – two seats are up for re-election)

MSIA members will be provided with all the necessary background material before the meeting via email.

Proxy Statement - - If you cannot attend the Business Meeting – both Associate and Employer members - please provide the attached proxy statement, for quorum purposes only, so that we can accomplish our Association business.

Annual Issues Survey - - Please provide your thoughts regarding the 2022 Annual Members Survey and get it back to us. All responses are kept strictly confidential and are the basis for our positions during the legislative session and during the rule-making process. If Associate and Employer members need another copy of the survey, just let me know.

Board Election - - The Associate Member Board seat, currently held by Mike Marsh of Midland Claims Service, and a member-at-large Board seat, currently held by Dee Walcheck of Logan Health, are up for election this year. Marsh is also the Secretary/Treasurer for the Association. Both Marsh and Walcheck have agreed to continue to serve, if nominated and elected to their current positions. Floor nominations are also permitted. Our Bylaws call for two-year terms on a staggered basis so we would avoid the potential of a wholesale change in the Board at one time. The Chair, Vice Chair and another member-at-large seats will be up for election next year.

Upon adjournment of the Business Meeting, after the Board member election, we will open the Annual Meeting, starting at 9a. The Annual Meeting is open to everyone attending the Governor’s Conference. Our featured guest speaker is Dr. Greg Vanichkachorn, Occupational & Aerospace Medicine Physician, Mayo Clinic.

Annual Meeting Guest Speaker - - Dr. Van’s presentation is Post COVID Syndrome: The Next Challenge in Occupational Medicine and Workers’ Compensation. We will learn about the historical basis for a post-viral syndrome and appreciate the diverse presentation of Long-COVID. Dr. Van will also go through the basic paradigms of treatment and discuss the unique challenges this condition poses for occupational medicine and workers compensation.

MSIA has secured one CE credit for Montana workers compensation claims examiners for attendance at the Annual Meeting. As a result, attendance will be taken to properly apply the CE credit. Please make sure to sign in and out of the meeting to get your credit.

Dr. Van is the medical director for Mayo’s first program for COVID long haulers, the Covid Activity Rehabilitation Program. Prior to his work at Mayo, he practiced in northwest Montana for nearly a decade, helping injured workers recover their function and lives. Outside of medicine, he is an avid fly fisherman, an Ironman triathlete, and a private pilot.

In addition, we will host two special guests, Mark Pew, the Rx Professor and Bob Wilson, both with WorkCompCollege.com who will briefly talk about their efforts regarding the college and their program to help train workers’ compensation professionals via an academic program.

MSF Board Declares $30 Million Dividend

  • Distribution on a Non-Loss Sensitive Basis
  • 5- Year Kids Chance Commitment

Today the MSF Board of Directors accepted and adopted a management proposal for the distribution of a $30 million dividend to all policyholders during the 2020 policy year. This follows the most recent $20 million dividend and $40 million dividend declared over the past two years.

Importantly, MSF has moved from a loss-sensitive distribution plan, where the dividend was distributed based on actual individual policyholder generated losses. In that process, some policyholders – those with a higher level of losses would not participate in the dividend participation. That process also made it very difficult for businesses to calculate the basis and the amount of the dividend. It was also difficult to explain.

In this non-loss sensitive distribution, in effect, if you were a policyholder during the time the dividend was declared for, in this case, policy year 2020, you will get a dividend and it is relatively easy to calculate what the dividend rate would be. Further – the Board adopted the management proposal that a minimum dividend of $100 be provided. The net effect is to provide a higher percentage distribution based on premium to the smallest of policyholders. Other than those smallest of policyholders, all others get about the same percentage of premium back in the form of a dividend. 

5 Year Kids Chance Commitment

The MSF Board did not take formal action based on a technical error in providing adequate notice of a public meeting issue but is expected to formally adopt a commitment to Kids Chance of Montana of up to $150,000 over the next five years. The funds will be based on matching donations generated by others to Kids Chance of Montana and will max out at $30,000 per year.

Kids Chance Board member (and MSIA Secretary/Treasurer) Michael Marsh initially suggested a different funding mechanism but neither the MSF Board Finance & Audit Committee, nor the full Board was ready to support that level of commitment. This proposal, which is expected to be formally adopted at the December 9, 2022 MSF Board meeting, provides for sustainable funding for Kids Chance as a dollar-for-dollar matching grant. This represents a significant commitment to Kids Chance and more funds available on an annual basis than MSF has ever provided before.

Kids Chance provides educational scholarships to children of those Montana workers who are severely injured or killed on the job. There are very few limitations on the level of education required for the scholarship and, importantly, it is not financially need based. Individual members of MSIA are actively involved with Kids Chance of Montana.

Governor’s Conference – Missoula - September 28 - 30

I have every expectation that this year’s Governor’s Conference will set attendance records. I think people are chomping at the bit to get out and get back to meeting with professional friends and peers, learn about the latest information and approaches in the business and just looking to get out after two years of pandemic induced on-line meetings.

If you are not sure whether you or your company would benefit from making contacts at the Governor’s Conference, I recommend this is the year you should attend. While the agendas on the past few years have been good – and this year’s agenda seems to be really good - this is a year you would not want to miss. Registration is available still open: 2022 Governor's Conference (regfox.com)

  • Workers’ Compensation Court Judge David Sandler will provide his update and case review from the last year.
  • Elaine Weiss, Policy Director for the National Academy of Social Insurance is the opening Keynote speaker and will kick off the Conference educational program with a review the National Commission Report, 50 years later.
  • Dr. John Schumpert, former MT Department of Labor medical director and President and Chief Medical Officer of Resources for Environmental and Occupational Health, will talk about Thoracic Outlet Syndrome
  • Bob Wilson, of WorkCompCollege.com, is nationally recognized is always entertaining and informative. He will talk about a better way to manage claims.
  • Mark Pew, the Rx Professor, is a passionate educator and agitator. He will talk about attracting and retaining the new generations to the business of workers’ compensation. Together, Pew and Wilson will also address the MSIA Annual Meeting (see above) and talk about the “new” work comp and how we can do our business better, rather than just continuing the same old ways.
  • We will have two roundtable discussions:
  • A Physician roundtable featuring Dr. Maggie Cook-Shimanek, Dr. J. Devin Owens, Dr. John Petrisko, Dr. John Schumpert and Dr. Hans Schwertz who will talk about Hot Topics in Workers’ Compensation.
  • A Claims Examiner roundtable featuring Kevin Bartsch of the MT School Boards Group (an MSIA member), Jaimie Kern of Intermountain Claims (an MSIA member) and Chris Simonson of MSF who will talk about their perspectives on the evolution of working claims in the Montana system.
  • I will be talking about my perspectives on the latest Workers’ Compensation Topics, Trends and What Will Happen Next (Maybe). Listeners are advised to bring a coin to flip as that has proven to be about as accurate as my predictions for the future of workers’ compensation. 
  • Amber Worman of Gallagher Bassett and Cira Koba, of Allan Koba Compliance Solutions will talk about the changes and challenges in the Medicare Secondary Payer Landscape.
  • Patrick Robinson, VP of Government Affairs will talk about the new Official Disabilities Guides platform and how it applies evidenced based medical concepts to treatment guidelines.
  • Tamara Hall is the closing Keynote speaker and will talk about conflict and how we can use it to better work together. Recently, the closing Keynote speakers have been off workers’ compensation topics, and extra-ordinarily interesting in learning more about ourselves and how we interact with each other. Given that Hall is the author of two books, “When Life Kicks – Kick Back, Survival Skills for Personal Crisis and Life’s Challenges” and Motherhood: A Noble Calling” I have no doubt she will be interesting, enlightening and will challenge us in our thinking. 

The 2022 Montana Governor’s Conference kicks off with the MSIA Annual Meeting starting at 9a on Wednesday, September 28 and runs to lunch on Friday, September 30. All sessions are at the Missoula Hilton Garden Inn.

The Annual Safety, Trail Runner, recognizing an up and comer in Montana workers’ compensation and the Trail Master, recognizing an established leader in Montana workers’ compensation awards will be presented on Thursday during the luncheon. And, there is a special event Thursday evening honoring a friend that I will make sure all MSIA members are well aware of.

Registration is available here - 2022 Governor's Conference (regfox.com)

WCRI White Paper - A Primer on Behavioral Health Care in Workers’ Compensation

We have known for some time that psychosocial issues impact workers’ compensation recovery times. Among the changes the COVID era has brought is a greater recognition within the workers’ compensation communities of the need to acknowledge and provide services beyond statutory benefits.

Some states require acceptance of mental-mental injuries and therefore the provision of behavioral health services as part of the claims process. Montana does not, and we are working to prevent it from becoming, a mental-mental coverage state. However, with the prevalence of presumptions now in workers’ compensation, and specifically the prevalence of particularly law enforcement presumptions for PTSD we have to acknowledge mental-mental coverage is becoming more common. WCRI acknowledges so when they point out that behavioral health claims that do not have a physical injury component are infrequent, but have been growing in frequency in recent years. 

In their latest white paper, reports on surveys they have done of professionals in the different fields. WCRI has quantified the intake surveys to measure the potential of behavioral health issues relevant to workers’ compensation recoveries and the issues most prevalent in behavioral health. The contention is that the behavioral health issues contribute to preventing faster recovery than the physical injury would otherwise indicate. Those issues, according to WCRI, are:

  • Poor recovery expectations
  • Fear of pain due to movement
  • Catastrophizing
  • Distress
  • Perceived injustice
  • Job dissatisfaction or
  • Lack of family or community support systems.

“Psychosocial factors and other psychological symptoms (such as anxiety or depression) are common human experiences. Not all workers with these experiences have delayed recovery; in fact, many may continue to have normal function and return to work. However, when these factors are elevated, they may interfere with the workers’ recovery.”

WCRI states that early identification of psychosocial factors is key to helping to mitigate against them affecting recovery from an injury. They cite the Washington (state) standards that call for screening for psychosocial issues at two to six weeks from lost time due to injury and the 2022 updates to the Colorado Low Back Pain guideline recommendation for screening as a routine part of care when such barriers to recovery present themselves at initial evaluations. The Colorado Treatment Guidelines are part of the basis for the Montana Treatment Guides.

Treatments vary, according to WCRI, but the most common is cognitive behavioral therapy (CBT) and specifically for those treating workers with injuries, work-focused cognitive behavioral therapy (W-CBT). W-CBT appears to be more specifically focused on dealing with pain, function and encouraging a return to work, than traditional therapy. CBT treatments generally focus on the provider listening, teaching and the use of techniques to address the issues with the patient learning and practicing skills to recognize and address the issues when they arise.

Ultimately, social determinants of health are issues workers’ compensation systems are accepting and addressing more and more. For us in Montana, recoveries from physical-mental injuries, which are covered now, can be impacted and not addressing them can lead to longer durations, more complications and higher costs. 

For more information on the WCRI White Paper – “A Primer on Behavioral Health Care in Workers’ Compensation,” contact us at the MSIA office.

Enjoy what’s left of summer and please be safe!