Traditional role as a solvent carrier. Looks like the good people of California beat State Fund to the goal of insolvency. So, it’s no surprise to me and it’s good to see State Fund President Oki ratlined out of there.
First HCOs Deliver Managed Care in Workers’ Comp
DIR’s Division of Workers’ Compensation has certified the first two managed care plans to provide medical treatment to injured workers in California. The certification brings to fruition a key workers’ compensation reform designed to control rising medical treatment costs, which have accounted for nearly half of workers’ compensation costs.
At a ceremony in San Francisco on November 22, DIR Director Lloyd W. Aubry Jr. and DWC Administrative Director Casey Young presented certificates to FHP Life Insurance Company of Costa Mesa and The Travelers Insurance Company/CONSERVCO HCO of Manhattan Beach to provide managed care medical treatment for on-the-job injuries and illnesses.
The managed care programs are officially called health care organizations, or HCOs.
FHP is certified to provide services in Los Angeles, Orange, San Bernardino, Riverside, San Diego and Ventura counties, and has a preferred provider network of approximately 2,000 participating physicians.
The Travelers/CONSERVCO will provide services statewide through its preferred provider network of about 3,000 participating physicians.
Both FHP and The Travelers/CONSERVCO are eligible to provide services as HCOs, because they are disability insurers licensed by the Department of Insurance.
Pre-authorized, full-service health care service plans licensed by the Department of Corporations–commonly called health maintenance organizations, or HMOs–also are eligible to apply for HCO certification.
Insurance carriers and employers self-insured for workers’ compensation may contract with two or more certified HCOs to treat injured workers. Employees then will be given the opportunity to enroll in one of the plans.
State law gives employees the option of predesignating their current doctor or another provider for treatment of any on-the-job injuries or illnesses. In many cases, it is anticipated that employees will be able to enroll with the same provider for general health needs and work-related medical treatment–allowing for greater convenience and continuity of care.
Under California law, all medical costs of treating work-related injuries and illnesses are covered by workers’ compensation insurance. There are no copayments or deductibles.
State law allows the employer to choose the health care provider for the first 30 days of an employee’s medical treatment. When an HCO provides treatment, the employer will retain control for an additional 90, 180, or 365 days. The variable depends on whether the employer also offers group health insurance, and whether the employee’s personal physician is available within one of the HCOs offered.
For additional information on HCOs, please contact the Division of Workers’ Compensation’s Managed Care Program at 415-557-8160.
Making the statement that the State Fund is solvent belies the lack of a financial rating, and a voluntary withdrawal from the rating process a couple of years ago. They are bankrupt, but too big for anyone to challenge. Check out the bottom line, they need to do a whole lot more increasing of price and quit undercutting the market in general.
State Fund is about as “bankrupt” as the Social Security system. Had the 20 some odd other carriers been as scrutinized as State Fund they might still be writing insurance in California. Dianne Oki did an excellent job of steering the State Fund through a very difficult period.
I read with great interest the State Fund’s Board of Directors’ comments alluding to the “Fund’s future direction.” Gee, and just what might that be, and who might that benefit?? It would seem that the Governator has appointed the fox to guard the henhouse.
This situation cries out for some investigative reporting.
The State Fund is in better shape than almost every other carrier in California. Ms. Oki was able to accomplish this in SPITE of Garamendi’s meddling. I would suggest that Bill and Bonnie are either insurance agents or they work for one of the marginal workers compensation carriers currently in the marketplace.
I wonder what it will cost the policy holders of State Fund to pay for this nationwide recruitment that Mr. Neal will be engaged in to find a new President for State Fund. I wonder if any CEO out there would consider the job if it only paid what past Presidents of State Fund have earned. Policy holders should demand to know how much money will be spent and why this will benefit them.
Traditional role as a solvent carrier. Looks like the good people of California beat State Fund to the goal of insolvency. So, it’s no surprise to me and it’s good to see State Fund President Oki ratlined out of there.
http://www.dir.ca.gov/Bulletin/Jan_Feb_95/Jan_Feb_95.html
First HCOs Deliver Managed Care in Workers’ Comp
DIR’s Division of Workers’ Compensation has certified the first two managed care plans to provide medical treatment to injured workers in California. The certification brings to fruition a key workers’ compensation reform designed to control rising medical treatment costs, which have accounted for nearly half of workers’ compensation costs.
At a ceremony in San Francisco on November 22, DIR Director Lloyd W. Aubry Jr. and DWC Administrative Director Casey Young presented certificates to FHP Life Insurance Company of Costa Mesa and The Travelers Insurance Company/CONSERVCO HCO of Manhattan Beach to provide managed care medical treatment for on-the-job injuries and illnesses.
The managed care programs are officially called health care organizations, or HCOs.
FHP is certified to provide services in Los Angeles, Orange, San Bernardino, Riverside, San Diego and Ventura counties, and has a preferred provider network of approximately 2,000 participating physicians.
The Travelers/CONSERVCO will provide services statewide through its preferred provider network of about 3,000 participating physicians.
Both FHP and The Travelers/CONSERVCO are eligible to provide services as HCOs, because they are disability insurers licensed by the Department of Insurance.
Pre-authorized, full-service health care service plans licensed by the Department of Corporations–commonly called health maintenance organizations, or HMOs–also are eligible to apply for HCO certification.
Insurance carriers and employers self-insured for workers’ compensation may contract with two or more certified HCOs to treat injured workers. Employees then will be given the opportunity to enroll in one of the plans.
State law gives employees the option of predesignating their current doctor or another provider for treatment of any on-the-job injuries or illnesses. In many cases, it is anticipated that employees will be able to enroll with the same provider for general health needs and work-related medical treatment–allowing for greater convenience and continuity of care.
Under California law, all medical costs of treating work-related injuries and illnesses are covered by workers’ compensation insurance. There are no copayments or deductibles.
State law allows the employer to choose the health care provider for the first 30 days of an employee’s medical treatment. When an HCO provides treatment, the employer will retain control for an additional 90, 180, or 365 days. The variable depends on whether the employer also offers group health insurance, and whether the employee’s personal physician is available within one of the HCOs offered.
For additional information on HCOs, please contact the Division of Workers’ Compensation’s Managed Care Program at 415-557-8160.
Making the statement that the State Fund is solvent belies the lack of a financial rating, and a voluntary withdrawal from the rating process a couple of years ago. They are bankrupt, but too big for anyone to challenge. Check out the bottom line, they need to do a whole lot more increasing of price and quit undercutting the market in general.
Wouldn’t you love to know the details of the retirement/separation package?
Yep, sure would
State Fund is about as “bankrupt” as the Social Security system. Had the 20 some odd other carriers been as scrutinized as State Fund they might still be writing insurance in California. Dianne Oki did an excellent job of steering the State Fund through a very difficult period.
I read with great interest the State Fund’s Board of Directors’ comments alluding to the “Fund’s future direction.” Gee, and just what might that be, and who might that benefit?? It would seem that the Governator has appointed the fox to guard the henhouse.
This situation cries out for some investigative reporting.
The State Fund is in better shape than almost every other carrier in California. Ms. Oki was able to accomplish this in SPITE of Garamendi’s meddling. I would suggest that Bill and Bonnie are either insurance agents or they work for one of the marginal workers compensation carriers currently in the marketplace.
I wonder what it will cost the policy holders of State Fund to pay for this nationwide recruitment that Mr. Neal will be engaged in to find a new President for State Fund. I wonder if any CEO out there would consider the job if it only paid what past Presidents of State Fund have earned. Policy holders should demand to know how much money will be spent and why this will benefit them.