On the job injuries and work-related health hazards can occur no matter if you work for a law firm or on a construction site. This is why every business in the U.S. that employs more than two people is required by law to have a valid workers’ compensation insurance policy, apart from businesses in Texas.
The exact requirements vary between states, but in general it is a good idea to have workers compensation insurance regardless just in case.
The benefits for the employees cover medical costs, sick pays, and rehabilitation costs. Should the unthinkable happen, the worker’s comp insurance covers any funeral costs.
What factors determined the workers’ comp insurance?
Your workers’ compensation insurance depends on three factors:
- Annual percentage of payroll
- The class code rate for your profession
- Experience rate modification
In the paragraphs that follow, I shall have a closer look at each of these factors. For now, suffice it to say that:
- The higher your salary is, the higher workers compensation premium you’ll get
- The class code classifies your job as a high-risk, medium-risk, or low-risk one. The riskier your job, the more money you can expect to get in case of an on-the-job trauma.
- Finally, the more years of experience you have under your belt, the higher workers comp premium you can expect to get in case of injury.
Classification code rates explained
Speaking of workers comp insurance, professions in the U.S. are classified by four-digit numbers or class codes. Each classification code is accompanied by a brief of the job and a class code rate.
When an insurance company has to pay a workers’ comp insurance benefit, they will take each $100 that you earn and multiply it by that rate. In the United States, the organization in charge of the class code rates is the National Council for Compensation Insurance (NCCI).
The Council’s primary function is to analyze the risks that each profession involves. As new jobs emerge all the time, class code rates are updated regularly. Office jobs normally have some of the lowest class code rates, as they involve the smallest risk of injury.
On the other end of the spectrum are oil rig workers, miners, firefighters, and police officers, who put their lives on the line every day.
A closer look at the Experience Modification Rate
Websites that calculate workers’ compensation insurances sometimes list the Experience Modification Rate (EMR), also as X-Mod or E-Mod. This rate estimates how likely it is for breakdowns and serious accidents to occur at your company. The more workers’ compensation claims a company has filed, the higher its EMR is.
Tech giants like Google typically have a low EMR, as their officials are less likely to get injured on the job. On the other end of the line, we can see companies like British Petroleum, whose workers are exposed to a higher risk of injuries while probing for oil in the Gulf of Mexico.
Small businesses should keep in mind that their EMR will initially be set at 1.0. After three years, the EMR will drop to the average for the sector.
Let me give a simple example. After the Deepwater Horizon disaster in 2010, BP’s EMR, which must have been high nonetheless, skyrocketed to an all-time high, because the index is affected not only by the frequency of the claims but also by their severity.
The average salary of a BP workman is over $100,000 a year. And each of the survivors had their medical bills, and lost wages covered by the insurance company.
The role of the payroll
Every employee at a certain company has a different class code rate, depending on the level of risk that their duties involve. These rates are added to the employee’s annual percentage of payroll.
Payroll’s total includes one’s net remuneration, benefits, paid leaves, sick pays, as well as any bonuses that they may be entitled to. Insurers normally underwrite policies at estimated premiums based on the employee’s projected payroll.
At the end of each fiscal year, the employee’s account is either credited or debited, depending on how much money they have received.
Workers’ compensation rates differ across the U.S.
Regarding workers compensation, states fall into three categories:
- NCCI states
- Independent bureau states
- Monopolistic states
Most of the states use the codes and rates provided by the Council. California, where businesses pay the highest workers’ comp premiums, has its own rates regulator – the Workers Compensation Insurance Rating Bureau of California.
Other states like Iowa, N Dakota, and Washington do not allow private insurers. Instead, they have set up a special fund that pays compensations to workers and their families in case of personal injury, illness, disability, or death. These states are known as “monopolistic” because workers’ compensations are regulated by the state authorities.
Workers’ compensation rates vary widely from state to state. The so-called monopolistic states like Oregon have the lowest rates: about $1.00 per $100 of payroll. States with independent rate bureaus pay workers compensation premiums of above $1.50 per $100 of payroll.
How does the worker’s comp calculator work?
The formula for workers compensation insurance takes into account the class code rate, EMR, and the businesses payroll:
Premium = (Payroll/$100) x Class Code Rate x ERM
To calculate the exact amount, you have to provide your business’ location, the latest EMR assigned to your company, and the different class code rates of your employees.
If you run a business with branches across the United States, then your officials will be entitled to receive the average workers’ compensation premiums for their state of residence.
Insurance companies calculate benefits on the basis of the employee’s average weekly wage. The employee’s daily wage is multiplied by the number of days they worked during the fiscal year. That number is then divided by 52 because there are about 52 weeks in a calendar year. This is how you get one’s average weekly wage.
A practical example
Let’s say a skilled workman made $53,000 last year and worked 236 days, considering time off, sick leaves, etc. This means the employee received $224.57 per day before tax. If we multiply this number by 260 (the number of days an employee would have worked in a full year, where the number of weeks is 52), we get $58,388.20.
This means that the employee would be entitled to receive workers’ compensation insurance premiums in the amount of $1,112.85 a week. If a work accident left him 100% disabled, they’d be entitled to 60% of that amount, or $673.71 a week.
State laws affect workers’ compensation rates
If you visit an online workers’ comp calculator and try to figure out how much you’d get if you got injured in a work-related accident, you’ll probably get an approximate value.
Actual rates are constantly fluctuating under the influence of different state laws and subsequent amendments. Different workers’ comp laws in the different states can oblige certain businesses to pay hefty insurance premiums, while others may be fully absolved.
Each state has its own list of approved medical fees which determine how much an injured worker’s treatment and rehab is going to cost. Companies operating in states where medical bills are higher are required to pay higher workers’ comp premiums.
If there are more insurance companies in a particular state, you can shop around and find the most appropriate insurance deal for your business. Rates in monopolistic states like North Dakota may be relatively low, but the state fund is your only insurance option and you have to pay whatever rates the state government approves.
Factors that can increase one’s worker’s compensation rate
There are certain factors that you have to take into account if you’d like to build a strong workers comp case. First, you should inform your insurance carrier of the number of injuries you suffered during a work-related accident, as well as the affected area.
Typically, brain injuries are the most expensive to treat and have the longest recovery period. Depending on their severity, they fall into several categories. They often cause full or partial disability.
It is also important to notify your insurer if a family member had to provide unpaid care for you during the recovery period. The caregiver may also be entitled to certain compensation. In addition to manhours, you can also include transportation, medical treatment, and the repair cost in your insurance claim.
The insurance company also wants to know who was at fault for the personal injury that you suffered a work. They are willing to pay more if you got injured because of someone else’s negligence.
Work Comp FAQ
#1. What is the average settlement for workers comp?
The sum of the settlements can range between $2,000 and $40,000. If you are planning to file claims with multiple insurance carriers, you should perhaps turn to a law firm to prepare the separate compensation cases.
#2 Is workers comp based on gross or net wages?
A workers’ compensation insurance policy is based on each employee’s gross payroll, no matter if they are hired on a full-time, part-time, or seasonal contract. For extra legal advice, you can contact the insurance company or your company’s attorneys.