TEXAS NON-SUBSCRIBER OCCUPATIONAL ACCIDENT INSURANCE
A Brief Overview
Non-Subscription is a proven alternative to workers' compensation. The right to opt out of the Worker's Comp system was included in the first Texas Workers Comp laws written in 1913. Businesses that choose not to subscribe become responsible for providing their own injury benefit plan to cover occupational injuries and illnesses, and provide for legal liability defense and damage payments.
Non-subscription became more popular as a result of the Workers Comp crisis of 1989. Many businesses were forced to opt out of the comp system or go out of business. As a result, insurers took this opportunity to develop products to insure the risks to non-subscribers.
Over the years since then these products have become more and more comprehensive, offering benefits for: medical expenses, disability compensation, life/AD&D benefits, and legal liability coverage. In recent years many have included binding mediation and arbitration programs. Additionally, these plans must comply with the reporting, disclosure, and fiduciary requirements of ERISA.
Some of the more notable employers that are non-subscribers include: Home Depot, H-E-B Grocery, Kroger Company, Randall's, Tom Thumb Markets, Dillard's, Pappas Restaurants, and Hoover Vacuums.
Employers frequently experience reduced costs as a result of lower premiums, tighter control over fraudulent claims, and fewer accidents due to the emphasis on safety and taking a proactive approach to employee welfare.
5 Reasons To Become a NonSubscriber
1. Better Medical Care for Injured Employees!
As a non-subscriber to the Texas workers compensation insurance system you can direct insured employees to the best occupational medicine providers as a condition to payment of injury benefits.
2. Immediate Notice of On-the-Job Injuries!
You can require employees to provide immediate notice of on-the-job injuries as a condition of payment of injury benefits. Earlier notice results in prompt medical attention from pre-approved healthcare providers.
3. Benefit and Liability Risks are Better Known and Fully Insurable!
Over the past decade, state and federal courts have well defined the employee benefit needs and liability risks of non-subscription. And several strong, experienced insurance carriers provide broad coverage for occupational medical, wage replacement, death, and other employee benefits. Liability coverage is also available, although used in less that .01% of all non-subscriber injury claims. Virtually any deductible and coverage limit is available.
4. A Road Well Traveled!
Approximately 40% of all Texas employers have rejected Texas workersı comp. Most have been non-subscribers for nearly a decade. Non-subscribers are also very well represented in Austin by the Texas Association of Responsible Non-subscribers (TXANS) and the Texas Association of Business & Chambers of Commerce.
5. Dramatically Lower Costs!
Texas is among the most costly states in the U.S. for workers comp medical and indemnity costs and lost productivity. Non-subscribers regularly report savings of 50% to 85% off of previous workers comp costs (while providing better medical care and achieving quicker return to work for injured employees).
Typical Plan Highlights
ı Combined Single Limit (CSL) of $1,000,000.00 with an aggregate limit of liability of $10,000,000.00 per accident.
ı Benefit Period of 104 Weeks
ı 7/28 Elimination period of disability
ı Insured by American fidelity insurance Company.
ı CSL is the aggregate of expenses incurred for Medical, Disability and Accidental Dismemberment and Death Benefits.
An OCCUPATIONAL ACCIDENT Plan HAS four KEY BENEFITS
1. Accidental death and Dismemberment
In the event of an on- the- job accidental death or dismemberment, the plan will pay up to $150,000 to the Employee or his beneficiary.
Burial: The plan also pays a burial benefit of $5,000.
All other occurrences of dismemberment are paid in accordance with a policy schedule.
2. weekly Diability
If an employee earns $8.50 per hour or greater; benefit equals 70% of his hourly wage If an employee earns less than $8.50 per hour; benefit equals 75% of hourly wage. In all cases the maximum weekly disability benefit is $600 per week.
Benefits are paid after a waiting period of 7 days. If the disability extends beyond 28 days, the first seven days are paid for retroactively.
3. medical expense coverage
The plan pays for a range of medical expenses incurred as a result of an on the job accident. The plan pays 100% of expenses after a deductible. Coverage is for usual customary and reasonable charges for medically necessary services ordered by a physician. Please refer to the policy for exclusions.
4. Employer's Liability
This covers amounts paid to obtain a release of liability or settle a claim for workplace negligence brought by a covered employee as the result of a covered injury.
Amounts paid to satisfy a judgement for an Employer Indemnity claim
Defense costs and expenses related to an Employer Indemnity claim