A SIG is a non-profit corporation that functions as a workers compensation insurance company. It is owned, controlled and run for the benefit of its members. All profits of a SIG (dollars remaining after the payment of claims and operating expenses) are ultimately returned to the members in the form of dividends.
Among the many benefits of SIG membership are high quality services, dividend potential, and control:
Services: The standards for claim management and loss control services for TPA-managed SIGs are far more stringent than those generally applicable to insurance companies. Members should expect greater levels of support and communication. These services are designed to contain the costs of claims while assuring prompt and fair treatment for injured employees.
Dividend Potential: Members’ workers compensation costs can be reduced by dividends – the profits of the SIG returned to the members. Those with the most favorable claim experience will receive the greatest percentage of dividends, a reward to those who most effectively control their claim costs.
Control: Members own and control the SIG and govern it through their elected Board of Directors. Committees to the Board, such as the Claim and Loss Control Committee, oversee key service programs. In addition, individual members have more control and input with regard to the handling of their own claims, as well as the ability to utilize the group’s loss control services to reduce their risk of claims in the future.
- Workers Compensation claim history
- Workers Compensation risks [hazardous operations]
- Financial strength [financial information is kept strictly confidential – neither the Board nor any other members of the group are privy to other members’ financial documents at any time]
- Commitment to safety
In addition to meeting the group’s underwriting standards, SIG members are required to provide CPA-prepared financial statements annually.
Coverage in a SIG is identical to that found in the fully insured market. The difference is that the individual member has far more incentive and ability to control losses and thus directly reduce the price for their coverage.
They may be. According to regulation, a Self-Insured group must follow all rates and rating rules applicable in the voluntary market for at least its first two years of existence. Once a SIG is able to demonstrate a two-year track record, it may apply to the Division of Insurance for a rate deviation.
We make immediate contact with the injured worker. The group and the Program Administrator jointly agree on claim processing standards that limit the number of claims an adjuster may handle. As a result, SIG customers are contacted sooner and receive a higher degree of attention right from the inception of the claim. The goal is to help mitigate loss dollars and return the injured worker to full duty or alternatively transition into a light duty assignment.
Loss control services are generally tailored to the individual member, in concert with the group’s overall safety philosophy. The intent is to uncover hazards that can help to control loss dollars and to educate members to prevent injury to their employees.
SIG members may be assessed based on the group’s overall loss experience during their period of membership. SIG members are subject to joint and several liability. In essence, all members of the group are responsible for the overall financial health of the group. That is why stringent underwriting standards are important and also why a long term commitment to safety and controlling losses is essential for the overall financial health of the group. Individual member losses and group losses are limited by the purchase of excess insurance.
SIGs purchase excess insurance to cap their exposure on any single claim and to limit the aggregate amount of claims that the SIG will pay in any one year. This is the key step to managing members’ risks. The excess insurance program has the effect of “capping” members’ worst-case scenario workers compensation costs in a SIG.
