10-29-12; IL WC Reforms Help Premium Costs a Bit; New IL WC Dental Fee Schedule Posted; WARN May Be Needed to Change to Staffing Co and much more

Synopsis: Illinois WC Reform Results Not So Great but Hope for the Future Remains When PPP’s Start.


Editor’s comment: The State of Oregon WC Premium Rankings are out. Illinois is ranked as the 4th highest premium in 2012 rankings, pegged at 151% of the median states of Georgia & New Mexico. If you are keeping score, we moved from No. 3 in 2010 down to No. 4 and are now better than wildly expensive Alaska, Connecticut and California. Many of our readers are happy to hear things didn’t get worse and we have to work for more improvement in the future.


If you care about cutting WC premium costs, we invite you to attend the IL State Chamber’s Annual WC Conference on October 25, 2011 and see what President Doug Whitley and his top-notch staff and sponsors like KCB&A are doing to help improve our state for WC costs—send a reply for details on registration or surf to their website at: http://ilchamber.org/illinois-chambers-4th-annual-workers-compensation-conference/


One motivating factor for the 2011 Reforms to our IL WC Act was the annual WC premium rankings from the State of Oregon. Illinois law actually included a provision for our state to create competing rankings—doesn’t appear that is going to happen any time soon. Oregon’s every-other-year Workers’ Comp Premium Ranking by State is out and can be located on the web at:




This biannual report ranks the WC premiums of all 50 states and the District of Columbia. The workers' compensation premium rates used for the study are from January 1, 2012, or late 2011 depending on the state, so they do not appear to include any of NCCI's current recommended rate changes for various states.


Texas is by far most improved, jumping 26 spots to finish in the top 15. Many observers feel they will make the Top 10 best in 2014. Their WC premium improvement has been remarkable, and puts them on another level compared to the other big population states/centers.


Illinois WC made some changes last year but the biggest and best should have been the WC Preferred Provider Program or WC PPP option. Right now, the WC PPP option for Illinois employers is sort of like looking through the glass at the candy in a candy store—it is nice and shiny and smells great but you can’t touch it. Despite the fact our Governor signed the 2011 WC Reforms last June, they still haven’t approved the rules to allow implementation. We expect the final approval of PPP’s to hit your WC program in mid-December 2012 but certainly no later than January 2013.


IL Department of Insurance Terminology Changed


When the IDOI submitted its proposed WC PPP regulatory modifications, it updated or clarified the preferred provider program terminology.


Health Care Preferred Provider Program (HC PPP) Administrator


Formerly referred to as the Preferred Provider Program Administrator (PPA). The HC PPP is a new term for the current/traditional PPOs and PPAs, which applies to both group health and workers’ compensation without WC employer direction networks.


The IDOI already updated its website to reflect this change in terminology:

Approved Health Care Preferred Provider Program Administrators; if you click on this link you will find all of IL HC PPP Administrators.

Provisionally Approved Health Care Preferred Provider Program Administrators--"Provisionally approved" refers to previously approved companies with renewal applications submitted to the IDOI.


Workers’ Compensation Preferred Provider Program (WC PPP) Administrator


Created by HB 1698/Public Act 97-18. This term refers to the new workers’ compensation designation that allows employer direction into an IDOI-Approved WC PPP network. Please note simply by offering an approved WC PPP network, employers will cut their employees’ choice of healthcare providers in half.

Approved Workers’ Compensation Preferred Provider Program Administrators; if you click on this link, you will find all of the IL WC PPP Administrators.

IWCC’s WC PPP Notification Form


For any employer with a designated IDOI-approved WC PPP, an employee must receive the IWCC’s official Notice of Preferred Provider Program for Workers’ Compensation Medical Care. That official form is available on the IWCC website in either English or Spanish. All IWCC forms, including optional WC PPP notification forms, are located in the Forms Section of the IWCC website.

Our recommendation for the top HC PPP or WC PPP source is Guy Swanson or Dave Kolb at HFN, Inc. They have been using a similar WC PPO concept for 25 years or more and they should be able to ramp that up quickly and smoothly to provide WC PPP services for your organization, once the rules are approved. If you need contact information, send a reply or simply surf to their great website at www.HFNInc.com.


We appreciate your thoughts and comments. Please do not hesitate to post them on our award-winning blog.




Synopsis: IL WC Dental Medical Fee Schedule now posted—IL WC adjusters should note the effective date for covered dental services starts on 6-20-12.


Editor’s comment: In the new tradition of globally controlling WC Medical costs, we salute our IWCC for posting a new dental schedule for folks who injure their teeth at work and require related dental care.


The IWCC updated its website this week with the effective date of the new schedule. The IWCC dental fee schedule will apply for all dates of service on or after June 20, 2012. 

Their fee schedule for dental services covers work-related dental services provided on or after June 20, 2012. Bills should be paid at the lesser of the actual charge or the WC dental fee schedule amount.

As part of the changes instituted by HB 1698/PA 97-18, the Illinois legislature directed the Illinois WC Commission to create this dental fee schedule. It is our understanding the schedule came together due to the combined work of the


      IL Workers' Compensation Medical Fee Schedule Advisory Board and

      Illinois State Dental Society who obtained and analyzed needed data.


We are certain attorneys on both sides will want to bring dental fee schedule-coded dental bills to disputed hearings. If you need assistance in getting dental bills coded, send a reply.




Synopsis: Be Fore-“WARN”-ed; Proper WARN Notices may be a Prudent Choice for HR Managers Switching to Staffing Companies.


Editor’s comment: We recently saw this class-action lawsuit while looking up other things and wanted to share it with our readers who may be considering changing your workforce.


On July 16, 2012, workers at Progressive Gourmet in Wilmington DE were told they had to reapply for their jobs through a temporary employment agency that would not provide health insurance and other benefits they received as former employees of the specialty food-distribution company. Those who refused to agree were quickly let go. In all, more than 70 workers or about one-third of the company's workforce lost their jobs due to their refusal to re-apply.


These claims are now part of a class-action lawsuit filed in U.S. District Court in Boston, alleging Progressive Gourmet violated the federal Worker Adjustment and Retraining Notification Act or WARN by not giving employees 60 days' notice of the layoff. The workers also filed a complaint with the National Labor Relations Board saying Progressive Gourmet's move was aimed at thwarting employees' efforts to form a union.


The Worker Adjustment and Retraining Notification Act of 1988 (WARN) is a United States labor law which covers employees by requiring most employers with 100 or more employees to provide sixty-calendar-day advance notification of plant closings and mass layoffs. Employees entitled to notice under the WARN Act include managers and supervisors, hourly wage, and salaried workers. The WARN Act requires notice also be given to unions, if any,  the local chief elected official (i.e. the mayor) and the state dislocated worker unit. Damages can be significant but are avoidable if the appropriate notices are provided. Our readers should also understand the cost and uncertainty of defending these actions in Federal Court can be moderately high.


The claims in the lawsuit may represent a trend in which many employers have increasingly used staffing companies to cut costs. This may be one of the first times a U.S. company has required all existing employees to reapply as temporary workers in such a transition. In other similar settings, workers who were asked to reapply with the staffing company were guaranteed a job for stated period with comparable salary and benefits. This may be a strong alternative to avoiding the raucous litigation and public relations impact of such a change.


KCB&A has no interest in the lawsuit reported above and we do not intend to affect its outcome. We appreciate your thoughts and comments.