Fall 2006

Texas Mutual Expands Network Service Areas

Texas Mutual Insurance Company has expanded the service areas of its workers’ compensation health care network option. The Texas Star Network_SM is now available to approximately 85 percent of Texas Mutual^®policyholders. Click here for a complete map of network service areas.

Texas Mutual Insurance Company launched the network option to help reduce the human and monetary costs associated with workplace accidents. Policyholders who are eligible for and choose the network option benefit from occupational health care providers and case management services designed to help injured workers get well and back on the job in a timely manner. Most policyholders also receive a 12 percent annual network premium discount.

Texas Mutual^® policyholders do not have to wait for their policy to expire to take advantage of the network option. For more information, employers should ask their agent or click here.

Fulfill your network responsibilities
Network participation comes with responsibilities for employers, injured workers, health care providers and insurance carriers. One of the primary employer responsibilities is properly rolling out the network option to employees. Employers should remember the following:

1. Injured employees do not have to seek care from network providers until employers have given them the Employee Notice of Network Requirements. Employers must provide the notice:
   • When the employer chooses the network option, or
   • Within three days of hiring a new employee, and
   • When an employee is injured.
2. Employers must post the notice at each of their business locations. Texas Mutual Insurance Company recommends that employers post the notice in the same location where they post their workers’ comp coverage notice, minimum wage posting and Occupational Safety and Health Administration information.
3. The notice must be in English, Spanish and any other language common to employees. Employers can visit the Health Care Network section for downloadable versions of the notice in several languages. Texas Mutual Insurance Company will have the notice translated into other languages if necessary.
4. Employers must establish a standardized process for delivering the notice. Some employers email the notice to employees, some distribute it during staff meetings and others include it in their new-hire packet.
5. Employees must sign an acknowledgment form stating that they received the notice, and employers must keep these forms on file. If an accident occurs, Texas Mutual Insurance Company may request a copy of the form as part of the routine claim investigation process.

If an employee refuses to sign the acknowledgment form, he or she is still responsible for following network requirements. Employers need to document the delivery process to prove they delivered the notice of employee responsibilities properly. Employers should document any refusal to sign the acknowledgment form, preferably in the presence of a witness. Employees who refuse to sign the form and do not comply with network requirements may be responsible for paying for their own health care.

The Health Care Network section has most of the information employers need to fulfill their network responsibilities. Besides the Employee Notice of Network Requirements, employers will find an employee acknowledgment form, a template for recording the delivery of the notice and an employee network presentation in English and Spanish. For more information, employers can call Texas Mutual Insurance Company at (800) 859-5995.

COMPNEWS - Fall 2006
Top Ten Ways to Improve Your Safety Program
Texas Mutual Expands Network Service Areas
New Interactive Tools Help Employers Improve Workplace Safety
New Program Recognizes Safe Workplaces
President's Message
You Need to Know
Fraud-Fighting Corner

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Texas Mutual Insurance Company.