Summer 2007

PAG Asks the Questions You Want Answered

This summer, Martin Leifker and the Texas Mutual Insurance Company e-business team unveiled a new look for the password-protected areas of this site. The redesign makes Texas Mutual^® online services even easier to use and navigate. Leifker previews the changes with Jane Jamison, chief financial officer at the Texas Boll Weevil Eradication Foundation.

---

Businesses use all sorts of sophisticated methods to find out what’s on their customers’ minds. Some analyze market data. Others review their sales trends or conduct virtual focus groups. Texas Mutual Insurance Company believes there’s no substitute for face-to-face communication.

This spring, the company held its annual policyholder advisory group (PAG) meeting. Fourteen policyholder representatives had the chance to sit down with company management and ask them anything they wanted. Here are some highlights from the meeting.

How does Texas Mutual Insurance Company decide who qualifies for dividends?
We cannot release details of our dividend calculation formula because the information is proprietary. We can tell you that claim loss history is a key factor.

Can I get a prospective employee’s workers’ compensation history?
Generally, no. The Americans with Disabilities Act, which applies to employers with 15 or more employees, prohibits an employer from making pre-offer inquiries into an applicant’s workers’ comp history. After making a conditional offer of employment and getting the applicant’s signed permission on a DWC Form-156, however, an employer may get such information by submitting the form to the Texas Department of Insurance, Division of Workers’ Compensation.

Should I report every accident, even if it’s minor?
We recommend that policyholders report all accidents as soon as possible. This will ensure that claims are investigated for compensability, and it will reduce the possibility of a duplicate medical provider payment. A medical provider’s bill is often the first notice Texas Mutual Insurance Company gets about an injury. In that case, the law requires us to establish a claim, investigate it and handle it within certain guidelines.

Can policyholders expect 24/7 access to Concentra clinics?
Concentra does not plan to offer 24/7 access to its clinics, but some of its clinics do offer after-hours coverage. For a list of Concentra clinics’ hours of operation, visit www.concentra.com. Injured workers should seek treatment in the emergency room if they need after-hours care. Ensuring that injured workers receive appropriate medical care is the main objective.

Can the network acknowledgment form process be streamlined?
Employers who choose the network must give each employee an Employee Notice of Network Requirements, and they must have each employee sign a form acknowledging that they received the notice. They must repeat the process at the time of injury. This is a regulatory requirement. We offer tools in the Health Care Network section to help employers with the process.

Does Texas Mutual Insurance Company offer sample loss prevention policies and programs?
The safety resource center has a variety of information. The assessment tool provides safety programs designed around policyholders’ operations. The resource catalog includes a sample drug policy, driver’s road test examination, auto inspection checklist and other materials policyholders can customize to meet their needs.

COMPNEWS - Summer 2007
Keep Older Workers Healthy and Productive
Texas Mutual Pays $125M in Dividends
PAG Asks the Questions You Want Answered
Learn How to Control Your Workers’ Comp Costs
President's Message: 
Another typical day at the office?
Sample Workplace Violence Policy
You Need to Know: 
Legislature passes workers’ compensation bills
New disability management rules take effect
State to release first network report card this fall
Learn more about the workers’ comp system
You need to know more

Fraud-Fighting Corner

Back to Table of Contents

Texas Mutual^® is a registered service mark of
Texas Mutual Insurance Company.