Texas Mutual Billing System
Responds to Providers' Requests
September 28, 2007 - Texas Mutual Insurance Company will launch its electronic billing system for health care providers by January 1, 2008. The system will comply with workers’ compensation electronic billing requirements mandated by the Texas Department of Insurance, and it will respond to providers’ requests for a streamlined, paperless billing process.
Texas Mutual Insurance Company contracted with Jopari Solutions Inc., a California-based supplier of e-billing and payment solutions for the insurance industry, to manage its e-billing system. Under the agreement, Jopari will serve as a gateway between providers and Texas Mutual Insurance Company for electronic remittance advice and the submission of electronic bills and attachments.
Until now, the workers’ comp system did not require health care providers to bill carriers electronically, as they do in group health insurance and Medicare. That changed when the Texas Legislature overhauled the system under House Bill 7 in 2005.
Rules adopted by the Texas Department of Insurance, Division of Workers’ Compensation require health care providers to begin submitting their bills electronically by January 1, 2008. If a provider has less than 10 employees, and workers’ comp represents less than 10 percent of their business, they are exempt from the requirements.
To register for Texas Mutual electronic billing services or get more information, contact Jopari at www.jopari.com or (866) 269-0554.
Dividends Drive Auto Dealers to Focus on Safety
September 5, 2007 - Texas Mutual Insurance Company announced a $985,520 dividend to the Lone Star Auto Dealers Association (LSA) workers’ compensation purchasing group today. The group has earned six consecutive dividends totaling more than $2.1 million.
Because dividends are based largely on the group’s overall loss ratio, members have an incentive to focus on safety. For San Antonio-based Kahlig Enterprises Inc., the process starts during the job interview.
“We feel like you hire your problems,” said David Hoyer, Kahlig Enterprises Inc. controller. “A thorough hiring process is crucial. If you hire responsible people who take ownership of their decisions, you’re going to do well from a production and safety standpoint.”
That philosophy has helped Kahlig earn about 31 percent of its premium back in dividends since 2004. Like many LSA members, Kahlig has qualified for group and individual dividends. Individual dividends are based on each policyholder’s personal loss ratio.
To help members improve their safety record, LSA provides an industry-specific safety plan. Members also have access to interactive safety tools at www.texasmutual.com.
For more information about LSA, click here, or visit www.lonestarautodealers.com. Texas Mutual Insurance Company notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends.
Texas Mutual Pays $2.9M Dividend to CompGroup AGC
August 29, 2007 - Texas Mutual Insurance Company announced a $2,960,537 dividend to the CompGroup AGC workers’ compensation purchasing group today. The dividend, which is the largest in Texas Mutual Insurance Company’s history, was based largely on the group’s safety record.
“Safety is ingrained in everything our members do,” said Julie Schatz of Roberts & Crow, the group’s administrator. “Our dividend track record speaks for itself. We’re proud of our members for keeping their workers safe on the job, especially considering the hazards of our industry.”
The Association of General Contractors (AGC) is a nationwide association of commercial construction contractors and industry-related companies. In Texas, AGC partnered with Texas Mutual Insurance Company to form a purchasing group. The group has earned more than $7 million in group dividends since 2002. Many members have earned individual dividends in addition to group dividends.
Employers who join the CompGroup AGC have access to an industry-specific safety plan, job site inspections, safety courses, accident investigations, updates on safety regulations, interactive online safety tools and a multimedia library of safety materials.
For more information about the CompGroup AGC, click here. Texas Mutual Insurance Company notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends.
A Quadruple Scoop of Double Dipping
August 20, 2007 - Texas Mutual Insurance Company reported today that four workers’ compensation claimants were sentenced, in separate cases, for fraud. The claimants collected a combined $17,346 in benefits they were not entitled to. All four cases involved a scam that investigators call double-dipping.
Double-dipping happens when claimants collect benefits for being too injured to work when they are, in fact, gainfully employed. Texas law requires claimants to contact their workers’ comp carrier when they return to work. Left unchecked, double-dipping and other workers’ comp fraud can lead to higher premiums for all Texas employers.
Three of the claimants, Jose Rubio of Houston, Rufino Montiel-Lopez of Austin and Marvin Reyes of Del Valle, were sentenced in Travis County district courts.
Rubio was ordered to serve one year of probation and pay $4,320 in restitution to Texas Mutual Insurance Company, plus fines and fees. Montiel-Lopez must serve 18 months of probation, perform 80 hours of community service and pay $3,188 in restitution to Texas Mutual Insurance Company. Reyes’ sentence includes two years of probation and 100 hours of community service. Reyes must also pay $1,555 in restitution to Texas Mutual Insurance Company.
In Brown County, Chris C. McCall of May was ordered to serve a five-year probated sentence and pay $8,283 in restitution to Texas Mutual Insurance Company, plus fines and fees.
Texas Mutual Insurance Company is the state’s leading workers’ comp insurance carrier. These cases were part of the company’s zero tolerance for fraud policy. For more information, visit the Fighting Fraud section.
TLWP Focuses on Safety, Earns Texas Mutual Dividend
August 13, 2007 - Texas Mutual Insurance Company, the state’s leading provider of workers’ compensation insurance, announced a $6,750 dividend to the Texas Lumber and Wood Products (TLWP) purchasing group today.
Texas Mutual Insurance Company evaluates purchasing groups for dividends 18 months after they are formed, and annually thereafter. Group dividends are based largely on premium volume and loss ratio. Groups reach 100 percent of their dividend earning potential in their third dividend evaluation.
“We’re excited that we earned a dividend in our first year of eligibility,” said Jim Roskopf of Guaranty Insurance Services Inc., TLWP administrator. “With this group’s commitment to workplace safety, we look forward to the possibility of larger dividends in the future.”
Texas Mutual Insurance Company notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends.
Lubbock Businessman Appointed
Chair of Texas Mutual Board
July 31, 2007 - Texas Mutual Insurance Company, the state’s leading provider of workers’ compensation insurance, announced that Richard Cooper of Lubbock has been named chair of the company’s board of directors. Cooper replaces Martin Young Jr. of Houston, who served as chair since 1995.
Cooper is president of National Travel Systems, a Lubbock-based travel management company specializing in Olympic sports events, government/higher education and international missionary travel programs, with offices in Austin, Dallas, Amarillo, Midland, Odessa and Indianapolis. He has served on the Texas Mutual Insurance Company board of directors since 1996. He serves on the board Executive Committee, and he has chaired the board Audit Committee for six years.
Cooper assumes the board chairmanship during a time when the Texas workers’ comp system is experiencing more change than it has in a decade.
“This is an exciting time for workers’ comp in Texas,” said Cooper. “Competition is high in the market, and the Legislature has renewed the system’s focus on returning injured workers to productive employment. The company has the board’s full support as it continues to lead Texas into a new era in workers’ comp.”
Last year, Texas Mutual launched the state’s first certified workers’ compensation health care network. The network’s goal is to control claim costs in Texas, which are among the highest in the nation, and help return injured workers to productive employment. During the past nine years, the company has put about $440 million back into the Texas economy through its policyholder dividend program, including a company-record $125 million this summer. It has also continued to solidify its reputation for promoting workplace safety, fighting fraud and helping injured employees return to work.
Energy Group Earns Third Texas Mutual Dividend
July 26, 2007 - Texas Mutual Insurance Company announced a $72,147 dividend to the Lone Star Energy (LSE) purchasing group today. The dividend was based largely on the group’s premium volume and loss ratio. LSE has earned more than $168,000 in dividends since 2005. The group is open to butane and propane gas operators and dealers. Any licensed Texas agent can place a qualifying client in the group, with the underwriter’s approval. For more information, click here. Texas Mutual Insurance Company notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends. Texas Mutual Pays a Record $125 Million in Dividends
July 25, 2007 - Texas Mutual Insurance Company began distributing approximately $125 million in individual policyholder dividends today. The dividend distribution is the largest in the company’s history. Approximately 37,500 employers, representing about 79 percent of the company’s policyholders, will receive a dividend. Loss ratio and customer loyalty through retention are key factors in determining which policyholders qualify. “The Texas workers’ compensation market continues to be very competitive,” said Russell Oliver, president of Texas Mutual Insurance Company. “We work hard to differentiate our company from other carriers by providing real value to our policyholders. Our track record for paying dividends gives them one more reason to stay with us.” With these dividends, Texas Mutual Insurance Company will have paid about $445 million in individual policyholder dividends during the past nine years. The company notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends. Texas Mutual Pays Dividend to Texas Sign Association
July 18, 2007 - Texas Mutual Insurance Company announced a $24,664 dividend to the Texas Sign Association (TSA) Comp Group Inc. purchasing group today. The dividend was based largely on the group’s premium volume and loss ratio. TSA is open to on-premises sign product manufacturers, sign supply distributors and associated sign service providers. Any licensed Texas agent can place a qualifying client in the group, with the underwriter’s approval. For more information about TSA, click here. Texas Mutual Insurance Company notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends.
Emergency Service Organization Group Earns
Sixth Straight Texas Mutual Dividend
July 16, 2007 - Texas Mutual Insurance Company, the state’s leading provider of workers’ compensation insurance, announced a $77,256 dividend for the Emergency Service Organization (ESO) purchasing group today. The group’s sixth consecutive dividend was based largely on its premium volume and loss ratio. “Emergency service employees and volunteers put themselves in danger to help others every day,” said Barbara Marzean of VFIS of Texas/Regnier & Associates, ESO group administrator. “Working with Texas Mutual, we’ve made safety a priority and helped our members earn a portion of their premium back in dividends.” Texas Mutual Insurance Company notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends. Texas Mutual Introduces Auto Repair Purchasing Group
July 13, 2007 - Texas Mutual Insurance Company and Frost Insurance Agency have partnered to launch the Texas Auto Repair purchasing group. The group offers members a money-saving workers’ compensation option. The Texas Auto Repair group is open to qualifying tire sales centers, general auto repair facilities, lube centers, auto parts stores and body, brake repair, automotive machine and radiator shops. Members retain their own experience modifier and earn a discount based on the group’s premium volume, regardless of their individual premium size. They can also earn potential individual and group dividends and adopt an industry-specific safety plan. “We expect the auto repair industry to grow with the population of Texas,” said Shanan Wagoner of Frost Insurance Agency, the group’s administrator. “As vehicles need repair, shops of all kinds will service them. This group will help employers save money and, more importantly, keep employees safe and on the job.” Any licensed Texas agent can submit clients for group membership. For more information, visit the Agents section at www.texasmutual.com. ZIPCO Services Indicted for Workers’ Comp Fraud
July 9, 2007 - Texas Mutual Insurance Company reported today that a Travis County grand jury indicted ZIPCO Services Inc. and its owner, Jerry Don Calicutt, on workers’ compensation fraud-related charges. The indictments allege that ZIPCO Services Inc. defrauded Texas Mutual Insurance Company of over $100,000 in premium. ZIPCO Services Inc. is an oil and gas contractor located in Kilgore, Texas. The indictments allege that the defendants misrepresented the size of ZIPCO’s operations and number of employees to Texas Mutual Insurance Company. Because workers’ comp insurance premium is based in part on payroll, the scheme allowed the company to pay less premium than it actually owed. Texas Mutual Insurance Company is the state’s leading provider of workers’ comp insurance and insurer of last resort. The investigation is part of the company’s “zero tolerance for fraud” policy. Note: A grand jury indictment is a formal accusation – not a conviction – of criminal conduct. Texas Mutual Pays $1.7M Dividend to TxOGA
July 2, 2007 - Texas Mutual Insurance Company, the state’s leading provider of workers’ compensation insurance, announced a $1,752,338 dividend for the Texas Oil & Gas Association (TxOGA) purchasing group today. TxOGA is the state’s largest association representing the oil and gas industry. TxOGA has earned over $5 million in group dividends from Texas Mutual Insurance Company since 2001. Dividends are based largely on the group’s growth and favorable loss ratio. “The oil and gas industry is experiencing resurgence in Texas,” said Jim Sierra, TxOGA master agent. “With increased production comes increased potential for injuries. Our dividend track record is a testament to our members’ commitment to keeping workers safe and on the job.” Texas Mutual Insurance Company notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends.