State Workers' Insurance Fund (SWIF) > Frequently Asked Questions

Frequently Asked Questions
(FAQs)

| Administration | Underwriting | Safety | Claims | Anti-Fraud |

Administration

Q
What is SWIF's written premium for 2010 and 2011?
A
2011 = $157,791,022
2010 = $162,174,053
 
Q
What is SWIF's Lost Cost Multiplier?
A
Current - 2.430 
Q
How many employees does SWIF have?
A
205- As of April 2012 
 
Q
What is SWIF's accident year loss ratio for the past three years?
A
2011 - 131.0%
2010 - 101.2%
2009 - 91.3%
(percentages are tentative pending SWIF's reserve estimate completion)
 
Q
How many injuries were reported to SWIF over the last three years?
A
Medical Only Indemnity
2011 - 5,246 2011 - 1,626
2010 - 6,858 2010 - 1,872
2009 - 8,863 2009 - 2,417
 
Q What is a PPO?
A A PPO is a Preferred Provider Organization, it is a list or “panel” of designated health care providers specializing in workers’ compensation by providing goal oriented medical treatment from board certified physicians that will facilitate a prompt recovery and a successful return to work.
 
Q Why post a panel?
A The Pennsylvania Workers’ Compensation Act gives employers the right to establish a panel of designated health care providers, when properly posted in the workplace and acknowledged by all employees, injured workers must seek treatment for their work related injuries with one of the designated providers for 90 days from the date of the first visit.
 
Q Why is SWIF offering a panel of providers?
 
A SWIF realizes that it’s vital that businesses take prudent steps in controlling their workers’ compensations costs.
 
Q What are the benefits of posting a panel?
A Reduced workers’ compensation medical and indemnity costs, a goal orientated treatment plan for your injured workers and improved treatment outcomes.
 
Q How can I get my own panel from SWIF?
A Contact Cathleen Fitzpatrick at 717-728-5502 ext. 1117 or by email at cfitzpatrick@hooverinc.com.
 
Q Does SWIF have a Pharmacy Program?
A Yes, administerd through KeyScripts.
 
Q If I’m an injured worker how will I receive my prescription card?
 
A Injured workers with compensable claims will automatically receive a pharmacy card listing the 4 closest pharmacies near your home.
 
Q What are the benefits in using this servce?
A You will receive your prescriptions faster, pay nothing out of pocket, reduce unnecessary phone calls and become eligible for home delivery.
 
Q How can I receive additional information on SWIF Pharmacy program?
A Contact KeyScripts at 1-866-446-2848 with questions, or to locate the KeyScripts Network pharmacy nearest you.
 
Q What is a Return to Work Program (RTW)?
A A RTW program is a proactive approach in restoring injured workers back to their former lifestyle in the safest and most effective manner possible.
 
Q Why implement a RTW Program?
A Workplace injuries, illnesses and accidents are costly to the employer and the employees. Preventing injuries is the best way to protect workers while controlling workers compensation costs. Employers and workers need a way to manage injuries if they occur. An effective RTW program assists in assuring that the worker obtains medical care during the initial stages of recovery, and during the subsequent return to productive employment.
 
Q What are the benefits of a RTW program?
A For the Employer - Reduced staff turnover and training costs, reduced fraudulent claims, saves indemnity expenses, overtime costs, improve morale and employee relations.
 
For the Employee - Increase self-esteem, contributes to a faster recovery by keeping the injured worker mentally and physically conditioned, maintains social contact with fellow employees and reduces negative financial impact many injured employees experience.
 
Final Result - A Win-Win for everyone.
 

Underwriting

Q
How does SWIF price Workers' Compensation coverage?
A
SWIF assigns the appropriate classification code(s) and multiplies the rate by every $100 of payroll to produce the base premium. The base premium is then multiplied by any applicable Experience Modification or Premium Discount. The total is the Estimated Annual Premium.
 
Q
When does Minimum Premium apply?
A
The minimum premium applies whenever the actual premium is less than the minimum premium for the selected classification code(s).
 
Q What is an Officer Exemption Form (LIBC 509 - Application for Executive Officer Exemption; LIBC 513 - Executive Officer Declaration), and when is it needed?
A
An Officer Exemption Form is a notice of rejection for Workers' Compensation coverage. When an Officer of a Corporation elects not to be covered by Workers' Compensation, they complete an "Application for Executive Officer Exemption Form" (LIBC 509) and an "Executive Officer Declaration Form" (LIBC 513). An Officer Exemption Form is only necessary for Corporations, since Sole Proprietors and Partners are automatically excluded from coverage. These Forms can be obtained from SWIF or the Bureau of Workers' Compensation, 1171 S. Cameron Street, Harrisburg, PA 17104-2501; telephone (717) 787-3567.
 
Q
Are employees covered while working in another state?
A
SWIF does not provide Workers' Compensation Insurance coverage for states other than Pennsylvania. It does, however, afford coverage for Pennsylvania hired employees who are injured out-of-state pursuant to the Extraterritorial Provisions of the Workers' Compensation Act. Although it is a very fact specific area of the law, the general rule is that coverage will be afforded to an individual hired in Pennsylvania, but assigned to work out-of-state on a temporary basis. Any benefits paid will be made pursuant to Pennsylvania law and not the law of the state where the work injury occurred. This is a complex and difficult area of the law, where questions of coverage and compensability often turn on the facts surrounding the employee's hire and the insured's business presence out-of-state. Such questions often require the advice of an insurance broker or lawyer. Obviously, it is better that these questions be addressed before an injury occurs.
 

Safety

Q How do I establish a certified workplace safety committee and earn the 5 percent premium discount on my next policy renewal date?
A See Certified Safety Committee Information under Resources.
 
Q What Loss Control Services are available?  
A
The services include, but are not limited to, on-site surveys, accident prevention training programs, and safety committee training. (See Loss Control Notice of Availability of Services)
 
Q
How do I get started?
A
Contact the Loss Control Manager at (570) 941-1653 to discuss your needs.
 
Q
What resources do you have to help me?
A
SWIF offers safety booklets, posters, and videos that can assist you in training your employees or raising their level of awareness about Workplace Safety. (See Available Safety Materials)
 
Q
Is there a cost to me for Loss Control Services and materials?
A
No. These services are included in your policy premium.
 

Claims

Q When, and to whom, do I report my injury?
A
Report any work related injury immediately to your employer. Your employer will then report your injury to SWIF.
 
Q Who will contact me?
A
On all reported claims, you will be contacted by letter from SWIF assigning a # to your claim. If your injury causes you to lose work for 7 days, you will be contacted by a SWIF Investigator working from the district office serving your geographic location.
 
Q What will my lost time benefits be?
A
Your benefits are based on your wages at the time of your injury.
 
Q Will my medical bills be paid?
A
All medical bills falling under the Workers' Compensation Act and applying to your accepted claim will be honored. 
 
Q When will I receive payment of lost wage benefits?
A
After your lost time claim is investigated and accepted, you should expect to receive a check within ten (10) working days.
 
Q What if I cannot do the job that I did before being injured?
A SWIF offers several services to see that you receive the best medical care for your injuries and the best vocational opportunities for your return to the workforce.
 

Anti-Fraud

Q
Who prosecutes the fraud cases discovered by SWIF?
A
Office of Attorney General
 
Q
Why isn't someone put in jail?
A
It is up to a court of law.
 

Contact Information

State Workers' Insurance Fund
100 Lackawanna Avenue
P.O. Box 5100
Scranton, PA 18505-5100
(570) 963-4635
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