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1 Landscape Contractors Insurance Services, Inc. Newsletter Summer 2014 Kim Ayala President/CEO President s Message Quarter Century of Service Celebrated as Client Benefits Continue to Grow As the temperature begins to rise across California I am happy to bring you the Summer edition of Complete Coverage. This year LCIS continues to celebrate its 25 years in business. Our Educational Open House in June was a big success and supported by many of our clients, vendors, carrier partners, friends and family. We honored 40 clients who have been insured with LCIS for the past twenty-five years and also honored over 350 clients who have been with LCIS for 15 plus years. Congratulations to all! After 25 years we adopted a new, modern logo. The revamped logo puts a more modern face to LCIS and presents a forward-looking and thinking organization while paying subtle homage to our old identity. You may have seen the new logo in the various newsletters. Take a look at the LCIS timeline in this edition to see what we have accomplished over the past 25 years. PRSRT STD US POSTAGE PAID Pasadena, CA PERMIT #740 INSURANCE SERVICES CLIENT SERVICES BUSINESS SERVICES FINANCING SERVICES RETURN SERVICE REQUESTED 1835 N. Fine Ave. Fresno, CA Landscape Contractors Insurance Services, Inc. We are also pleased to announce that in the first year over 1100 participants have joined Golden Oak Co-Op. As an insured Golden Oak Co-Op participant, in addition to our competitive insurance, rebate and equity programs you also have access to a unique selection of value added services. Last year we launched LCIS Business Services which includes added value services powered by BizAssure providing legal, safety, claim and IIPP reviews and consulting. This month we are excited to add our newest partner The Harvest Group Landscape Business Consultants. This partnership will provide clients with business training and customized consulting for landscapers. We are deeply committed to providing you, our valued client, with the Best-in-Class insurance products, services, tools, customer service, and assistance that you have come to know and expect of us. I would like to take this opportunity to thank you for choosing Landscape Contractors Insurance Services, Inc., as your insurance broker. Sincerely, Kim Ayala

2 LCIS Celebrates 25th Anniversary QUARTER CENTURY OF SERVICE Landscape Contractors Insurance Services celebrated its 25th Anniversary June 5th at its Fresno headquarters. Many clients, CLCA members and friends participated in the festivities. CLCA SJV MEMBER and golf aficionado Terry Mahlman, LCIS VP Business Development, enjoys the afternoon s activities with LCIS Board Member Keith Walton of Land Care, Inc. FRIENDS CELEBRATE Judi Smith of LCIS and LCIS Director Mickey Strauss enjoy catching up at the celebration in spite of the warm Fresno weather. APPRECIATION Kim Ayala, who recognized several long-time LCIS clients, is shown here presenting a 25-year certificate of appreciation to LCIS Director and Past CLCA State President Rich Angelo. HARVEST GROUP VIPS Bill Arman, Ed Laflamme and Steve Cesare, were among several presenters at the LCIS event. The Head Harvesters are frequent contributors to this publication. MOTHER/DAUGHTER TEAM Benefits and marketing guru Ashley Hissong and mom Kim Ayala welcome celebrants. Ashley has made presentations regarding Obamacare throughout the state. ENJOYING FESTIVITIES are LCIS rep Pam Kinne, Director Pete Dufau, LCIS rep and multi-clca Chapter member Dan Dvorak, and LCIS Secretary Nelson Colvin. PAST LCIS PRESIDENT Jerry Elson and his wife Brenda were involved when LCIS was founded 25 years ago, and are proud of its success. PRESIDENTIAL DUO LCIS Directors Barbara Alvarez and Pete Dufau also happen to be Past CLCA State Presidents, as were several attendees at the Fresno event. 2 GO-TO information source for the CLCA-SJV Chapter Newsletter is LCIS rep Ramon Simpson, shown here enjoying the celebration with his lovely wife Billie. TIME MANAGEMENT and other important business principles were the subjects of a discussion between CLCA Ambassador Charles Nunley and business coach Bill Arman. MAKING SURE all runs smoothly at the big 25th Anniversary party like that last-minute ice run is Mike Ayala shown with wife Kim. Congratulations to LCIS and the team that organized the great celebration.

3 Clients, Friends & Family Join in the Celebration BOARD MEMBER Lebo Newman enjoys the afternoon with LCIS reps Gil Gonzalez, Pam Kinne and Dan Dvorak. LCIS Team Members were gracious hosts and made sure the event ran smoothly. LIVE OAK LANDSCAPE S Frank Quaresma receives a 25 year award from Kim Ayala during the day s festivities. ASHLEY HISSONG, shown here with husband Jon, was deeply involved in the planning and coordination of the successful and fun-filled event. ENJOYING the special event are LCIS reps and long-time friends Mike Dunn and Ramon Simpson. 25 YEAR AWARD goes to Chris Hecht of Chris E. Hecht Design & Landscape Construction, Inc. Presenting is LCIC President/CEO Kim Ayala. VP OF SALES David Bloodgood, Joshua Parrish and Connie Carpenter enjoy the party and one another s company. LAND CARE, INC. VIP and Board Member Keith Walton is presented his 25 year award by Kim Ayala. ALL SMILES throughout the celebration are LCIS team members Janet Schoenfeld and Benita Hall. FIRST DEPENDABLE S Tom Raasch enjoys celebrating with old friends and associates Kim Ayala and Pete Dufau. THREE AMIGAS Maria Vera, Helen Rodela and Melissa Tetzlaff smiled a lot, greeted guests, and had fun all afternoon. KEY MEMBERS of the committee that helped to organize and stage our big 25th Anniversary Celebration gather for a group photo at the end of the evening. Great job! 3

4 u MISSION STATEMENT u To provide quality insurance products at competitive prices, along with superior service through our commitment of excellence to our customers and employees. More 25 th Anniversary Highlights GREETING 25th LCIS Anniversary guests as they arrive is Director of First Impressions Helen Rodela. Contact Us Toll-Free (800) Extension # Kim Ayala, President/CEO 511 Sharon Barroca, Program Operations Manager 572 David Bloodgood, Vice President of Sales 545 Connie Carpenter, Services Manager 552 Debbie Kirby, Administrative Manager 514 Terry Mahlman, Vice President Business Development 580 Janet Schoenfeld, Assistant Vice President of Accounting 513 Ashley Hissong, Agency Promotion & Development Manager 527 Lydia Coldren, Marketing Manager 583 Certificate Request Fax (800) LCIS Website KAISER PERMANENTE reps Deborah Murdock and Joanna Capriola enjoy the day s festivities with Ashley Hissong. GRASS MASTERS reps Larry and Carolyn Jack mingle with Certificates Supervisor Kim Saenz. 4

5 Safety Tips Summer 2014 Safety Tips for Chainsaw Use By Erick Farruggia, Safety Achievement, LLC Clip here to share with your crew! 5 One of the most potentially dangerous tools anyone can use is a chainsaw. Its reputation for colossal injury is further enhanced by films using chainsaws as weapons. But with proper training and enforcement of approved safety practices, this important tool can be of major benefit for landscapers and homeowners alike. Following are a few guidelines for the proper use of chainsaws: Get to Know Your Equipment The more you know about your saw, and all the tools and equipment you use, the better. Knowing how your tools and equipment operate will give you a better understanding of how to use them safely. Pre-Check Your Equipment Make sure the saw s engine is in good running order. A clean air filter, good spark plug and muffler will allow the engine to run better, making your work easier, as will keeping the chain sharp. You can use a heavy rag when handling the chain. Use Personal Protective Equipment When using a chainsaw use a high visible hard hat with face shield, eye protection, hearing protection (chain saws create high noise levels 95 to 115 dba), leather gloves with ballistic nylon reinforcement on the back (for grip, cut protection and absorb vibration), leg protection (trousers or chaps with sewn-in ballistic nylon pads; trousers that protect the belt line offer more protection from cuts than those that stop at the upper thigh), and protective footwear (the ones made of ballistic nylon offer the best cut protection). Only wear ANSI/NIOSH approved PPE. To improve communication between the crew, earmuffs with radio communication capabilities can be used. Fall protection devices must be used when working at heights. A visual inspection must be performed each time prior to using the fall protection device. A formal inspection must also be performed every 6 months (records must be kept). Experts do recommend replacing harnesses every five years (even when no damage is evident on the device). Three Sizes There are three ranges of saws, small, medium and large. Select your saw based on the job. Small 8-12 inch bar size, works best with small branches and 6-10 inch diameter trees. Medium inch bar size is good for frequent log cutting and felling of small trees inches in diameter. Large 20 inches plus is for large jobs and should only be used by well trained professionals. Follow the Maintenance Guidelines Each manufacturer will have its particular maintenance procedures and timelines for their equipment air filter, fuel filter, spark plug, lubrication, etc. so follow them closely. As a general rule the following steps should be taken before EVERY use: Clean/ adjust chain tension, check/service the chain oiling system, tighten all hardware, inspect fuel system, inspect the chain brake mechanism, and inspect the kickback (nose) guard. Fueling & Transporting Allow saw to cool before fueling. Use a funnel or pouring spout to prevent spills. Fuel the saw on bare ground. Move fuel container at least 10 feet from the saw before starting. Put the chain guard on the bar when not in use. Never carry a chainsaw in the passenger area of a vehicle. When carrying the saw in a vehicle, secure the saw from movement, keep the saw with fuel cap up to prevent the fuel from leaking. Also, keep it away from lanyards, harnesses, etc. to avoid damaging the PPE. When a worker needs to move the saw, have them carry it on their side with the bar chain cutting away from the body. Starting and Operating Many injuries occur during starting because the worker does not have control of the saw. The preferred method is to first place the saw on the ground. While holding the saw down securely with one hand, pull the starting cord straight up with the other. Trying to start the saw while holding it above the ground, may cause it to tip toward the leg and cause serious injury. The position of the thumbs is also very important for control of the saw. The user should close the loop while gripping the handles for more positive control. Avoiding Kickback Kickback occurs and can cause injury when the saw rotates back, or kicks back at the operator due to the nose of the saw contacting an object or obstruction. To minimize kickback danger, use a saw equipped with a chain brake or kickback guard. Hold the saw firmly with both hands, watch for twigs that can snag the chain, and don t pinch the chain while cutting the log. Saw with the lower part of the bar close to the bumper, not on the top near the nose. Maintain high saw speed when entering or leaving a cut. Never reach above your shoulder to cut, as the chain is too close to your face in this position. Cutting Do s and Don ts Avoid making cuts with the saw between your legs. Do not stand on a log and saw between your feet; stand to the side of the limb you are cutting. When operating, stand to the side of the saw, not directly behind it. Do not cut with others in line with the chain in case it breaks. Keep the chain out of the dirt and rocks. Do not cut when you are off balance or where you may trip over debris. Be sure the fallen tree is stable, and stand on the uphill side when removing limbs. Always keep both hands on the saw when cutting. Use a wedge to keep the log from binding the saw. Beware of limbs under tension, as they may spring back when tension is released. The preceding are some general guidelines only. It is suggested that your employees take an approved OSHA equipment safety course to ensure you maintain a safe workplace. Lastly, companies need to enforce safety rules to prevent serious accidents, and not wait until one has happened. Erick Farruggia is the President of Safety Achievement, LLC, a firm specializing in safety consulting and OSHA outreach training. Prior to his nine years in safety, Erick (a native of Argentina) worked for 12 years in the landscape industry. Erick Farruggia Safety Tips Wanted! Do you have some safety tips that have made a difference for your company? Send them to LCIS at the address below, ATTN: Editor, and they might appear as future Safety Tips of the Quarter to share with your fellow CLCA members N. Fine Ave., Fresno, CA (559) ph / (559) fx Website:

6 Consejos de Seguridad verano La motosierra es una de las herramientas más potencialmente peligrosas que cualquier persona pueda utilizar. Su reputación como causante de terribles lesiones es aún mayor gracias a las películas que utilizan motosierras como armas. Pero con el entrenamiento y la aplicación de prácticas de seguridad adecuadas y aprobadas, ésta importante herramienta puede ser de gran beneficio para los jardineros y propietarios por igual. A continuación se presentan algunas pautas para el uso adecuado de las motosierras: Conozca sus Herramientas Cuanto más sepa acerca de su motosierra, y todas las herramientas y equipos que utiliza, mejor será para usted. Saber cómo sus herramientas y equipos operan le dará una mejor comprensión de cómo utilizarlos de manera segura. Inspeccione el Equipo Antes de Usarlo Asegúrese de que el motor de la sierra se encuentra en buen estado. Un filtro de aire limpio, buena bujía y un buen silenciador permitirá que el motor funcione mejor, haciendo que su trabajo sea más fácil, y manteniendo la cadena afilada. Puede utilizar un trapo grueso al manipular la cadena. Utilice Equipo de Protección Personal Cuando esté operando una motosierra use un casco altamente visible con protección para la cara, lentes de protección, protección auditiva (las motosierras crean altos niveles de ruido 95 a 115 dba), guantes de cuero con refuerzo de nylon balístico en la parte posterior (para un mayor agarre, protección contra cortes y absorción de vibración), protección para las piernas (cubre pantalones o chaparreras con almohadillas de nylon balístico; los pantalones que van hasta la cintura ofrecen más protección contra posibles cortaduras que los que terminan en la parte superior del muslo), y calzado de protección (los hechos con nylon balístico ofrecen la mejor protección contra cortes). Sólo use Equipo de Protección Personal aprobado por ANSI / NIOSH. Para mejorar la comunicación entre los miembros del equipo, se pueden utilizar auriculares con comunicación de radio. Cuando se está trabajando en altura deberá usarse el equipo para prevenir caídas. Cada vez que sea necesario utilizar el dispositivo de protección contra caídas deberá realizarse una inspección visual del arnés, sogas etc., además de esto una inspección formal debe realizarse cada 6 meses por una persona competente (deberán mantenerse registros de las inspecciones). Los expertos recomiendan reemplazar los arneses cada cinco años (incluso cuando no hay daños evidentes en el dispositivo). Tres Tamaños Hay tres gamas de motosierras, pequeñas, medianas y grandes. Seleccione su sierra basado en el trabajo. Pequeño Barra de 8-12 pulgadas, funciona mejor con pequeñas Consejos de Seguridad para el Uso de la Motosierra Por Erick Farruggia Safety Achievement LLC ramas y árboles de 6 a 10 pulgadas de diámetro. Mediano Barra de pulgadas es bueno para cortar troncos frecuentemente y para talar árboles pequeños de pulgadas de diámetro. Grande Barra de 20 y más pulgadas es útil para trabajos grandes y sólo deben ser utilizados por profesionales bien entrenados. Siga las Directrices de Mantenimiento Cada fabricante tiene sus propios plazos y procedimientos de mantenimiento cambio de filtro de aire, filtro de combustible, bujías, lubricación, etc. conózcalos. Como regla general, los siguientes pasos deben tomarse antes de CADA USO: Limpieza / ajuste de tensión de la cadena, comprobar / servicio del sistema de lubricación de la cadena, apriete toda la tornillería, inspeccionar el sistema de combustible, inspeccionar el mecanismo de freno de la cadena, e inspeccionar guarda anti contragolpe. Llenado de Combustible y Transporte Permita que la sierra se enfríe antes de poner combustible. Use un embudo o pico vertedor para evitar derrames. Ponga combustible en la motosierra teniendo como base suelo desnudo. Mueva el contenedor de combustible por lo menos 10 pies de la sierra antes de comenzar. Cuando no esté en uso coloque el protector de la cadena en la barra. Nunca lleve una motosierra en el área de pasajeros de un vehículo. Al transportar una motosierra en un vehículo, asegúrese que la sierra no tenga movimiento, mantenga la motosierra con su tapa de combustible bien ajustada para impedir la fuga de éste y mantenerlo alejado de cuerdas de seguridad, arneses, etc., para evitar su daño. Cuando esté trabajando y necesite mover la motosierra de un lugar a otro llévela a su lado con la cadena de barra de corte alejada de su cuerpo. Inicio y Operación Muchas lesiones ocurren durante el arranque cuando el trabajador no tiene control de la motosierra. El método preferido es colocar la sierra en el suelo. Mientras sostiene la sierra de forma segura con una mano, con la otra tire del cordón de arranque hacia arriba. Tratar de arrancar la motosierra mientras la sostiene sin apoyarla en el suelo, el movimiento que usted realiza puede ocasionar que la motosierra toque una pierna y causar lesiones muy serias. La posición de los pulgares también es muy importante para el control de la sierra. Para un mejor control el usuario deberá mantener la mano bien cerrada alrededor del asa de la motosierra. Evitar el Retroceso El retroceso se produce cuando la sierra patea hacia atrás o hacia el operador debido a que la punta de la sierra entra en contacto con un objeto u obstrucción; este efecto de pateo puede causar lesiones graves. Para reducir al mínimo el peligro de contragolpe, utilice una sierra equipada con freno de cadena o guarda de contragolpe. Sujete la sierra firmemente con ambas manos, tenga cuidado con las ramas que pueden enredarse en la cadena, y no pellizque la cadena durante el corte del tronco. Posicione la motosierra con la parte inferior de la barra cerca del paragolpes, no en la parte superior cerca de la nariz. Mantenga alta la velocidad de la motosierra al entrar o salir de un corte. Nunca introduzca la mano por encima de su hombro para cortar, ya que la cadena está demasiado cerca de su rostro en ésta posición. Cortar lo que Hacer y no Hacer Evite hacer cortes que queden entre las piernas con la motosierra. No suba a un tronco y ponga la motosierra entre sus pies; póngase al lado de la rama que esté cortando. Cuando esté usando la motosierra, póngase al lado de la motosierra, no directamente detrás de ésta. No corte cuando otros compañeros de trabajo estén cerca por si acaso de que la cadena se rompa. Mantenga la cadena fuera de la tierra y las rocas. No corte cuando usted está fuera de balance o donde usted puede tropezar con escombros. Asegúrese de que el árbol caído esté estable, y manténgase en la parte más elevada al remover ramas. Mantenga siempre ambas manos en la motosierra cuando esté podando. Utilice una cuña para evitar que un tronco grande pellizque o trabe la cadena de la motosierra durante el corte. Tenga cuidado con las ramas que tengan tensión, ya que pueden rebotar cuando estas se liberan durante el corte. Lo anterior son sólo algunas pautas generales. Se sugiere que sus empleados reciban un curso de seguridad de los equipos aprobados por OSHA para así mantener un lugar de trabajo seguro. También sugiero a la gerencia el hacer cumplir las reglas de seguridad antes de que un grave accidente lo obligue a implementarlas. Erick Farruggia es el Presidente de Safety Achievement LLC, una firma especializada en consultoría de seguridad industrial y entrenamiento en estándares OSHA. Antes de sus 9 años en la seguridad, Erick (natural de Argentina) trabajó durante 12 años en la industria de la jardinería. Erick Farruggia 1835 N. Fine Ave., Fresno, CA (559) ph / (559) fx Website:

7 Employee Spotlight The atmosphere at LCIS is unlike anywhere else I have worked. Everybody is rooting for you to succeed. Danielle Judge, Account Manager, started with LCIS in Danielle has been in the industry for several years but says, The atmosphere at LCIS is unlike anywhere else I have worked. Everybody is rooting for you to succeed. Danielle s loves are her nephew, three nieces, two cats and her four fur babies Jake, Brownie, Trenton and Ruger who were all rescued from local shelters. And if Danielle s profound love of her fur babies wasn t enough, in her free time she enjoys volunteering at the Fresno Bully Rescue. Maria Vera, Services Clerical Assistant, is one of LCIS newest employees, beginning in January She is a huge help to everyone at LCIS. Maria says, I like working for LCIS because it s a unique agency. Everyone here is so friendly and is willing to help out Everyone here is so friendly and is willing to help out with anything. with anything. My department feels like a family and I enjoy coming to work every day. One of her favorite quotes, Find a job you love and you ll never work a day in your life. Maria is a huge football and boxing fan. She enjoys traveling out of town to watch boxing fights live with her family. She also has a much more reserved side and loves simply winding down with a good book and a coffee. Her favorite book thus far is The Big Short, which is about the stock market crash in WC Guru CCWC Conference Highlights I recently attended the California Coalition on Workers Terry Compensation Mahlman (CCWC) Annual VP Business Conference and would Development like to share with you some of the highlights of the conference. For those of you who are not familiar with CCWC, the objective of this coalition is to create a more balanced and efficient workers compensation system. They were instrumental in developing the reforms in SB 863, signed into law in For more information about CCWC, you can check out their website or contact our own Nelson Colvin, who is a Board Member of CCWC. A great deal of the conference was focused on the results of the SB 863 reforms, as well as discussing current trends and employer/insurance company strategies for mitigating costs of claims. Here are some key discussion areas: Shauna Lucero, Bond Specialist, who was born in Germany on a Military base but grew up in Madera, CA, has been with LCIS since Prior to LCIS, Shauna worked in the industry for 10 years at another agency and prior to that she worked for a general contractor. With those careers combined, it gave her a wonderful foundation for being able to understand contractors needs. Shauna says, LCIS is very warm and welcoming. Being from a small town, I like the hometown feel I get here at LCIS. Shauna is the proud mother of a daughter who is a classic example of an overachiever and two sons one of whom is living his dream in New York and the other who is joining the Marines this year! In Shauna s spare time, she enjoys everything about the outdoors. She is an avid camper and hiker, and she loves to fish! In addition to her adventures The purpose of the SB 863 reforms was to increase benefits to injured workers while creating savings through system changes that would more than offset the benefit increases. The goal was to achieve a 2 to 1 savings to benefit ratio, and while that has not be achieved, a recent Division of Industrial Relations (DIR) study (available on the DIR website SB863AssessmentWCReforms.pdf.) determined that it has helped mitigate WC insurance rates by 3%. The savings are expected to grow as all of the reforms become fully implemented. The reform that has most benefitted from SB 863 are the lien issues that have been choking the WC system - causing backlogs in the court, lengthy litigation and slow resolution of claims. This is primarily a Southern CA phenomenon. In 2011, there were 470,000 liens filed in the WC system. Following implementation of filing fees and lien activation fees, that number was cut by more than 50% Continued on Page 8 outdoors, she s quite the crafty woman, who likes to salvage and refinish old items. Her current project is turning an old door into a headboard. Claudette Stockbridge, Commercial Lines Rater, has been with LCIS since Claudette has been in the industry since 1983 and has held positions ranging from Loss Control Representative Secretary to Claims Clerk and now Commercial Lines Rater. Claudette states, I enjoy working for LCIS because of the people. We are a closeknit family type of office and we all try to help each other get the job done! Outside of work, Claudette, has a love for her dogs. She has had as many as four dogs at one time. She currently has two dogs, a silky terrier and a terrier mix. Claudette s favorites include: camping, spending time at the beach, reading murder mysteries and watching suspense movies. 7

8 Harvest Group and LCIS Become Affiliate Partners David Bloodgood VP of Sales We are pleased to announce our new affiliation with the business coaching firm The Harvest Group, and their Head Harvesters Bill Arman and Ed Laflamme LIC. With decades of industry specific management and marketing expertise, they bring additional depth of knowledge to our Account Managers and Account Executives, helping them to better understand what landscape owners go through on a day-to-day basis. They will also provide our members added knowledge in the form of webinars, seminars, and as part of the new Harvest Academy (www.harvestwayacademy.com) an extremely valuable online resource. Ed Laflamme has been in the Green Industry for the past 43 years. He earned the PLANET, LIC certification, Landscape Industry Professional and authored the hugely popular book Green Side Up Straight Talk on Growing and Operating a Profitable Landscaping Business. While Ed was building the largest landscape maintenance company in Connecticut, Bill Arman was enjoying a nearly 30 year career at ValleyCrest Companies. At ValleyCrest, Bill went from apprentice gardener level to becoming the Regional VP of Southern California, and VP of Human Resources. After his vast experience working on recruiting for the largest landscape company in the country, Bill decided to share his expertise by writing the book, The Harvest Way for Recruiting & Hiring The Right People, available at www. HarvestLandscapeConsulting.com. Harvesters Bill and Ed co-founded The Harvest Group in 2007 and now serve Harvest Group members in 42 states and 5 countries. Their purpose is to help landscape company owners harvest their potential, making them even more successful. We know that just about anyone can provide an insurance quote and we understand that you have many choices when selecting your insurance professional. Your clients call you because they know you are a specialist in your field of expertise, and with over 25 years of landscape industry insurance experience, LCIS remains the benchmark when it comes to protecting your business and offering leading edge business services. We have now added to these benefits industry specific, margin driving consultative solutions through our newest affiliate partner, The Harvest Group. Remember, price is what you pay today while cost is what you eventually pay once it is all said and done. While our focus at LCIS is to help you with both, the true long term savings comes in evaluating and improving your costs. This has long been the goal of LCIS and is now the goal of our affiliate partnerships (BizAssure and The Harvest Group) offered through Golden Oak. Please stay tuned for more great news regarding our affiliate partnership offerings, and as Bill and Ed like to say, Now go harvest your potential! I wish you continued success and growth. David R. Bloodgood, CIC VP of Sales 8 WC Guru CCWC Conference Highlights continued from Page 7 to 213,000 liens in The fees eliminated many of the frivolous liens filed by medical providers whose treatment was denied or medical fees reduced to the CA fee schedules. The DIR estimates savings to CA employers and insurers at greater than $270 million per year. Effective 2013, the reforms removed disputes regarding medical treatment from the court system to an independent medical review (IMR) process. With the IMR process, physicians employed by the contracted IMR vendor, Maximus, make decisions on the appropriateness of treatment, applying evidence-based treatment guidelines adopted by the State. The DIR study shows that IMR is upholding insurance carrier utilization review decisions in more than 80% of the IMR cases. Half of the IMR cases are for insurance company denials of pharmaceuticals, such as opioids. The results of the IMR process have been favorable, and have taken medical determinations out of the hands of liberal WC Judges, who generally approved the disputed treatments. Unfortunately, the IMR process has been bogged down because employee-retained attorneys file an IMR dispute on every denial of treatment. The IMR decisions sometimes take up to 9 months for a decision, often extending temporary disability and delaying appropriate treatment. The DIR had estimated the IMR process would result in 4,000 IMR cases per month. The actual number was nearly 20,000 cases per month. Following increased staffing and process changes by Maximus, they are in a catch-up mode and are expected to be meeting their 45-day state-mandated timeframe by November Despite the benefits of the reforms, WC rates in CA continue to rise. CA continues to rank near the top for the highest WC rates across the United States. The average cost of a California indemnity claim (involving temporary disability and/or permanent disability) for 2013 is projected at just under $87,000! Of that, 58% are medical costs. Indemnity costs have remained relatively stable, while medical costs have risen 51% over the past eight years. Add to that an increase in claim frequency four of the past five years (while other states have declining claim frequencies) and insurance carriers remain pessimistic regarding their ability to make money writing California workers compensation especially in Southern California. Key areas of focus going forward for the DIR and insurance carriers include: Controlling medical inflation, with an emphasis on controlling use of opioids/narcotics and revision of the Medical Treatment Utilization Schedule. Eliminating the delays within the IMR process. Streamlining the Qualified Medical Evaluation (QME) by providing an online system to produce immediate panels. Development and implementation of fee schedules for copy services, interpreters and home health care. As always, please feel free to contact me if you would like to obtain further information on any issues relating to workers compensation.

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