• Although workers' compensation programs work well, they are limited by the reliance on the legislative process in each state
  • Option programs are flexible, nimble and better able to incorporate rapid marketplace changes for the betterment of injured workers
  • Many employers want to pay better benefits than Workers' Compensation for legitimately injured workers.  The Option allows easy program customization rather than being limited to one size fits all workers' compensation mandate approach

 

What's more, the simplicity & efficiency of Option programs has another benefit, it's a friendly environment for quality medical doctors!

Option Group Health

Two Easy Ways to Execute:

  1. Employer may voluntarily elect, or insurance carrier/TPA may implement by employer individually or across all employer clients

  2. Implement / Communicate







Impact Example:
Closed Formulary
Widespread use for over 15 years

Workers' Comp

Seven Challenging Steps to Execute:

  1. Common process:  Proposed legislation drafted state by state & House vs. Senate

  2. Committee discusses & votes

  3. Revised bills

  4. Vote by House & Senate Separately

  5. Governor Signature

  6. Rules Adopted

  7. Implement / Communicate

Same Impact Example:
Closed Formulary
As of 1/1/16 23 States still do not have a drug formulary*

*According to WCRI 2016 Annual Report, page 6.