Our Response to COVID-19
The coronavirus disease (COVID-19) continues to affect many regions of the world and the full impact of this virus is still unfolding.
We’re committed to taking proactive measures to safeguard our employees, agents, policyholders and injured workers during this challenging crisis. We’re also offering necessary support to lesson the impact of COVID-19 through our People First Relief Program.
For the additional benefit of our customers, below are several commonly asked questions and resources that will assist you in understanding our response to this unprecedented situation.
Senate Bill 1159
The California Legislature recently approved Senate Bill 1159, which will impact COVID-19 cases amongst all workers. The bill went into effect Sept. 17, 2020. The full text of the bill can be found here.
When an employer knows that an employee has tested positive for COVID-19, they must report it to their claim administrator within three business days via fax or email.
Employers will face a $10,000 fine if there are false reports or they fail to submit information. For a full summary of the bill, reporting instructions and frequently asked questions, please visit our Senate Bill 1159 page.
Information for Agents
Expediting Midterm Payroll Changes
AF Group (including Accident Fund, Third Coast Underwriters, United Heartland and CompWest) is committed to helping our policyholders during this unprecedented national health crisis by providing premium relief to businesses that have slowed or temporarily ceased operations by offering midterm payroll changes on an expedited basis.
If you are requesting payroll reduction to $0, please reach out to your business development consultant to discuss whether the business is still operational. Our preference is that you keep policy payrolls no lower than $10,000. Please note that all payroll changes are done on an annual basis, not pro-rata.
For insureds who pay premium through our AccuPremium payroll reporting option (not applicable to United Heartland), their premiums are determined by actual payroll. They should continue to report payrolls as they typically would each time — and if payrolls are lower, report accordingly within AccuPremium and the system will generate a lower premium amount due on their policy. If their firm is temporarily closed, they should continue to report $0 payroll based on their payroll reporting frequency for the duration of the closure. As business resumes under “normal” conditions, premiums will be based on the actual payroll they enter.
We will contact our agents later in the year to inquire about policies that have had significant decreases in payroll. In order to avoid large additional premium at audit, we will want to raise payrolls when policyholders’ businesses reopen to reflect realistic annual levels.
If you have any questions about reducing payrolls during this time, please call your business development consultant.
For Our Policyholders:
Reopening Operations and Preventing Virus Spread
- Accident Fund Preventing Virus Spread Landing Page
- 3CU Preventing Virus Spread Landing Page
- CompWest Preventing Virus Spread Landing Page
- United Heartland Preventing Virus Spread Landing Page
Cal/OSHA Emergency Temporary Standards
Effective Nov. 30, 2020, the California Office of Administrative Law implemented the Cal/OSHA Emergency Temporary Standards. These regulations change your obligations regarding COVID-19 cases in the workplace.
For further information, please review the following Cal/OSHA resources:
Preparing Your Business
As the coronavirus disease 2019 (COVID-19) outbreak continues to spread and attract significant media and public attention, we want to provide you with assurance that, as your workers’ compensation provider, we are working diligently to ensure we are prepared to conduct business without interruption during this evolving health situation.
Helping to protect your business and employees is our highest priority, and that’s why we encourage you prepare for COVID-19 (and other potential health risks) by:
- Making sure your business continuity plans are in place to cover any challenges presented by potential large-scale disruptions (including review of work-from-home and travel policies)
- Reviewing best practices related to preparing and maintaining a healthy work environment, such as this information provided by the World Health Organization
- Monitoring the Centers for Disease Control and Prevention for the latest information on the status, progression and prevention of COVID-19
While the full outcome of this situation is yet unknown, we are confident that together, we can each do our part to protect our workplaces and keep employees safe and healthy.
Thank you for the opportunity to serve your business.
Submitting a Claim
As the coronavirus disease 2019 (COVID-19) outbreak continues to spread, we’ve started receiving an increased number of inquiries regarding work-related COVID-19 claims. Because coverage varies with workers’ compensation statutes from state-to-state, any case reported would be evaluated based on the specific details/circumstances before determining if the claim was compensable.
Our recommendation is that all potential work-related COVID-19 claims be submitted so our claim representatives can investigate them properly. We have implemented our infectious disease claim handling protocols and compensability will be based on the investigation and fact pattern of each claim, including:
- The individual facts and merits of the actual claim (non-hypothetical)
- The individual workers’ compensation statutes and case law of the specific state
- Any further direction from a political entity
It’s important to note that no one factor will determine whether an COVID-19-related illness is compensable – all reported cases will be evaluated individually. If a claim is reported, but is closed with no applicable claim costs, it will not impact the workers’ compensation premium or experience modifier.
Thank you, as always, for your continued partnership as we work together to keep workplaces safe.
The resources below will help you gather pertinent details about a COVID-19 case in the workplace. A claim must still be filed through the regular process
For COVID-19 claims in the state of California, please be sure to visit our Senate Bill 1159 page.
With the continuing spread of the coronavirus disease 2019 (COVID-19) and subsequent closure of many businesses, we understand that some of our customers will struggle to make timely premium and/or audit payments. As your insurance partner, we want to provide the assurance that we will work with our policyholders to accommodate requests regarding payments or non-pay cancellations.
We are taking several steps to assist in these situations. First, we are suspending all non-pay cancellation actions for 60 days, beginning Monday, March 23, 2020. This should provide respite from financial obligations for businesses especially hurt by reduced business. Additionally, we are committed to working with our policyholders who need to reduce payrolls on a temporary basis. We will also offer payment options for policyholders struggling to make recent audit payments.
Agents are encouraged to contact us — or policyholders can contact us directly — to make arrangements or exceptions, if this becomes necessary. We will review each exception on an individual basis and work with the agent and policyholder to determine an acceptable solution. Note that if we do not receive communication from either the agent or customer, we will follow normal payment and delinquency procedures.
For additional details regarding payroll changes, payment exceptions and on-site Loss Control and Audit visits, please see our frequently asked questions below.
We greatly appreciate your continued partnership as we work together to keep people safe.
Preparing for Premium Audit during COVID-19
It is customary for your insurance company to perform a premium audit at the end of your one-year workers’ compensation term. This allows us to compare the estimated payrolls used to rate your policy at the beginning of the term with the actual payroll paid during the year. Keeping careful and complete records helps ensure the accuracy of the audit, which has become even more critical with COVID-19. The following tips will help you prepare for your annual premium audit.
Many businesses have had to reduce staff or pause operations during government shutdowns due to COVID-19. This changes the exposure and payrolls on your policy and will have an impact on your total premium.
As always, keep careful records of payroll for employees who perform functions different than the governing classification, or main function, of your business.
Employees whose job duties were modified during the pandemic: This includes employees who used to perform the main function of your business and were temporarily moved to reduced duties, such as clerical work, during the pandemic. It is important to note the date their duties changed and exactly what their new duties entailed – as well as the date that each employee went back to their normal job functions.
Employees who were furloughed due to government mandated shutdown: This includes employees you continued to pay but were sent home with no job duties at all. There must be no possibility of these employees experiencing a workplace injury during this time. This payroll may be assigned to classification 0012 with a zero rate, if this applies in your state. (At time of publication, the furloughed employee code has not been adopted by Oregon or Texas.) Individual state regulations on this topic may vary. Detailed records, including the date of the furlough and the return-to-work date are important.
Employees who became telecommuters during the pandemic: Many employees who can perform their job duties from home began working remotely to reduce their exposure to COVID-19. These employees can be eligible for a reduced rate on their workers’ compensation payroll, so careful tracking of the time work-from-home duties began and ended is important.
If you have any questions on how your workers’ compensation premium might be affected during the COVID-19 health crisis, please contact your agent.
Audit Information for California Policyholders
The state of California does not permit insurance companies to waive audits. However, under the current circumstances, we can pause the estimation of non-responsive policyholders. Once the stay-at-home order is lifted, these audits will be revisited.
The Workers’ Compensation Insurance Rating Bureau (WCIRB) still requires us to provide them with final audit information within 120 days of policy expiration. We will follow up with policyholders that are directly impacted by COVID-19 and unable to provide us with the necessary audit documentation to complete the audit when the crisis abates.
Currently, our staff auditors are conducting remote physical audits. Staff will not go on-site until the stay-at-home order has been lifted and we’ve determined it’s safe to do so. Remote physical audits are conducted by our staff and vendor auditors via email and phone. In addition, we’ll be utilizing mail and voluntary audit processes.
Policyholders are encouraged to continue reporting their actual payrolls to us through their payroll vendor if they’re currently on one of our pay-as-you-go programs (i.e. AccuPremium) or through their agent so we can endorse their current policy appropriately.
Frequently Asked Questions
Q: Policyholders are having to reduce or eliminate payrolls due to a rapidly changing business environment. Policyholders have concerns about their ability to pay their insurance premium. How is AF Group going to handle these situations?
A: We are taking several steps to assist in these situations. First, we are suspending all non-pay cancellation actions across all brands for 60 days, beginning Monday, March 23, 2020. This should provide respite from financial obligations for businesses especially hurt by reduced business.
Additionally, we are committed to working with our policyholders who need to reduce payrolls on a temporary basis. We will also offer payment options for policyholders struggling to make recent audit payments.
Q: Some policyholders are having to deploy their employees in new or additional roles to help them cope with the downturn in their business. How will AF Group handle these situations at audit time?
A: We will be as flexible as possible with audits, assuming policyholders keep detailed payroll records of employees whose primary duties have changed. In these situations, we will allow payroll to be split among class codes (e.g., a restaurant worker becomes a driver for home delivery).
Q: There may be delays due to remote work situations in binding coverage on policies that have been quoted with an AF Group company. How will you handle the backdating of policy binding?
A: We will follow our standard backdating process of obtaining a ‘no known loss’ letter to verify the account hasn’t suffered losses during the time period between the bind date and the order.
Q: How will AF Group handle non-renewals of policies during this time?
A: Non-renewals will be handled on a case-by-case basis, but we will try to limit those that occur over the next 60 days. If necessary, we will look at extending coverage on a short-term basis to allow non-renewed policyholders time to secure replacement coverage. Please discuss any pending non-renewals with your business development consultant or underwriter.
Q: How will you handle payroll reporting and payments for policyholders on the AccuPremium pay-as-you-go program?
A: Our AccuPremium servicing company is providing assistance to customers who need to report zero or lower payroll. Also, as mentioned above, we will be suspending all non-pay cancellations for a 60-day period to allow our policyholders additional time to make their payments.
Q: How will we handle onsite requirements for loss control visits?
A: For those insureds who cannot or will not accommodate onsite servicing, we may be willing to delay in person visits or explore alternative options prior to quoting, binding or issuance. Alternatives may include completing a phone or virtual survey. The expectation is that as soon as practical, we will work with policyholders to reschedule onsite visits.
Q: How will AF Group handle onsite premium audits?
A: If an onsite audit is not possible during this time of public health crisis, we will make arrangements to meet at a different location or obtain the needed records electronically. As mentioned above, we will suspend any rules against splitting payroll for individual employees as long as the employer is able to provide documentation of payroll splits during the policy period.
Visiting Our Facilities
In the interest of health and safety, any visitors, contractors or other individuals entering an AF Group facility or office will be required to fill out a questionnaire about their current travel activity prior to being allowed entry.
Guidance for Disinfecting Workplaces
As businesses and public spaces prepare to reopen, it’s important to properly clean and disinfect all surfaces to help reduce the risk of exposure to COVID-19. Click here for guidance from the Centers for Disease Control.
Expedite Your Payments – Enroll for EFT Today!
March 25, 2020
With the disruptions that COVID-19 continues to cause to standard business practices, we encourage injured workers to utilize our Electronic Funds Transfer (EFT) option for receiving payments. Having checks deposited directly into a bank account eliminates the need for in-person banking and minimizes interruption that could occur in the printing and mailing cycle.
Follow these short steps to enroll for EFT
- Click to your workers’ compensation carrier’s website below
- Select ‘Login’ at the top of the page, then ‘Injured Worker Login’
- Add bank information through the ‘Manage Bank Info’ option in the top right of the menu
Accident Fund: 866-206-5851
United Heartland: 800-258-2667
Third Coast Underwriters: 866-641-2328
Contact our Service Center at the applicable phone number above should you have any questions or issues with enrollment.
*Injured workers with litigated claims do not have online claim access. Please call our Service Center to enroll.
**Please note that EFT is not an option for Wisconsin Districts Mutual Insurance or League of Wisconsin Municipalities Mutual Insurance program claims administered by United Heartland.
Arkansas Insurance Department — Consumer Contact Email Address
Idaho Insurance Department — Consumer Contact Email Address
Illinois Department of Insurance — Consumer Contact Email
To file a complaint:
For New Jersey Policyholders:
Per NJ Insurance Commissioner Bulletin 20-15, you have the option of electing a 90-day grace period to pay insurance premiums. You can elect this 90-day emergency grace period to begin retroactively on April 1, 2020 or to opt for the grace period to begin on May 1, 2020. During the elected 90-day period, we are waiving all late fees and have a moratorium on non-pay cancellations. After the moratorium is lifted, you will have the option of breaking your outstanding premium into installments of up to 12 months. In order to choose these options, you will need to call our Service Center and talk to a customer service representative at 1-866-206-5851.