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 remain committed to taking proactive measures to safeguard our employees, agents, policyholders and injured workers during this crisis. For the benefit of our customers, below are several commonly asked questions and resources that will assist you in understanding our response to this situation.
Senate Bill 1159
The California Legislature approved Senate Bill 1159, which impacts 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.
For Our Policyholders:
Reopening Operations and Preventing Virus Spread
Information on disinfection, distancing and hygiene best practices for a variety of industries:
- 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
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
Submitting a Claim
We have received 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.
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.
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: 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.. 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.
Q: How will we handle onsite requirements for loss control visits?
A: We are currently utilizing alternative methods such as phone and virtual surveys. The expectation is that as soon as practical and safe, we will work with policyholders to schedule 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.
Q: Are COVID-19 claims factored into my Experience Modification calculation?
A: NCCI (National Council on Compensation Insurance) and all independent state rating bureaus have decided to exclude claims attributable to the COVID-19 pandemic from experience rating. NCCI recommended this action for the following reasons:
- COVID-19 pandemic claims may not be a good predictor of safety practices.
- COVID-19 pandemic claims are unlikely to be a reliable predictor of an employer’s future claims costs or whether there will be a pandemic in the future.
- It’s also appropriate to exclude claims attributable to the COVID-19 pandemic from various state merit rating plans (where applicable) because these plans base the applicable credit or debit percentage on the number of claims reported during a specified period of time.
Please refer to NCCI or the applicable independent state rating bureau with additional questions – or click on the following NCCI circulars.
Also see Submitting a Claim.
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!
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.
For Oregon Policyholders:
State of Pennsylvania webpages dedicated to the Coronavirus issue