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Excess Workers’ Compensation Assumed Reinsurance Large Deductible Group Captives

MECC 2015

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Page 1: MECC 2015

Excess Workers’ Compensation

Assumed Reinsurance

Large Deductible

Group Captives

Page 2: MECC 2015

about

MECCSince its formation in 1986, MECC has focused exclusively on providing workers’ compensation excess insurance products to individualemployers, groups and insurance companies nationwide. While thepolicy coverages offered by carriers may look similar, whatdifferentiates MECC is our approach to helping customersachieve best practice performance in their workers’compensation program. MECC focuses on helpingcustomers take greater control of their costs byproviding innovative solutions that will lower theirtotal cost of risk.

Superior Strength

Page 3: MECC 2015

• Superior Strength

• Early Identification & Intervention

• Best-In-Class Excess Claims Management

• Willing to Invest in Better Solutions to Achieve Better Outcomes

A+A.M. Best Rating:

(Superior),FSC XV ($2 Billion or Greater)

MECC is a member company of W.R. Berkley Corporation,a Fortune 500 company.

Page 4: MECC 2015

products

Workers’ Compensation Excess Insurance Products

We provide tailored workers’ compensation excess insurance

products that meet the unique needs of individual employers,

groups and insurance companies, nationwide. Industries include,

but are not limited to: Manufacturing, Healthcare, Education,

Public Entities, Agriculture, Construction, Transportation,

Non-Profit and Retail.

Page 5: MECC 2015

COVERAGE• Excess Workers’ Compensation: Individual & Group Self-Insurance

• Assumed Reinsurance

• Group Captives

• Large Deductible

DISTRIBUTIONMECC distributes its insurance products

and effective solutions through a nationwide

agency network, which is supported by

MECC’s underwriting and field sales support

team. Our sales and underwriting professionals

work with agents to tailor coverage and

services to the specific needs of each client.

Page 6: MECC 2015

services

Willing to Invest in Better Solutions to Achieve Better Outcomes

MECC understands the importance of creating a culture of safety,

as well as best-in-class excess claims management. Developing

and maintaining an effective program takes time and

resources. Our services are available to supplement

and strengthen your program.

Page 7: MECC 2015

CONSULTING& ONLINE RESOURCES• Industry Practice Leaders (Education / Healthcare / Public Entity)

• Client Advisors

• Large-Claim Expertise (Pharmacology/Medical/Legal)

• Predictive Analytics on Migratory Claims

• Performance Benchmarking Analytics

• Frequency & Severity Analytics

• Web Seminars

• Return To Work Resources

• On-site Loss Prevention

• Vendor Partners

Page 8: MECC 2015

claimsWith caseloads that are 50% below the industry

average, you can rest assured that we will be able to

devote the time required to provide consultation to

help customers manage the most complex claims,

starting on day one.

Best-In-Class Excess Claims Management

Page 9: MECC 2015

CLAIMS EXPERTISEMECC clients have access to the most experienced and respected excess workers’ compensation claims professionals and best-in-class resourcesin the industry.• Medical Director (Physician)• Medical Management Consultants (Registered Nurses)• Claim Analysts• Claim Attorneys• Specialty Vendors• Top-Rated Centers of Excellence• Medicare Set Asides• Opioid Management• Settlements• Pharmacy Benefit Management• Peer to Peer Reviews• Return to Work• Bill Negotiations• Medical Intervention• Functional Restoration• Catastrophic Ancillary Services• Home Modification Services• Investigations• Predictive Analytics

Page 10: MECC 2015

Early Identification & Intervention

predictive analytics

Page 11: MECC 2015

MECC’s early identification and intervention

strategy consists of two predictive models:

Model #1 This model identifies claims likely to exceed

$50K. Our clients are able to prioritize their

claims and align the proper interventions to

improve the injured worker’s quality of life,

ultimately saving money in lower claim costs.

Model #2For claims predicted to exceed the self-insured

retention, MECC’s best-in-class excess claims

experts apply effective intervention strategies

that result in better outcomes for all.

Page 12: MECC 2015

reportsMECC clients have full access to their workers’ compensation program

data. These reports include benchmark, performance matrix, policy

coverage terms, and total cost of risk.

Page 13: MECC 2015

BENCHMARKThis report shows multiple views of how your workers’ compensation program is currently performing compared to your peers.

PERFORMANCE MATRIXSee how your claim frequency and average cost per claim compare to your unique benchmark expectation.

POLICY COVERAGE TERMSReview your current and historical policycoverage terms with MECC.

TOTAL COST OF RISKThis report shows you the impact of alllosses and expenses associated with on the job injuries and their administration for each policy period.

Page 14: MECC 2015

optum

Opioid Defense Manager is designed to protect employees, physicians and employers by

reducing inappropriate drug use while maintaining the necessary balance to provide pain

relief for the claimant.

MECC has partnered with Optum, an innovative, best-in-class provider of claim

management solutions using advanced technology that recognizes at-risk clamants.

Page 15: MECC 2015

PHARMACY BENEFIT MANAGEMENT (PBM)

OTHER SERVICES• Clinical Services• Durable Medical Equipment• Home Health Services• Home & Vehicle Modifications• Orthotics & Prosthetics• Electrotherapy• Translation Services• Transportation Services

Page 16: MECC 2015

msa optimizerOur nurses proactively work with your claim professionals prior

to settlement discussions and MSA preparation to engage

expert clinical interventions. This includes reducing unnecessary

treatment, prescription costs and improving injured

worker function, leading to lower ongoing

medical costs. This is a free service on your

reportable excess claims.

Page 17: MECC 2015

WHAT IS AN MSA?A Medicare Set Aside (MSA) is the tool used to fund future Medicare-covered expenses that arise from a Medicare beneficiary’s work related injury. MSAs are the recommended methos to protect Medicare’s interests..

HOW IS THE MSA AMOUNTDETERMINED?The amount is determined after a reviewof lifetime projected medical services iscompleted by a third party vendor and then submitted to Centers for Medicare andMedicaid Services (CMS) for approval.Medical cost projections for individualMSAs vary dramatically among vendors.MSA submissions that are “under-estimated” can be increased substantially by CMS; those that are “over-estimated” can leave money on the table and be an unnecessary financial burden to the employer.

Page 18: MECC 2015

Superior Strength

Early Identification & Intervention

Best-In-Class Excess Claims Management

Willing to Invest in Better Solutions to Achieve Better Outcomes

www.mwecc.com