Obamacare exchanges to be used for work comp enrollment

Turns out one reason the small employer mandate has been delayed is the Feds are incorporating a national “single payer” work comp program that is not quite ready for prime time.

The POWER (Protecting Our Workers and Ensuring Reemployment) program, which will be administered by the Office of Workers’ Compensation Programs, had been back-burnered while the tech folks worked on the other parts of the site, added capacity, and straightened out the back-end issues related to enrollment, payment, and citizen verification. POWER was not part of the original healthcare reform bill; it was initiated as part of a Presidential directive shortly after PPACA was passed and signed in to law.

Now that the health exchange “glitches” are mostly fixed, the expectation is the workers’ comp program will be moving very quickly. It should be much less complicated, as there will be a single payer (the Feds’ OWCP), a single payment system, and universal benefits and coverage specs.  Detailed in the POWER initiative, the program will measure employers’ performance across eight metrics, with those employers failing to demonstrate improvement targeted for additional Federal oversight.

DOL is targeting June 1 as the implementation date; small employers (26-99 employees) will be required to sign up for POWER as their current workers’ comp policies expire.  (The POWER press release says this should make for an “orderly and straightforward transition”; safe to say that’s highly doubtful).  Evidently employers WILL be allowed to “opt out” of POWER; this requires completion of an application of exemption, documentation of three years’ ex mods below 1.00, and a commitment from their current carrier to maintain current premiums; it has to be renewed every year.  While not too onerous, the paperwork and reporting burden may well give employers pause.

According to an OWCP press release, the POWER program is intended to “reduce the administrative burden on small employers while ensuring rapid, professional, and fair adjudication of claims for injured workers.”  Although this will “negatively impact” some insurance companies, the (anticipated) reduced expense for employers coupled with the additional oversight by OWCP staff will help “improve the competitiveness of America’s small business.”  POWER will use the OSHA reporting system to cross-index claims reporting to ensure all claims are captured; evidently there’s sensitivity/concern that some employers will avoid reporting claims to reduce the risk of the dreaded “additional Federal oversight.”

The details – The federal fee schedule will likely be used for medical treatment, and indemnity benefits will be almost certainly be pegged to the existing DOL standards.  OSHA will have to revamp their reporting process, with much more emphasis on timeliness and additional data points captured; expect the Exchange website to be used for claims reporting.

What does this mean for you?

We can only hope it doesn’t take months to figure it out.