About this guide

The American workers’ compensation (comp) program was established more than a century ago. Intended as the grand bargain between employers and workers, the workers’ comp system is a cooperative arrangement to reduce the conflicts that can arise between businesses and employees when accidents happen in the workplace.

Workers’ compensation insurance provides cash benefits and/or medical care for workers who become injured as a direct result of their job. More specifically, workers’ comp laws give employees the right to collect for injury, disability, or death if it occurs in the course of employment. It also helps cover employees’ lost wages, medical bills, and legal expenses. The grand bargain is this: No matter who is responsible for the workplace injury, the employee can receive workers’ comp benefits. In return, the business owner will be protected from lawsuits related to the injury.

Since workers’ comp is legally required in nearly every state and situation, having adequate coverage and following policy requirements helps ensure you won’t have to pay fines or face imprisonment.

Finding the right coverage is important, especially if you’re just starting a new business. There are four main factors that insurers consider when estimating a premium for workers’ comp insurance: location, type of work, payroll, and claims history.

This guide will help you understand how workers’ comp insurance can protect business owners and employees, how policies are priced, and how small businesses can reduce insurance costs. Please note: This guide is intended as an educational resource only. As laws and best practices can change, please refer to your state legislation and/or a trusted advisor for specific legal counsel. 


Table of contents

What is workers’ comp?

  • History

  • The basics

  • No-fault laws

  • Regulation

  • State laws

Why get workers’ comp?

  • Employer benefits

  • Employee benefits

Who needs workers’ comp?

  • Small businesses with employees

  • Small businesses without employees

How does workers’ comp work?

  • How to get workers’ comp

  • What you’ll need

  • Class codes

  • Next steps

  • Cost of workers’ comp

  • Reducing costs

  • Owner responsibilities

  • Paying claims

Which workers’ comp insurer is right for you?

  • Finding the right insurer

  • Meet Pie Insurance

  • Resources


What is workers’ comp?

History

Before workers’ comp legislation came to the United States, workers injured on the job had to fight for compensation for lost wages, medical expenses, and other reparations. To do so, workers had to prove negligence by their employers, which typically meant a long, costly, disruptive legal battle. Since securing payment was an uphill fight, not many employees received settlements. In fact, even in fatal accidents, only about half of the victims’ families received payment, and if they did, it was only about a year’s pay.

The first comprehensive U.S. workers’ comp law was adopted in Wisconsin in 1911 Nine other states also passed regulations that year—and not a moment too soon; in 1913 alone, more than 25,000 employees were killed in work-related accidents and about 700,000 were seriously injured. Considered the first type of social insurance in the country, workers’ comp provisions were adopted rapidly. Thirty-six more states followed suit before the close of the decade. In fact, by 1921, only six states had not authorized compensation for workplace injuries. Eventually, the last holdout was Mississippi, which finally passed workers’ comp guidelines in 1948.

The basics

Since their beginning in the 1900s, workers’ comp laws have evolved significantly. The contemporary basics of workers’ compare include:

  • Workers’ comp is state-regulated—meaning its laws are determined by each state’s legislative body and implemented by a state agency.

  • Included regulations have common principles across the country, with some differences across states.

  • Workers’ comp provides payment of lost wages, medical treatment, and rehabilitation services to workers who have experienced an occupational injury or developed a disease due to their work.

  • Benefits are provided to injured workers without regard to fault and, in return, employers’ liability is limited.

  • The calculation of benefits takes into account future wages lost for permanent disabilities.

  • Not all occupational injuries are paid for by workers’ comp coverage.

No-fault laws

Workers’ comp laws today are no-fault laws. No-fault compensation is based on the principle that injured employees are entitled to receive compensation for their injuries without proving fault against the opposite party.

The amount that an employee who makes a claim receives isn’t impacted by any potential carelessness or guilt on their part. However, a worker does lose his/her right to compensation if the injury is a direct result of being impaired by drugs or alcohol—or from an attempt to injure himself or someone else.

Benefits provided by workers’ comp insurance are the only benefits, called the exclusive remedy, available to employees. Employees can’t sue employers in court for additional benefits.

Regulation

Each state administers its own workers’ comp program through a commission or board that makes sure businesses comply with workers’ comp laws. The board is a state agency that processes the claims. It determines whether the insurer will reimburse for cash benefits, medical care, or both. It also determine the amounts payable. Weekly cash benefits and medical care are paid by the employer’s insurance carrier, as directed by the board.

The U.S. Department of Labor maintains contacts for each state’s workers’ comp agency. To learn about the laws in your area, visit your state’s department site. To learn more about the laws that affect your business, you can view the state-by-state comparison of workers’ comp laws. This useful resource is maintained by the National Federation of Independent Business (NFIB) and provides links to each state agency.

State laws

All states except Texas require that businesses with employees carry workers’ comp insurance, but the specific requirements and regulations vary by state. For example, the states disagree about covering psychological conditions if they weren’t caused by a physical injury on the job. In addition, some states are open to reconsidering employment during an employee’s time on permanent disability. Other insurance companies will conduct periodic check-ins to see if an employee is working or able to work.

The U.S. Department of Labor maintains contacts for each state’s workers’ comp agency. To learn about the laws in your area, view the state workers’ compensation map.


Why get workers’ comp?

Employer benefits

As an employer, your workers’ comp policy helps protect your company from being sued by employees for workplace injuries, and it helps keep you from having to pay directly for employee injuries. This coverage can reduce your risk of significant financial loss in case one of your employees is harmed while performing work duties. Again, since workers’ comp is legally required in nearly every state and situation, having adequate coverage and following policy requirements helps ensure you won’t have to pay fines or face imprisonment.

Employee benefits

As for your employees, they can also benefit from workers’ comp protection as they may receive financial protection for an injury that occurs at work. Often, employees can’t afford significant out-of-pocket medical expenses and lost wages. When covered by a workers’ compensation policy, employees who have sustained a work-related injury may recover lost wages and receive other helpful accommodations.


Who needs workers’ comp?

Small businesses with employees

All states (except Texas) require that businesses with employees carry workers’ comp insurance, but the specific requirements and regulations vary by state. If you are an employer, you will likely need to cover all of your employees, but you may not be required by law to carry coverage for yourself as an officer or partner.

Of course, regardless of the laws in your state, paying out-of-pocket for work-related injuries can be financially devastating for a small business. Getting appropriate coverage for yourself and employees may help you avoid this type of financial loss.

Small businesses without employees

If you don’t have employees, you may not need to carry workers’ compensation insurance from a legal standpoint. That said, you may still want to invest in a workers’ comp policy for yourself or subcontractors, or you may need to have a policy if another business you work with requires it.

Here are four different scenarios to consider when evaluating whether you should purchase workers’ compensation insurance (even if you are not legally required to):

1. You are a small business owner or sole proprietor without employees or contractors.

In this case, you may not need worker’s compensation coverage. However, you may be required to complete a sole proprietor workers’ compensation exemption form, get it notarized, and pay a fee.

2. A business wants to use you as a contractor but requires you to have workers’ compensation coverage.

Some companies won’t use you as a contractor if you aren’t covered by your own workers’ compensation insurance policy. It doesn’t make sense for them to take on the risk of using an uninsured contractor because, if you’re injured, they’ll have to pay out of pocket and may even be sued. Businesses are legally permitted to ask you to show a certificate of insurance (COI) if you want to contract with them.

3. You want to be covered by insurance in case you’re injured while working.

Even if you are a sole proprietor or small business owner working alone, you may choose to buy workers’ comp coverage for yourself simply because it makes good sense (especially if your work involves high-risk activities like construction). If you are injured while performing your work, you’ll be covered by your own workers’ comp policy. That way, you won’t have to try to get your personal health insurance company to cover your injury—something most health insurers won’t do. Health insurance companies also won’t provide partial reimbursement for lost wages the way many workers’ compensation policies do.

4. You are a small business owner or sole proprietor who uses one or more contractors.

If you use an independent contractor, subcontractor, or leased employee to perform work for you (even part-time work), you may be required to get workers’ comp coverage. Refer to your state’s laws for specifics.

Keep in mind, if you choose not to get workers’ compensation insurance, you can be held liable for injuries that happen on the job. Best practice is to have coverage for yourself and anyone who works for you, and you should be sure any workers you employ show proof of their own COIs.


How does workers’ comp work?

How to get workers’ comp

Depending on your state, you can get workers’ comp insurance through private insurance providers or through state-funded programs. If you obtain workers’ comp from a private insurance carrier, you can choose to go directly to an insurance company or through an insurance agent or broker. 

Finding a workers’ comp insurance provider that offers a quote online can streamline the process, saving you time and money. What’s more, if you have a small business, consider working with a company that specializes in small businesses. That way, you won’t be sharing the volume of risk that larger companies can carry. 

What you’ll need

Getting a workers’ compensation insurance quote is not as challenging as you might imagine. With a bit of preparation, you’ll be able to easily obtain a quote for your business.

To get a workers’ comp insurance quote, you’ll need the following information:

  • Name and description of your business

  • Federal employer identification number (FEIN) or social security number (SSN)

  • Business structure such as limited liability company (LLC), corporation, or partnership

  • Desired start date of coverage

  • Location of your business

  • Number of location(s)

  • Number of employees 

  • Annual payroll based on location and job type

  • Workers’ comp claims history (also called loss experience)

  • Applicable class codes

Class codes

You will need employee class codes to get workers’ comp insurance. Class codes are three- or four-digit codes that insurance companies use to estimate rates based on the risk level of work that employees are performing. Workers’ compensation codes are maintained by the National Council on Compensation Insurance (NCCI), an independent organization that gathers and analyzes data on workers’ compensation insurance. The NCCI establishes and maintains workers’ compensation class codes for hundreds of thousands of businesses across the United States. Additionally, some states have rating bureaus that have their own sets of workers’ compensation class codes.

Class codes indicate risk. For example, a clerical employee who works at a computer (class code 8810) is typically at lower risk of injury than a carpenter who works on upper levels of buildings (class code 5403) may be. As there are fewer hazards associated with a desk job compared to a construction site job, it costs a company less to insure the clerical worker. In this case, class code 8810 is associated with a less expensive rate than class code 5403.

If you’re a business owner, it’s critical that you use accurate workers’ comp class codes to categorize your employees. Improper or incomplete coding can be a costly mistake. Inaccuracies in coding may be discovered during annual insurance audits, and business owners can be held responsible for making up the financial difference. Furthermore, deliberately falsifying a code is considered fraud and can result in fines or imprisonment.

Take the time to properly code employees. Workers who have multiple roles may need to have a split code. What’s more, when employees’ responsibilities change, their codes may need to be adjusted. Business owners should contact their state’s insurance department or access the NCCI manual to find the correct workers’ comp class codes for their employees.

Next steps

After you request a workers’ comp quote, you’ll be contacted by the insurance provider through email or phone for any follow-up information. Next, the insurance provider will send your workers’ comp application to an underwriter. If it is approved, you will receive your workers’ comp policy quote and will need to sign it to start the policy and coverage for your team.

Cost of workers’ comp

Employers are responsible for paying for workers’ comp insurance. Employees are not required to contribute to the cost. The cost to the employer is passed on to consumers or clients in the prices that the business charges for its products or services.

When you first purchase a policy for your company, the price you’ll pay (called your premium) will be estimated based on several factors. Then, after the policy period is over, your provider will perform an audit to ensure that the estimate was accurate. Your business will receive a refund or pay the additional premium if there were changes in your business’s risk or workforce composition.

Workers’ compensation rates range from $0.57 in Texas to $2.32 in Alaska per $100 of covered payroll (though these numbers are often subject to change). This amount is the average employer cost for workers’ compensation, according to the National Academy of Social Insurance’s (NASI) Workers’ Compensation Report. There are four main factors insurers consider when estimating your premium. These include:

1. Location

Because workers’ compensation is regulated at the state level, the location of your work affects your workers’ comp insurance costs. To find your state’s workers’ comp agency, visit the U.S. Department of Labor’s state workers’ compensation map.

2. Type of work

As previously mentioned, the type of work your employees perform determines your class codes. These class codes are often defined by the National Council on Compensation Insurance (NCCI), an independent organization that conducts research on U.S. businesses. The NCCI uses these three- or four-digit codes to categorize the types of work each of your employees perform. You can look up your workers’ comp class codes online yourself, but you should also speak with a workers’ comp insurer who can confirm you are using the correct code. Refer to this guide’s section regarding class codes for more information.

3. Size of payroll

Your workers’ comp cost also depends on the size of your workforce, and more specifically, your total payroll. It’s important to report your payroll accurately because the amount directly affects your workers’ comp insurance rate. Therefore, underestimating or overestimating payroll can impact the cash flow of your business. A workers’ comp premium audit (formerly known as a workmen’s comp audit) compares the estimated payroll provided by the business owner at the beginning of the policy period to the actual payroll at the end of the policy year. It also verifies the type of work that is performed by the company. Then, if the actual amount is less or more than the estimate, the auditor determines if the premium needs to be adjusted. To avoid surprises at the end of the year, review your company’s job descriptions with your insurer when you buy your policy. This way, you can confirm the class codes are correct.

It’s important to note: Payroll includes categories such as wages, salaries, bonuses, and overtime but excludes categories like tips, gratuities, employee savings plans, and employee discounts. Consult the NCCI for a comprehensive list of the factors that are included in payroll for workers’ comp. When you’re shopping for workers’ comp insurance for your small business, use an average of your monthly business payroll for your estimate.

4. Claims history

Insurers also consider your history of claims. They use what’s called an “experience modification factor” or “experience mod” when determining your workers’ comp insurance rate. This factor must be included (by law) in defining your rate. It reflects your workplace safety compared to other similar businesses.

  • An experience mod of 1.0 is considered the industry average.

  • An experience mod of more than 1.0 is called a debit mod (your losses are greater than the average) and you may pay more for insurance.

  • If your experience mod is less than 1.0, this is called a credit mod (your losses are less than the average) and you may have a discounted premium.

If you’re starting a new business, you obviously won’t have any workers’ comp claim history. In this case, you won’t have an experience mod that can be factored into your calculation. Instead, you may pay more for workers’ comp insurance until your new business has established a track record.

By promoting and practicing workplace safety, you can influence your experience mod and your rates considerably. The fewer claims you have, the better your experience mod is and the greater the chance is that you will qualify for a lower premium.

Reducing costs

If you’re a small business owner, you can cut your cost for workers’ comp insurance by up to 30% by purchasing your insurance from a company that specializes in insuring only small businesses.

To reduce your risk of being hit with workers’ comp claims (and increased insurance premiums), make workplace safety a priority. There are a few important patterns you should recognize:

  • Workplace injuries and fatalities occur more often in smaller businesses than larger ones.

  • Workplace injuries occur less often when workplace safety activities are in place.

  • Small businesses are less likely to engage in workplace safety activities than larger ones.

  • New businesses are less likely to have workplace safety activities in place than older ones.

Implement a comprehensive workplace safety program to provide your employees with a healthy environment and support them with regular safety training. Visit Pie Insurance’s website for safety tips and resources.

Owner responsibilities

There are many responsibilities that small business owners have when it comes to workers’ compensation. In most states, an employer should:

  • Maintain records of any accidents.

  • Report all accidents to state agencies within a certain period.

  • Inform your insurer of any accidents within a certain period.

  • Provide your employees with information about their workers’ comp rights, benefits, and claims process.

  • Inform your employees of the timeline for reporting injuries.

  • Let employees know that if they don’t follow the notification period requirements, they may not be eligible for benefits.

  • Give your employees all of the necessary forms for reporting injuries as well as your workers’ comp insurance information.

  • Make sure that an injured employee gets prompt medical attention with an approved provider.

  • Be sure that the healthcare provider’s report is filed along with the workers’ comp claim (before the deadlines pass).

  • Confirm that your employee has received either an approval or denial of the claim.

  • Help your employee return to work by retraining the employee.

Paying claims

A workers’ comp claim is paid if the employer and insurance carrier agree that the injury is work-related.

  • If the insurance carrier disputes the claim, no cash benefits are paid until a judge decides who’s right.

  • If a worker isn’t receiving benefits because the employer or insurance carrier is disputing the injury, he or she may be eligible for disability benefits in the meantime.

  • Any payments made under the disability program will be subtracted from future workers’ comp payments.


Which workers’ comp insurer is right for you?

Finding the right insurer

If you’re a small business owner seeking workers’ comp coverage for your employees, look for a provider that offers:

  • A convenient, fast quote process

  • A team of insurance professionals who make workers’ comp easy to understand

  • Small business savings and expertise

Meet Pie Insurance

Pie provides workers’ compensation insurance coverage to small businesses across the nation through a simple online experience. Get a quote in three minutes.


Resources

National Academy of Social Insurance – https://www.nasi.org/

National Federation of Independent Business – https://www.nfib.com/

Pie Insurance – https://pieinsurance.com/blog/

U.S. Department of Labor – https://www.dol.gov/

 

 

Thanks for reading! Please note that this content is intended for educational purposes only. As laws change regularly, you should refer to your state legislation and/or an advisor for specific legal counsel. If you’re a small business owner, learn more about workers’ compensation insurance or check your current rate in 3 minutes.

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