Offering Various Workers’ Compensation Program Solutions

Group Administration

The group administrator as the Trustees representative:
Executes the policies of the Board of Trustees of the group self-insurer and manages the activities of the group self-insurer's corporation. In conjunction with the board of trustees, and their appointed actuarial, sets the contribution level (premium) of each SIG member in order to fund the injured worker claims and associated expenses. In compliance with the DIR Regulations the administrator submits annual reports of estimated future liabilities, actuarial reports and audited financial reports on the SIG to the Office of Self Insurance Plans.

OPERATIONAL ACTIVITIES

The group administrator is also the “back office” or operational arm of the group and provides a variety of services to the
group such as the following:

Coordinates the preparation of the initial feasibility study for establishment of the Group
Process new member applications from underwriting to OSIP submittal.
Establish a contribution rate for new members
Invoice members monthly for their contributions
Provide Accounts Receivable and Payable Services
Preparation, Coordination, Submittal, and Archival of Annual Reports, Actuarial Reports, and Audit Reports.
Annual report, audit and reserve report submittal and archival
Manage proof of insurance certificates
Provide regulatory compliance services
Represents the board in the group’s interactions with auditors, actuaries, banks and excess carriers.
Assist during state Audits
Coordinate the board and membership meetings

CLAIMS OVERSIGHT

We pride ourselves in the “Hands-On” approach. In doing so we have found that a hands-on approach to operating a program is a path to success, which led us to obtaining authority for Finish Line Self Insurance Group to be Self-Administered and then certified as a TPA, which has led to Finish Line Self-Insurance Group being the only SIG in California that not only administers their own claims, but is also a certified Third Party Claims Administrator (TPA). We believe that managing the oversight of the claims is one of the most important roles of cost control for a self -insured group.

We know claims oversight from the ground up! This is why we take pride in efficiently and effectively supervising claims from the onset through settlement. As part of our supervision of the TPA we require that they focus on getting the injured worker the treatment and care they need for a quick return to work and order surveillance of the injured worker if warranted.

If it’s broken, we want it fixed, but if we suspect that a claim is of a suspicious nature or that the injured worker is not responding to treatment as would be expected we will authorize the TPA to investigate the case via surveillance of the injured worker’s acts of daily living and of their social-media footprint.

Clients of SIG Solutions benefit from the ability to participate in a boutique medical provider network (MPN) of healthcare professionals that have been vetted by SIG Solutions for their expertise in treating worker compensation claimants.

Loss Prevention and Safety Management

The best claim is the one that didn’t happen. The State of California requires that all group members have an effective Injury and Illness Prevention Plan (IIPP). The groups must also have ongoing risk control and safety program in place.

SIG Solutions provides the gateway to a certified safety professional who will work with the group to assure that they are compliant with state and federal worker safety regulations.

Through the safety specialist your workers’ and their supervisor’s will learn about job related safety topics specific to your
particular industry.