The workers` compensation system provides an "exclusive remedy" to employers and employees and is designed to simultaneously achieve the goals of safer workplaces, prompt compensation and treatment of those it protects and reduced litigation costs to all parties.

Coverage A: Worker`s Compensation Coverage
Worker's Compensation insurance provides coverage for the statutory obligation of an employer to provide benefits for employees as required by:

• Worker`s Compensation law or occupational disease law of any state or territory of the United States, including the District of Columbia, and
• United States Longshore and Harbor Worker`s Compensation Act.

Employers Liability
Employers Liability insurance provides coverage for the legal obligation of an employer to pay damages because of bodily injury by accident or disease, including resulting death, sustained by an employee. Employers Liability coverage applies only if the injury or death of an employee arises out of and in the course of employment and is sustained:

• In the United States of America, its territories or possessions, or Canada, or
• While temporarily outside the United States, its territories or possessions or Canada, if the injured employee is a citizen or resident of the United States or Canada; but suits for damages and actions on judgements must be in or from a court of the United States, its territories or possessions or Canada.

Unless specifically excluded, coverage for the liability of an employer under admiralty law and the Federal Employers Liability Act is provided by employers liability insurance.

Deductible Coverage
Act 44 of 1993 requires an insurer issuing a worker`s compensation policy to offer a deductible program upon a policyholder`s request.

• Deductible coverage shall be made part of the policy if requested by the policyholder. Underwriting criteria for deductible coverage are to be established by individual carriers.
• The claimants` benefits will be paid by the insurance carrier without regard to any deductible.
• The policyholder must agree to reimburse the carrier for the deductible amount for any benefits paid to claimants.
• Failure to the policyholder to reimburse the carrier for any deductible amount shall be treated as non-payment of premium under the policy.
• The premium adjustment for the deductible provisions of the policy shall be reported as a credit which shall be applied prior to experience modification or other carrier premium modifications.

Failure to Carry Workers` Compensation Coverage
An uninsured employer faces grave civil and criminal risks for failing to maintain continuous workers` compensation coverage. Not only can the employee sue the employer in tort for work-related injuries or diseases, in which suit the employee may recover amounts in excess of those allowed under workers` compensation. but the employer and those individuals responsible to act on its behalf may each be criminally charged for each day`s failure to maintain continuous workers` compensation coverage.

Misdemeanor convictions can result in the potential imposition of a $ 2,500 fine and up to one year in imprisonment for each day the employer is in violation of the requirement to maintain workers` compensation coverage. Felony convictions can result in the potential imposition of a $ 15,000 fine and up to seven years imprisonment for each day the employer intentionally violated this requirement. Further, the employer and those individuals responsible to act on its behalf may be required to pay all benefits awarded by a workers` compensation judge.

The Bureau of Workers` Compensation investigates employer compliance with workers` compensation laws and may initiate the filing of charges against employers and individuals responsible to act on its behalf if workers` compensation coverage is not continuously maintained.

Further, any individual, including competitors, may seek county district attorney approval to file a private criminal complaint against an employer who fails to maintain workers` compensation coverage when required to do so.

State-Certified Workplace Safety Committee Program
Employers Save 5% Annually On Their Workers’ Compensation Policy Premiums

How can I start saving now?
First, establish a workplace safety committee that meets the requirements listed below. Then, after six months of operation, complete a committee certification application and submit it to the PA Bureau of Workers` Compensation for approval. Beginning in 2007, employers will be able to complete applications online. For more information relating to online filing, go to www.dli.state.pa.us, Keyword: HandS.

What are the basic requirements?
Committees must have a minimum of two employer and two employee representatives, meet monthly and be in operation for at least six full months prior to submitting an application. Committees must record and maintain membership lists, meeting agendas, attendance lists and meeting minutes.

All committee members must be trained annually on the following three topics by qualified trainers: Safety Committee Operation, Hazard Inspection and Accident Investigation. The Bureau of PENNSAFE offers free training on the three required topics.

What happens when I am approved?
You`ll receive written notification from the PA Bureau of Workers` Compensation to provide to your insurance carrier. The 5% discount will be calculated and applied at the next policy renewal date following certification.

Do I have to repeat this whole process to qualify for the discount in the future? No. Each year you will automatically receive a one-page certification renewal form 60 to 90 days in advance of your policy renewal date. The renewal form includes your previously entered information, so all you have to do is update any information that has changed and sign it (in doing so, you attest that the committee continues to operate and meet requirements).

How long can I receive the 5% discount?
As long as you continue to follow the state`s workplace safety committee requirements and regulations, you are eligible for the 5% discount.

Physicians List Defined
The PA Workers` Compensation Act gives employers the right to establish a list of designated health care providers. When the list is properly posted, injured workers must seek treatment for the work injury or illness with one of the designated providers for 90 days from the date of the first visit. There are some specific guidelines provided in the rules and regulations for these lists:

• The employer must provide a clearly written notice to employee of the employee`s rights and duties.
• The notice must be signed by the employee at the time of hire, whenever changes are made in the list and at the time of injury.
• The list must contain at least six providers; three of the six providers must be physicians.
• Providers as defined in the Act are more than just physicians.
• Each provider`s name, address, telephone number and specialty must be included on the list.
• If a particular specialty is not on the list and the specialty care is reasonable and necessary for treatment of the work injury, the employee will be allowed to treat with a health care provider of his or her choosing. Martin v. WCAB (Emmaus Bakery), 652 A.2d 1301 (Pa. 1995)
• The employer may not direct the employee to any specific provider on the list.
• The employee may switch from one designated provider to another designated provider.
• Listed providers must be geographically accessible.
• Listed providers must contain specialties appropriate for the anticipated work-related medical problems of the employee.
• If employer`s list of designated providers fails to comport with the Act and the regulations, the employee has the right to treat with a provider of his or her choice.