Masonry Magazine August 1986 Page. 26
WORKERS COMPENSATION
One definition is a price high enough to enable the insurance carriers to pay the claims, while earning profits sufficient to attract capital to the industry. This is the usual criterion state insurance boards use when reviewing rate filings.
But high as rates may be, at this time they do not even meet the standard. Not only is the insurance industry not making "exorbitant" profits, in many states many carriers are making no profits at all. The NCCI estimates that the industry as a whole will suffer underwriting losses of $4 billion in 1984 out of a total premium of $18 billion. Some carriers will do better than that, of course (and some worse), but even when investment income is factored in, we are no longer looking at modest profits, but real losses.
In the end, something will have to give, and it is most unlikely that society will accept paring back the benefits of injured workers. That can mean only one thing-rates will have to go higher. Insurance companies cannot continue to operate at a loss, but the claims must be paid.
A Guide to Medical Acronyms
During the last few years, there has been a significant increase in the use of acronyms associated with the health care industry. Listed below is a guide to some of the more common acronyms:
HMO: Health Maintenance Organization, a pre-paid health care plan.
PPO: Preferred Provider's Organization, offers reduced fees if certain hospitals and doctors are used by employee groups.
IPA: Independent Practitioner's Association, a group of doctors offering discount fees to employee groups.
ACC: Ambulatory Care Centers, freestanding emergency clinics.
PPS: Prospective Payment System, the new government payment system for Medicare patients.
DRG: Diagnostic Related Groups, 470 different illnesses in which the PPS allows Medicare payments for a set number of days.
PRO: Peer Review Organization, established by the U.S. Department of Health and Human Services to review hospitals and doctors treating Medicare patients.
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26 MASONRY-JULY/AUGUST, 1986