Pinnacol spends plenty on privatization effort

Once again Pinnacol Assurance is in the news. The Denver Post is reporting in an article that they have spent $1.6 million since January in efforts to promote its privatization. Lobbying, advertising and public relations are part of this effort. This has raised concerns about what it has been doing and whether it is sensible though Pinnacol has defended by indicating it was due diligence to protect policyholders. The privatization effort remains controversial and many oppose it. You can read the article for more on Pinnacol's efforts. The story has been around for many months. You can expect the story to continue. My view is that Pinnacol is thriving and wants more autonomy. Private entities have less scrutiny and Pinnacol has seemed quite aggressive in its push for privatization.

Pinnacol Privatization Again in the News

The Denver Post is reporting that business groups and others are upset with Pinnacol's ads touting the benefits of privatizing Pinnacol Assurance. It is asserted the ads violated an agreement not to lobby on the issue while the matter is under review by a task force. What the article points out is that Pinnacol is the state's insurer of last resort for high risk businesses. That is why Pinnacol was originally set up by the state of Colorado and then has grown to be the largest insurer in Colorado of workers compensation claims. This effort to privatize is not surprising. Pinnacol is large, apparently thriving, with ample funds available that in the past the state was interested in obtaining. My experience tells me that when a nonprofit becomes quite successful the entity wants to move out on its own. I saw that with Blue Cross Blue Shield when it became Anthem. There can be interest in expansion beyond the state borders and Pinnacol executives can operate unfettered by state oversight. In theory the state gets an investment apparently worth $340 million and a dividend every year. Of course Pinnacol's offers seem to vary which is, I suspect, just part of the negotiating. The real question I have is whether privatization might impair the very purpose for the state's interest which was to insure high risk ventures. The construction trades have many injuries and are costly to insure. Without state involvement might this endanger state businesses? Private insurers certainly have more freedom to operate than an entity with state oversight. Of course my other concern is valuation but that is negotiable.

Pinnacol again seeks privatization

The Denver Post is reporting how once again there is an effort to privatize Pinnacol Assurance, the state's quasi public/private workers comp insurer. Pinnacol is also the largest insurer in Colorado in this area. Now they are reviewing the proposal that the state gets a 40% stake worth $340 million dollars in return for greater autonomy for Pinnacol. What sticks with me is that the state saw big cash amounts held by Pinnacol and wanted a piece of that to help with the state budget. Pinnacol then sought to get away from state influence and control. This is a story that reminds me of the old serial thrillers. This version is still controversial as I suspect some may question the wisdom of the state agreeing to this. Colorado created Pinnacol to make it easier for businesses, especially high risk businesses to obtain workers compensation insurance for a fair price. I remember getting claimant benefit checks from the state accounts but that was years ago. The point is that it has thrived and been effective in Colorado with state backing and now that it is doing well wants more autonomy. Control and money issues are involved so of course with such issues comes controversy.

Colorado workers comp insurance rates to go up

The Denver Post is reporting that businesses can expect a rate increase on their workers compensation insurance coverage. This after a few years of declines. Why? The number of claims is not going up. The explanation appears to be in the continuous and unrelenting increase in medical costs. Here is the Colorado statement on all this. This rise in medical costs when the economy is not inflating remains ominous for all of us. The failure of society to address this is rather sad. We all talk about it but it takes a concerted effort and in our politically charged country we are less interested in problem solving and more in ideology. Wouldn't it be nice if they set up a task force to address such costs in a sensible way? I mean an across the board analytical review. If medications are a big factor find ways to lower that expense. If we need more nurses or practitioners find ways to increase the numbers with educational incentives. If caution leads to the running of multiple and usually unneeded tests find ways to prioritize those tests rather then run all of them at a time. If malpractice rates are too high find ways to make providers accountable without increasing those rates. I mean weed out the bad apples especially in workers compensation. Simplify the paperwork too! While I do like the medical treatment guidelines I saw recently what appears to be making it more complicated to obtain prior authorization. In workers compensation there are many disputes in what I see as primarily medical legal issues. When we go to a hearing and it seems to be a legal issue on compensability in reality many such cases involve medical causality. So some of these rising costs involve insurers hiring experts to question causality and treatment. As an example an attorney related to me that he had obtained a DIME opinion that the claimant is not at MMI. In the past this just led to more treatment and a reassessment. Overcoming a DIME historically has not been easy but the pattern is now to question everything. There are doctors out there that will nearly always assert an injury is not work related or that the DIME doctor made a mistake. A DIME would cost $675 but they spend $5000 or more fighting it. The point is not all the rising costs in workers compensation are based on purely medical matters. Some come from the insurer disputing matters. It also drags out the proceedings which I do not really see as helping the claimant needing treatment and it is costly. In any event businesses can expect higher workers comp premiums next year.

Social Security Disability Close to Insolvent?

The AP news is reporting that Social Security disability is getting close to insolvent. The news article points out that with the aging of boomers and the economy more people are applying for disability benefits. So right when we are all concerned about debt and revenues we have another sign of the times. Despite the fact that for years the entire Social Security system was dipped into by the federal government instead of set aside we have another potential problem. I am not sure how many may think that those getting SSDI and SSI are not entitled but the vast majority of those drawing benefits have run a gauntlet to obtain benefits which are a fraction of what you can earn in the world of employment. I remember one time realizing how tough it must be for one client who was earning over $60000 a year to seek annual benefits that were perhaps 20% of what he had earned. Yet he had to go to a hearing (the wait took over a year) to prove he no longer was employable. When you are not working and in poor health the process can seem agonizingly slow. Sure some of those receiving benefits may not deserve them but almost all do deserve them and the program has worked for many years. There is a need for increased revenues into the system yet politics is getting in the way. I can say that some feel lifting the cap or lid for contributing into the system would make it solvent but that may not be passed. Currently all wage earners pay into it up to $106800. If you make more you do not pay more. So the athletes, the corporate executives and others making really good pay have a benefit none of the rest of us have. They do not pay a dime over $106800.
UPDATE AND A NEW VIEW ON THIS: Over at another website they are reporting that this story about insolvency is not totally accurate. The article points out SSD programs and the fund are not close to insolvent but that it is more of an accounting situation. In the past the disability fund and the retirement fund have separate accounts but have transferred funds between them from time to time. A simple accounting transfer and both are solvent until at least the year 2035. This should remind us to be careful about assuming all the stories swirling about Social Security are accurate. One source for further details to strengthen Social Security is here.

Pinnacol Withdraws Handling Cases for State

This article from the Pueblo Chieftain states that Pinnacol Assurance is withdrawing from being the adjustor or representative for the state of Colorado's workers comp cases. If you worked for the state and had a work injury Pinnacol would have handled the claim for the state. It charged for doing that and decided it no longer wanted to handle the claims. The state acted and replaced Pinnacol with another company, Broadspire. Some may be upset with Pinnacol since it was very closely associated with the state from its inception. The reason given...that state claims are hard to handle may or may not be so but Pinnacol may be setting up to break away from the state entirely too. I do know that in the past it was more difficult to settle when we had to go through an attorney who then went to Pinnacol who then had to go through the state agency/employer.

Colorado Governor Reviewing Privatization of Pinnacol

As noted today in this Denver Post article it appears there still is interest in privatizing Pinnacol. Pinnacol Assurance is the state's largest workers comp insurer and originally was set up by the state to assist businesses especially high risk businesses in obtaining workers comp insurance. Despite many insurers saying otherwise usually premiums generate decent revenues. The so called cash reserves are amounts set aside to deal with claims or matters that require reserves but they do seem like profits when they get pretty high. Colorado legislators, in the past, thought about taking some of that to help with the budget problems but it never happened. New board members were appointed and there remains interest in exploring privitizing Pinnacol. The last time Pinnacol was willing to pay to obtain more private operations. One Republican legislator has said any cash to do so should go to the business owners who paid Pinnacol and are considered policyholders but of course Pinnacol also has a public side so once again we will see what happens.

Medicare Rights Group Against GOP Changes

There seems to be a constant assault on Social Security and Medicare/Medicaid coming from I would call the far right of the political spectrum. The fact that Social Security has not been the real problem with the federal deficits and actually was borrowed against to fund government spending does not matter now. While there is no question that structural changes to make it more solvent may be soon needed the current effort seems nothing short of inhumane in its consequences if enacted. While that will not happen I find it amazing after all these years to see some questioning the usefulness of such benefits. The inability of some to accept the notion that we just need to cover the old, the disabled and the young astounds me but I guess they do not generate much income so we should minimize them is their attitude. Anyway this medicare rights group notes their disagreement with the GOP effort of one representative to pare down benefits. Also the Alliance for Retired Americans is voicing its concerns. Lastly at another site for the "middle class" they are also critical of this proposed legislation.

Pinnacol Has 3 New Board Members

The Denver Business Journal is reporting that 3 new people were voted onto the Pinnacol board by the legislature. One of them was highly critical of Pinnacol so it will be interesting to see what comes of this. Pinnacol Assurance is Colorado's largest workers comp insurer and has a long history. It was originally set up by the state and is a hybrid of public and private interests. Pinnacol wants more autonomy and yet many in the state legislature are upset with how it now operates. See for example one recent legislative effort in an article in the Denver Post. However Pinnacol does have points going for it. I have previously reported on this so this is just another entry in an ongoing story.
UPDATE: New Board votes to take away the CEO's bonus and in this article in the Denver Post more is discussed about Pinnacol.

Pinnacol Golf Junket for Executives in 2010 Hits News Again

Channel 9 News and other media in Denver are reporting today on last years golf trip by Pinnacol executives. Pinnacol was required by a court order to disclose this information and as might be expected it is raising eyebrows. Some are saying the chief executive should resign. It does seem outrageous especially when you realize Pinnacol is meant to be nonprofit. Things like pink golf balls for the ladies, lavender pedicures, and even over $400 spent at the airport lounge and over $7000 in room charges for the chief executive. The total? Over $300000.00 for this Pebble Beach Golf trip. It is also reported that state auditors criticized Pinnacol for its lavish spending history in September. Pinnacol fought to prevent release of this information but had to do so. Now many are very upset at Pinnacol. Since Pinnacol is a mix of public and private the disclosure could not be kept a secret as can be the case with private companies. I imagine that compared to others such as the financial bank companies this is not that horrible or lavish but tell that to the injured worker of even the small business that is pinching pennies in these hard times.

Everyone Seems to Benefit Except SS Recipients

The tax cut extension certainly seems to be benefiting all Americans except those just drawing Social Security benefits. Those earning over $250,000 continue to receive a tax break estimated at a cost of $75 billion. But also the Social Security tax is reduced for one year from payroll deductions and this appears to cost about $120 billion. See this article at CNN Money. My concern is if that payroll deduction is made permanent it sets up Social Security to take the fall for being too costly so benefits need be cut. You take away the SS payroll collections and then blame it on Social Security itself! Additionally despite this enormous giveaway they then quietly killed any chance to help out those on Social Security with a one time $250 check to make up for two years of no cost of living increase. Cost for that? $14 billion. Reason given? It is too costly. Makes you wonder about our priorities.

Federal Subcommittee Examines State Workers Comp Systems

On November 17th a congressional subcommittee looked into and expressed concern about state workers compensation systems. There was testimony taken and written statements provided which reflect what I see as legitimate concerns about many state systems. The link I have provided here takes you to the webpage and from there you can listen to and read much of what was provided. One concern was over the American Medical Association 6th edition for rating permanent impairment. Colorado still uses an older version. The 6th edition deviates from past editions in a significant way including what appears to be a lack of evidence based protocols. In any event more worrisome is the view that over the last 20 years benefits have been reduced and this may have increased other disability claims such as SSDI and SSI claims. What was historically intended to help injured workers in an efficient manner has, over time, become inadequate and not equitable. In Colorado you only have to look at the definition of permanent total disability to see how legislation has intentionally sought to cut benefits. At Colorado Revised Statutes 8-40-201(16.5) total disability is defined as being unable to earn any wages in any employment. Does this mean if you can only work a few hours for minimum wage you are not totally disabled? Insurers do so argue that very point and Colorado is tough compared even to Social Security disability. Harsh results? Often but insurers merely use existing Colorado law to keep benefits low. Other areas of controversy are pre-existing conditions or for that matter insurers questioning if work activities are responsible at all. In Colorado nearly 25% of workers comp claims are contested and never admitted without a hearing. Those interested can read the last published figures for the year 2005.

Pinnacol's Recap of 2010 Legislation

Pinnacol at its website has neatly organized the 2010 legislation which it then reviews from its perspective. Included are links to each bill so you can read the bill itself. Pinnacol handles more workers comp claims then any other insurer in the state of Colorado. It certainly intends to be active in watching future legislative efforts and to be a voice for its point of view. The legislators noted are perhaps the most interested in fostering change in the system. How the political alignment changes after the coming elections may also affect future Colorado legislation in 2011. Injured workers are not as big or organized as business and insurance interests but should pay attention and support those legislators interested in change from their point of view.

Pinnacol CEO Interviewed

A few weeks ago the Pinnacol CEO was interviewed. I just came across it and thought it would be interesting to see what he had to say. You can read what he said here. Pinnacol is still interested in what he calls "separation" from the state which to me still means autonomy. He points out that premiums for businesses have been reduced by 50% over the past 5 years. He also believes the economy is still not that great. Pinnacol tracks payrolls and they are not picking up. My impression and the statistics I've seen suggest that claims are down and have been declining for several years. In fact in my view it started even before the latest economic turndown. Are jobs being shipped overseas? What do you think? The problem this country may be facing is how do you remain a consumer when your income is down? But whether injured or unemployed we really should make a committment as a nation to retraining and vocational rehabilitation. If we are losing assembly line jobs we need to replace them with desk and tech and skilled trade jobs.

Legislative Advisory 2010

The Colorado Division of Workers Compensation has posted a legislative advisory that briefly reviews the 2010 legislation that is applicable to workers compensation. While the legislative session is over the Division will proceed forward with rule making that may pertain to the recent legislation. Some of this recent legislation is significant. The advisory is just 6 pages so you can easily see for yourself.

Pinnacol Bonuses and Travel audited

The Denver Post is indicating that Pinnacol was audited by the state in this article. Pinnacol Assurance is the state's largest workers compensation insurer and has been in the news often in the last year. The criticism is that Pinnacol pays higher then average bonuses and its travel benefits were also high. Of course Pinnacol is not completely public and operates also as a private insurer so it is a hybrid. In any event the criticism continues though it is nothing like the Wall Street bonuses we have read about. Pinnacol seems to be doing pretty well though the state and many others are dealing with the recession. Some would say it is at the expense of claimants and business owners. Others would say it is just doing a good job. This story is being reported everywhere. It is on Channel 7 News. At the Denver Business Journal it is reported with the attached audit should you wish to read the details.

Workers Comp Penalties are Increased

One statutory change that was signed as law by the governor pertains to penalties. The maximum penalty for a violation of a workers comp law/order is now $1000.00 a day although it can be apportioned or split with half or more to the party and the rest to a fund. Any penalty remains in the discretion of the judge. I would prefer that penalties be imposed more often in workers compensation proceedings where benefits are withheld. I would also prefer that they have some teeth rather then be a minimal amount. If a penalty is meant to punish or teach a lesson it fails to do that if the time and expense of proceeding makes it not wise to proceed. The victim if you will should not be the one punished. That just fails to enforce the intent of the provision. In any event the legislature is increasing the amount that can be imposed as a penalty.

Pinnacol Again in the news...for golf getaway.

The Denver Post is reporting that Pinnacol Board members were at a Pebble Beach golf resort where a round is $500 and the room rate starts at nearly $700 a night. Pinnacol is partly private and partly public. They are the largest workers compensation insurer in Colorado. Looks like the media is investigating the expenses of the trip and Pinnacol is asserting its records are confidential business documents. Pinnacol has been a state agency/political subdivision since 1915 but has been given more autonomy over the years. It has sought even more independence but is also under some scrutiny. This latest news is certainly keeping them in the public eye. Pinnacol can surveil injured workers. Looks like the shoe is on the other foot right now. The comments following the news article are also interesting.
UPDATE: This is an interesting read but mostly focuses on Pinnacol must change its ways.

Update on the Status of Colorado Bills

Here is a link to a summary on the status of the various bills which may impact Colorado workers compensation matters. I'll comment in a later post on some of these but for the time being the link really does a very good job of giving us a heads up on the proposed bills some of which have passed and been signed by the governor. It appears for this year the legislative activity is just about over but it may take a several more days to see what is passed and signed by the governor.

No Deal for Pinnacol This Year

The Denver Post is reporting that there will be no deal for Pinnacol this year. I've posted on Pinnacol numerous times here and more recently Pinnacol was trying to put together a deal for greater autonomy from state control. Pinnacol was originally set up by the state to help Colorado businesses obtain decent workers compensation coverage. Over the years it has worked itself into a major force in the workers compensation market. It handles the biggest share of work injury claims in this state. Given its size and revenues the state sought to obtain income to help with the state budget and also had increased interest in Pinnacol. In any event Pinnacol and the state ended any effort this year to work something out. Pinnacol wanted to pay for greater autonomy and that is out for now. I expect more on this next year. The story does not impact claimants except that some legislators have been unhappy with what they perceive is Pinnacol's power and unfair treatment of claimants. It can lead to law changes that benefit all claimants.
Update: View a more detailed story on this here.