What's New for Self-Insurance

The latest news


Collaborative care takes center stage at the colloquium on occupational health best practices.

July 11, 2014.

On June 18, about 75 people from L&I and the self-insurance community met at Group Health in Seattle to share best practices for helping injured workers heal and return to work. This event focused on identifying risk factors for disability and collaboration among professionals to reduce the risk of work-related disability. The colloquium included a mixture of presentations and panel discussions.

Karen Jost, the new Health Services Analysis Program Manager, noted, "Managing and preventing disability is important to all employers. The colloquium was an opportunity for self-insured employers, TPAs and L&I staff to gain better understanding of and discuss strategies for identifying workers at risk for developing long-term disability."

Now in its fifth year, the colloquium is held twice per year and is jointly planned by L&I staff from Health Services Analysis, the Office of the Medical Director and the Self Insurance Section, along with representatives from the self-insurance community.

The theme for the event was "Collaborative Care in Healing and Returning to Work." The presentation materials are attached below.

L&I Colloquium on Occupational Health Best Practices (4.3 MB PDF).

L&I Self-Insurance Program Manager, Natalee Fillinger, is leaving.

June 12, 2014.

Natalee Fillinger will be joining the Puget Sound Workers’ Compensation Trust to develop their new legal program. Her last day leading self-insurance will be July 2.

During Natalee’s time in self-insurance, she was able to develop and implement the Self-Insurance Core Assignment Manager (SI-CAM) system for both tracking self-insurance claims adjudication time-frames and begin to evaluation the quality of claims decision making. Natalee initiated and completed Wage Consistency for the Self-Insurance Community, including developing and implementing a new SIF-5A wage form.

Additionally, Natalee began the complex task of addresses self-insurance auditing. Working collaboratively with business and labor, SI Audit Reform has already created a process for both complaint-driven and issue-driving auditing, a new emphasis on training for externals via a commitment to E-Learning, and up-dating incorrect and problematic forms. While Natalee would have loved to complete the important tasks of self-insurance, particularly audit reform, she is excited about the new challenges and happy to be moving closer to family.

SI Compliance Operations Manager, Jim Nylander and SI Claims Operations Manager, Brenda Heilman will continue to handle their daily operational leadership responsibilities for the self-insurance program. Please continue to work with them as you normally would. We are very lucky to have their many leadership talents available to help us all during this time of change and transition.

Effective July 1, Steve Reinmuth will serve as the interim contact for the self-insured community who would have contacted Natalee for self-insurance matters.

We expect to open a competitive internal and external recruitment next week for the program manager position and hope to have made a hiring decision by late summer or early fall.

The self-insurance program is sad to see Natalee go and wishes her all the best.


L&I self-insurance testing secure email.

January 3, 2014.

What we’re doing:
A few self-insurance staff are testing the use of encrypted, in other words, secure email when sending coorespondence to users outside the state government network like YOU!

What will secure email be used for?
Those L&I staff testing secure email will be able to send administrative requests about the claim which may include the L&I claim number. Areas within the Self-Insurance Section, such as Audit, Certification Services, and administrative staff, will be the primary testers. Some examples of how secure email will be used are to:

  • Request and receive payroll and claims costs from employers and their Third Party Administrators (TPAs).
  • Send a copy of the claims list and request wage information.
  • Exchange information to clarify details of pension billings or other assessments.

However, we won’t be using secure email to manage the claim. Why not?
Claims adjudication at the L&I is accomplished through use of our claims adjudication system called LINIIS. LINIIS information is connected with other information systems used in the adjudication oversight of self-insured claims, including the Claim & Account Center (CAC) and our ORION system that contains the imaged claim file. Secure email is a separate system that is not connected to and does not update LINIIS or ORION. 

What can you expect when receiving a secure email?
The first time one of our testers sends you a secure email, you will be asked to register at the Secure Email Portal by following these steps:

  1. The message will contain an Open Message button that will open the registration page with your email address already filled in.
  2. Enter a password that complies with the following standards established by Washington State policy. Passwords must be at least 10 characters in length and meet all of the following conditions:
    • Contain a number.
    • Contain both uppercase and lowercase letters.
    • Contain at least one special character, such as ~ ! @ # $ ? ^ & Note that the asterisk and period are not valid special characters.
    • The password cannot include your name, email, or be a complete word.
    • Be significantly different from the previous 4 passwords. Passwords that increment (Password1, Password2, Pasword3…) are not considered significantly different.
  3. Reenter the password.
  4. Click the Register button.

After successful login, the secure email will be displayed.

Tips:

  • If your email doesn’t support active links, copy and paste the link provided into your browser’s address bar.
  • Depending on your email settings, secure email from us may be blocked or quarantined by your anti-spam software. You can check your quarantine server or work with your local email administrator or internet service provider.
  • The secure email may have been delivered to your “junk” folder, where you can retrieve it. Add the sendsecure.m86security.com to your “safe sender list” so that any future notification will get routed to your inbox.
  • If you can’t find the secure message notification email, contact your IT department or internet service provider and have them white list sendsecure.m86security.com, which is IP address 63.71.11.102 for inbound mail. Then ask the L&I message sender to resend the secure email.

A few other things:

  • The Secure Email Portal will automatically sign you out after a period of inactivity.  To login to the Secure Email Portal again, click the OK button from the dialog box and reenter your credentials.
  • If you don’t access your secure email from L&I within 30 days, that means open it, then the message and all attachments will be deleted and a notification returned to the sender.
  • If you forward the secure email to another External User, that user will be prompted to create a new account, in other words, register through the above steps.
  • The Secure Email Portal doesn’t store sent messages.  If you need to keep a copy of the email, include your email address in the To or Cc fields.

Questions?
If you have questions on setting up your account, go to External End User Training Guide: Secure Email Extract (2.2 MB PDF).

Confused about the difference between eCorrespondence and Secure email?

  • eCorrespondence is an optional electronic method to receive claims correspondence from L&I instead of receiving it as you do now, paper copies in the mail.
  • Secure email is a way for L&I to correspond with you on administrative (not claims management) issues in a secure way.

For more information on eCorrespondence, see What’s New on the self-insurance website.


Electronic correspondence available to self-insured employers early 2014.

January 3, 2014.

Self-insurance to give option for eCorrespondence
We are upgrading our claims correspondence system early next year. New features of our correspondence system include the option for eCorrespondence, meaning the ability to electronically receive claim-related correspondence and legal notices.

The eCorrespondence feature will be available to these customers:

  • Employers.
  • Third Party Administrators (TPAs).
  • Workers.
  • Attending medical providers. 

Customers who sign up for eCorrespondence won’t receive paper mail from L&I, with the exception of closing orders.

As we get closer to implementation, we will be sending out more information about how to sign up.

Impact on self-insured employers who sign up for eCorrespondence
If you opt into the eCorrespondence, there will be a new process for you to calculate and manage timelines for protesting or appealing orders:

  • 60 days from date sent, instead of the grace period for mailing of 60 days plus mailing time.

Workers will be given the same opportunity
Information from L&I will be going out to injured workers about signing up for eCorrespondence.
Workers who sign up for eCorrespondence need to understand:

  • This applies only to claims correspondence they would have received from L&I, not the self-insured employer.
  • They should expect to continue to receive correspondence from their self-insured employers as they currently do now.

Self-insured employers should be prepared for questions from their injured workers about eCorrespondence.

Want to continue receiving paper correspondence on claims?
Just don’t sign up when the eCorrespondence option is offered.  You will continue to receive paper claims correspondence in the mail. 

Confused about the difference between eCorrespondence and Secure email?

  • eCorrespondence is an optional electronic method to receive claims correspondence from L&I instead of receiving it as you do now, paper copies in the mail.
  • Secure email is a way for L&I to correspond with you on administrative (not claims management) issues in a secure way.

For more information on Secure email, see What’s New on the self-insurance website.

For more detail on eCorrespondence features, go to Go paperless with eCorrespondence.


L&I self-insurance needs to know: Self-insured employers, are you converting from ICD-9 to ICD-10 Codes?

January 3, 2014.

Background
Effective October 1, 2014, Labor and Industries (L&I) will implement the conversion from the International Classification of Diseases (ICD) 9 codes to the updated ICD-10 codes. Although workers’ compensation is technically exempt, L&I is converting to ICD-10 to align with industry standards.

Need more information before deciding whether to convert?

  • Medical providers are required to convert to ICD-10 codes.
  • Self-insured employers are not required to convert to ICD-10 codes.
  • The WAC rule regarding the criteria for a provider’s proper billing is being updated to include the requirement of ICD-10 codes on bills.
  • Self-insured employers are encouraged to convert to ICD-10 codes so that proper billing may be more easily determined when self-insured employers are evaluating bills and processing these for timely payment.  

Visit the Centers for Medicare and Medicaid Services (CMS) ICD-10 website for the latest news and resources to help you prepare. Sign up for CMS ICD-10 Industry Email Updates.

Why we need to know what you’re doing about the code conversion
The department would like to give our medical providers a list of those self-insurers who will also be converting to ICD-10 for their workers’ compensation claims. 

How to let us know
Please email us at SITrainerquestions@lni.wa.gov with one of the following:

  • Yes, we plan to convert to ICD-10 codes for workers’ comp claims effective                                   .  Or
  • Yes, we have a tentative plan for ICD-10 conversion, but no firm timeline yet.   Or
  • No, we have no plan for converting to ICD-10 codes at this time.

Thank you in advance for your participation.


Use the new SIF-5A to calculate wages on new claims.

December 3, 2013.

On all new claims, use the new SIF-5A.


Effective December 1, 2013:
You are required to use the new SIF5-A form to calculate wages. 

The old SIF-5A is came off the self-insurance website on December 2, 2013:

  • If you started the wage calculation on the old SIF-5A, continue using it for the life of the claim. 
  • Ray Hershey will take requests for the old SIF-5A, making sure you need it before sending it by email. Ray’s contact information is:

Web Resources
Along with the SIF-5A Cover Sheet: Wage Calculations, you can use the Claims Adjudication Guideline, Wages and Temporary Total Disability, pages 5 through 27, for detailed instructions.


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