Magazine article Risk Management

The Truth Behind 24-Hour Coverage

Magazine article Risk Management

The Truth Behind 24-Hour Coverage

Article excerpt

ENVISIONED BY SOME observers as a sure-fire way to reap savings, the socalled 24-hour care plans are one of the most widely discussed issues on today's benefits scene. In principle, 24-hour plans are designed to reduce the high costs associated with claims administration while eliminating "double dipping"the filing of claims for the same injury under both workers' compensation and employee benefits plans. A 24-hour plan would accomplish this by combining elements of workers' compensation and group health insurance programs to provide coverage to employees both during and after work.

Although the concept of 24--hour coverage has existed for a number of years, the discussion today is centered on the actual merging of workers' compensation and health benefits. "In the past, the idea of 24-hour coverage focused on joint management of both workers' compensation and employee health claims." says Cecily Gallagher, a principal in the San Antonio office of Tillinghast. "Today, however, the talk about 24--hour coverage focuses on any program that provides benefits for both non-occupational medical and disability benefits and workers' compensation in a single plan." Proposals vary. Ms. Gallagher reports that some plans would provide full-time medical benefits to all employees, while limiting indemnity benefits to occupational injuries; others would offer complete benefits for all injuries, but only work-related diseases. Another plan calls for universal coverage designed to provide medical and disability benefits for all illnesses and injuries on an around-the-clock basis.

Today's concept of 24hour plans represents a completely new type of coverage that has yet to be tested on a large scale. "These plans are currently in an embryonic stage: no insurer has yet written a policy for 24-hour coverage," says Larry Kibbee, vice president of the Alliance of American Insurers in Schaumburg, Illinois. …

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