The Oregon Workers’ Compensation Division has posted the following bulletin on how to apply employer-paid medical reimbursement claim costs for individual claims for unit statistical reporting purposes, and provides max reimbursement amounts.
This bulletin tells insurers how to apply employer-paid medical reimbursement claim costs for individual claims for unit statistical reporting purposes and provides updated maximum reimbursement amounts. This bulletin replaces Bulletin No. 345 dated Aug. 19, 2010.
An employer may choose to reimburse its workers’ compensation insurer for medical services on accepted non-disabling claims up to certain amounts and not have those medical expenses charged to the employer in any other way. ORS 656.262(5).
Before each policy year, insurers must send employers a notice advising of the employer’s right to reimburse insurer-paid medical service costs up to the maximum amount set by the director. OAR 436-060-0055(2) outlines the information that must be provided in the notice. An employer may choose this reimbursement option regardless of which workers’ compensation carrier insures the employer or whether the insurance policy addresses the reimbursement option. The insurer must exclude the reimbursed costs from the employer’s experience rating.
For 2012, the maximum reimbursement amount remains unchanged at $1,700. Base the application of the reimbursement amount on the date of injury, regardless of the effective date of the policy.
Insurers reporting to the National Council on Compensation Insurance, Inc., under the URE Workers’ Compensation Statistical Plan approved by the director, are to use up to $1,700 per non-disabling claim if the injury date was on or after Jan. 1, 2012. If the injury date was before Jan. 1, 2012, refer to the chart on the back of this bulletin for reimbursement amounts in effect at that time.
The complete bulletin with rates is available here (.doc).