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TXANS Association of Responsible Nonsubscribers

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Iíll admit I was once on the side of those making the safety program argument because I believe the best program is one that prevents injuries from happening in the first place. But after working in the nonsubscriber arena for 20+ years, Iíve moderated my view. While I still very much believe that injury prevention should be the principal goal of ANY benefit program, I see too many instances where nonsubscribers, including those with excellent safety programs, face problems that could have been completely avoided.

Hereís one example. An employee of a nonsubscribing company sustains a relatively minor injury and reports the injury to the appropriate manager. The manager fails to notify the claims administrator of the injury so instead of being directed to a qualified medical provider the employee chooses his own treatment facility.

During the course of treatment, the medical provider is unwilling to work with the employer to identify alternative positions that could accommodate the employee as he recovers and the employer receives a medical bill equal to the annual gross domestic product of a small nation.

While simply stated and a perhaps a little exaggerated, the example demonstrates my point. Despite an exemplary safety program, substantial amounts of coverage and an up-to-date injury benefit plan, a seemingly simple breakdown can have costly consequences.

Better training or allowing employees report their own injuries directly to the claims administrator might have prevented the problem but there are also hundreds of other issues that could have arisen during the course of the claim.

So as we reflect on our original question as to the crucial element that would ensure the success of any nonsubscriber program, it is easy to see from this example that there is no single issue. The benefit plan is as important to the success as insurance which holds the same significance as communication and effective claims management. The success of a nonsubscriber program cannot hinge on a single issue but rather on effectively managing each and every element of a responsible nonsubscriber program.

Steve Bent is the Executive Director of the Texas Association of Responsible Nonsubscribers and the Employment and Economic Policy Center.

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