Rate Framework: Experiencing Rating Programs

Starting January 1, 2020, our new premium rate-setting model will be replacing all existing experience rating programs. We will be moving to a prospective rate-setting approach instead of a retrospective rate-setting approach. This means that your individual claims experience will be factored in when we set your premium rates.

Here is a list of your final statements, rebates/surcharges and adjustments:

Experience rating program

Final statement issued

Final rebate

Final Surcharge

MAP

December 2018

2019 premium year

2019 premium year

NEER

November  2020

January 2021

December 31, 2020

CAD-7

September2020

November 2020

October 31,2020

Rate Framework: Experiencing Rating Programs

How will I transition into the new premium rate-setting model?

Your 2020 premium rates will be set using your paid claims experience for injuries or illnesses from 2013 to 2018. If you were part of an experience rating program, your experience rating adjustments issued in 2016, 2017 and 2018 will also be considered in your 2020 premium rates.

Experience rating adjustments issued in September 2019 will not be included in your 2020 rates calculation, as they will not yet be available when we set rates.

Also important to note:

  • If a business is eligible for NEER in 2018, then your first NEER statement, a system generated statement issued quarterly to all NEER businesses that includes claims information for monitoring purposes, will be issued in 2019, and will not be included in your 2020 premium rate calculation.
  • Our new premium rate-setting model will take effect on January 1, 2020, with businesses receiving their final NEER and CAD- 7 statements in the fall of 2020. The statement will include any adjustments based on the first assessment of their 2019 claims, second assessment of their 2018 claims, third assessment of their 2017 claims and fourth assessment of their 2016 claims. These would be the final assessments for each of these accident years.

Example: Business A is assigned a NEER surcharge of $100,000, based on their September 2019 statement. In September 2020, NEER costs drop for Business A, since there are fewer claims and an increase in health and safety initiatives for that year, resulting in a $20,000 rebate. This business would receive its $120,000 rebate in December 2020. The final NEER assessment will be issued in November 2020 and rebate cheques will be mailed in January 2021.

Similarly for a business that’s part of the CAD-7 experience rating program, the final CAD-7 assessment will be issued in the fall of 2020, which will account for the 2019 and 2018 review years. If a business is entitled to a rebate, the rebate will be mailed in November 2020.

I’ve already received an adjusted premium rate under one of the MAP, NEER or CAD-7 experience rating programs, why are these years being considered again under the new model?

Any rate adjustment under the existing experience rating programs is applicable only to years preceding implementation of the new model. We use claims experience from these years to set future premium rates. This means that the experience for these years is not being double-counted. We simply use it as a guide to future rate-setting. This rate-setting approach is the same approach used under the current system for setting rate group rates.

Will I continue to receive rebates/surcharges under the new model?

No, since we are moving to a prospective rate setting approach, there will be no rebates or surcharges under our new model. The rates you pay under the new model will better reflect your individual claims experience, making experience rating programs unnecessary.

Are my past rebates going to be used to calculate my rate?

Yes, we will consider your 2016 to 2018 premium rate adjustments under the NEER, CAD-7 and MAP programs and your claims experience from 2013 to 2018, to determine the rate you will pay under our new model.

What claims will be used to calculate my rate under the new model?

All allowed claims will be considered when calculating your rate under the new model, including claims with “zero costs.” It is important to note that certain claims will be excluded at the employer level. For example, specific long-latency occupational disease claims will be excluded. As well, certain high cost claims will be capped based on an employer’s per claim cost limit. These concepts exist as well in the current experience rating programs.

Why does the new model factor in both allowed lost time and no-lost time claims, when setting rates?

Both lost-time and no lost-time claims lead to benefit payments under the Workplace Safety and Insurance Act. As a result, we use both types of claims for the determination of an employer’s predictability and actual claims cost.

Note: The impact of a single claim will vary by business depending on the class a business belongs to, their individual risk and other parameters as defined by the new model.

Can I get detailed breakdown of how my claims affect my rate?

Starting in 2020, you can request an extended summary statement that provides details about how your individual premium rate was calculated, your individual rate adjustments based on your claims experience and a breakdown of your claims costs. Only claims costs paid are included in the calculation of your rate. Concepts such as reserve factors and loading factors will not be used under our new rate setting model.

How is my past experience used in ER programs vs. rate framework?

Pre-rate framework

Under the current rate-setting system, we consider six years of experience to determine your rate group rate for all businesses, whether or not they participate in the experience rating programs. Then, in addition to that, for businesses participating in experience rating programs, we look at three years to determine your adjustment. Each year, you are charged your individual rate, that is, the rate group rate adjusted with the prospective adjustment for businesses participating in experience rating programs.

Post-rate framework

Under our new model, we will look at six years to set employer individual rates and there will be no additional adjustment programs. Please note: We will treat excluded claims under the rate framework the same as we did previously.

NEER and CAD-7

Will my new rate include my NEER adjustments that I’ve already paid for (or received) for a specific year?

Information for businesses eligible for NEER in any injury year issued in calendar years 2016, 2017 and 2018.

  • If you were eligible for the NEER program for any injury year issues in calendar years 2016, 2017 and 2018, your Current Organization Adjustment will be used when determining the 2020 premium rates as it appeared in the:
    • NEER Organization Summary Statement for September 30, 2016,
    • NEER Organization Summary Statement for September 30, 2017 and
    • NEER Organization Summary Statement for September 30, 2018

For single or multi-account organizations, all rate number NEER organization summary statements will be used in determining a business’s 2020 starting point.

The 2019 NEER organization summary statements for September 30, 2019 will not be considered in the 2020 rate setting as this information will not be available when we set 2020 rates.

Merit Adjusted Premium (MAP) Program

How is past experience used in MAP vs. rate framework?

Pre-rate framework

Under the current rate-setting system, we consider six years of experience to determine your rate group rate.

Then, in addition to that, we look at three years to determine a MAP adjustment.

Each year, you are charged your individual rate, that is, the rate group rate adjusted with your prospective MAP adjustment.

Post-rate framework

Under rate framework, we will look at six years to set employer individual rates and there will be no additional adjustment programs.

We will treat excluded claims under the rate framework the same as we did previously.

If a business has received the 10 per cent discount through the MAP program, will that discount be grandfathered into the new model?

The MAP program will end before our new premium rate setting model is implemented and the 10 per cent discount will not be transitioned into the new model.

We will use your experience under the current system from 2013-2018 (and MAP premium rate adjustments for premium years 2016-2018) to determine the rate you will pay under the rate framework. 

As a small business that’s currently in MAP, how will lifetime claims cost for a 2018 claim affect my rate under the new premium rate setting model and is there a claim limit that will guide decisions relating to return to work?

No, there is no claim limit in the new model that would guide any decisions relating to return to work, as is now the case under MAP. In the new model, all claim costs will be considered a part of a business’s individual claims experience and will be used to set a business’s individual rate. Premium reductions or increases will be driven by your claims costs in comparison to your class.

Under the new model, all benefit payments made during the six years preceding the rate calculation year for injuries arising during this six-year period will be taken into account when setting rates for the rate year. For example, rates set for 2020, the rate year, will be set in 2019, the rate calculation year. All benefit payments made from 2013 to 2018 for work-related injuries/illnesses arising from 2013 to 2018 will be taken into account for the rate calculation.

There are per employer claim limits, varying with the predictability level of your business. These serve to limit the extent to which individual experience will factor into your rates. Claims excluded from individual employer rates in this way are charged for at the class level i.e. distributed over all businesses within the same class.