| Q. |
Why was the CAS program
established? |
| A. |
The East Texas Educational
Insurance Association, the West Texas Educational Insurance
Association, and the Texas Public Junior & Community College
Employee Benefits Consortium were established as a long-term
solution to the high cost of workers’ compensation coverage
for Texas schools. CAS understands that every dollar spent belongs
to the client. CAS takes an aggressive and pro-active stance
in every aspect of the claims process. This assures our clients
the lowest possible claims cost. In
addition:
- CAS clients have 40% fewer employee
injuries. Fewer injuries translates into lower claims cost.
- A recent study indicates that CAS’
aggressive approach reduces our clients cost 30% over the
competition.
- CAS offers custom designed managed
care programs which provide the highest level of treatment
while keeping total claims cost lower.
- CAS identifies the claims cost in
advance. Therefore, the client can avoid unexpected surprises
in their budget.
- CAS specializes in developing innovative
solutions to control insurance costs.
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| Q. |
What are the limits
of liability for the school district? Who is responsible for
paying the claims once the district’s liability has been
met?
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| A. |
The district is liable for claims
and sharing up to the amount of their loss fund. No district
is responsible for claims and sharing in excess of their own
loss fund. Should the district’s claims exceed the loss
fund, all members of the association who have not exceeded
their loss fund will share in the cost of the claims according
to their loss fund percent up to the specific limit. Should
a single claim exceed the specific limit, the excess insurance
carrier will assume financial responsibility of that claim.
If all districts exceed their individual loss fund due to
claims and sharing, the excess insurance carrier will assume
financial liability for all outstanding claims. (As indicated
in the first question above, the purchase of excess insurance
is included in the fixed cost.)
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| Q. |
How does a participating
school district withdraw from the program? |
| A. |
Any district that wishes to leave the
program must give a 60-day written notice prior to the effective date for the
new policy year. Also, a district must give notice when their agreement term is
ending and they wish to leave. If not, the program will automatically renew. If
a district is currently in a multi year contract, they may not leave without a
penalty. |
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| Q. |
Who handles my account?
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| A. |
Several people are assigned to each
account based on physical location, severity of claims, and size of district.
Each district has been assigned a minimum of four representatives in addition
to the CAS managers and supervisors. These four people are: your account
representative, customer service representative, loss control/safety
representative, and claims adjuster. |
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| Q. |
Who do I call when I have
a question about fund sharing? |
| A. |
Brenda Stephenson, Vice President,
will answer questions about fund sharing, checks and payments.
She may be reached at 800-765-2412 x228. However, if there
is a question about a claim regarding issues other than money
or benefits to be paid, you may contact your adjuster.
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| Q. |
I’ve had my first
injury. What do I do?
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| A. |
Initially, a first report of injury form
should be filled out and sent to CAS. Then, the adjuster will speak with the
claimant and district regarding details of the claim. Finally, medical
providers and the claimant will be paid benefits. |
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| Q. |
Where do I get additional
TWCC forms? |
| A. |
Initial supplies of the required forms
are included in the CAS Administrative Services Kit, which is mailed to all
districts upon enrollment in our program. The TWCC Quick Forms Software Program
provides the forms. Forms may be obtained by contacting your Customer Service
Representative. In addition, you may obtain forms from the Internet. Also, you
can always make copies of your original forms. |
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| Q. |
How do I inform employees
they are covered? |
| A. |
CAS is your workers’ compensation
claims administrator. All clients/districts must post notices
providing this information in both Spanish and English. These
notices are included in the CAS Administrative Services Kit.
However, should you need additional copies, please call your
Customer Service Representative at CAS to obtain copies of
these notices.
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