CHWCA Annual Program Review For Period of 1/1/11-12/31/11 April 27, 2012 Prepared and Presented by: Innovative Claim Solutions, Inc.

Claims Entered 1/1/10 to 12/31/101/1/11 to 12/31/11 AbsolutePercent for one yearChange Total Claims % Total Indemnity Claims % Total Medical Only Claims % Avg. Incurred Cost per Claim$5,498 $11,454 $5,956108% Total Paid$478,557 $1,063,760 $585,203122% Total Est. Future Liability$621,009 $1,009,325 $388,31663% Avg. # of Disability Days % per Lost Time Claim Number of Lost Time Claims % 12/31/201012/31/2011 AbsolutePercent Open Claim InventoryChange Indemnity % Medical Only % Total Open Claims % Est. Future Liability$7,657,324 $9,435,118 $1,777,79423%

Bill Review Savings During the period of to for CHWCA, 4,400 bills representing $3,553,718 in billed charges were submitted for review and adjusted to the fee schedule and PPO discounts that resulted in gross savings of $2,035,890, and a net savings of $1,789,211, or 50.4% Utilization and Peer Review Savings During this period 62 cases were submitted for Utilization or Peer/Physician Advisor Reviews. Of those cases submitted, 33 cases were recommended for denial. Of those cases denied, 2 cases were appealed. None of those cases appealed were reversed, leaving 33 cases as denied services. Excess Recoveries At the present time, ICS is updating various excess carriers on 39 claims that have penetrated the reporting level. During this period $438, was recovered on 9 different claims where the payments have exceeded the JPIA’s retention levels. We will continue to pursue regular reimbursements on all claims whose payments exceed retention levels.

Delays/Denials During this period thirty-two claims were placed on delay. Additionally, there were twenty-eight denials during this period. Of the twenty-eight denials, five were reversed leaving twenty-three as denied. Subrogation/Contribution Recoveries During this period a total of $114, was recovered through subrogation, fraud or contribution recovery efforts from other carriers or parties on seven claims. The following chart shows these recovery totals: Recovery TypeRecovery AmountTotal RecoveriesTotal Paid Subrogation$111, $130, Fraud*$2,400.00$10,800.00$111, Contribution*$1,081.81$31,027.66$191, Totals$114,584.53$152,930.38$433, *These are on-going recoveries that will continue.

Settlements Case resolution is an important aspect of any program. During this period forty- two cases were settled, twenty-five by Stipulation, sixteen by Compromise and Release and one by Findings and Award. Of the forty-two cases settled, twenty- two cases did not require applicant representation and twenty-four did not require defense attorney representation. Notices of Representation During this period eighteen notices of representation were received. This represents a decrease of 28%, (or 7 notices), compared to the same period last year. This is also a 9.9% litigation rate, below the statewide average of 14%.

Comparative Payment Analysis Comparative Payment Analysis by Date of Injury Payments for1/1/10 -1/1/11 -AbsolutePercent All Claims for All Years12/31/1012/31/11Change TD Paid$443,586.66$509,556.80$65, % PD/C&R Paid$374,139.11$889,792.78$515, % Medical Paid$1,206,414.03$1,896,083.14$689, % Vocational Rehab Paid$1,667.28$0.00-$1, % Legal/Investigations Paid$303,275.02$331,937.50$28, % Total Paid:$2,329,082.10$3,627,370.22$1,298, %

Average Indemnity Days For all indemnity claims receiving temporary disability benefits during this period, the following chart depicts the average number of indemnity days per claim. The indemnity days are calendar days off due to injury. Delay in Reporting During this period, 181 claims were reported with an average delay of 4.73 days from the date of employer’s knowledge to the date ICS was notified compared to 4.87 days for the same period last year. The median delay was 1 day, while 15% were not reported within the State guidelines of 5 days. PeriodIndem DaysClaimsAverage 1/1/09-12/31/ /1/10-12/31/ /1/11-12/31/

Claims by Fiscal Year based on Date Entered

Total Paid and Incurred by Fiscal Year based on Date Entered

Frequency Analysis Summaries The following graphs are based on claims entered from 1/1/2011 through 12/31/2011. Age of Injured Worker

Length of Service