COMBINING SERVICE & SAVINGS SAFE, LLC 620 Erie Blvd West, Suite 100 Syracuse, NY 13204 Toll Free (866) 300-SAFE SAFETPA.COM

SAFE Program Businesses of any size benefit from a structured Return to Work Program for Injured Workers. This program is an effective way to reduce the costs associated with a Workers’ Compensation injury. The direct savings include a reduction in paid indemnity benefits to the injured worker and the reduction in the long term medical costs due to the early intervention services. The business benefits from lower insurance costs due to the decrease in the Workers’ Compensation Experience Modification factor. SAFE has a proven track record of returning an injured worker back to work through a 10 step process. The staff at SAFE will walk your business through the establishment of the program and problem solves to remove any barriers that may arise. The following results are real numbers showing the difference SAFE can make.

Return To Work Ratio   97% Overall RTW Ratio

SAMPLE ACCOUNT Company A – If Premium at 1.0 is $800,000 Year Modifier Premium Variance   2013 1.34 $ 1,072,000 +$272,000 2014 1.51 $ 1,208,000 +$408,000 2015 1.45 $ 1,160,000 +$360,000 2016 1.09 $ 872,000 +$ 72,000 2017 .88 $ 704,000 - $ 96,000 2018 .89 $ 712,000 - $ 88,000

Average Experience Modifier

SAMPLE ACCOUNT 2011 2012 2013 2014 2015 2016 2017 Total OSHA cases   Total OSHA cases Lost day OSHA cases Restricted Duty OSHA cases Other cases Total Lost work days Restricted Days Injury rate DART rate 2011 67 35 34 1502 31 8.2 3.8 2012 54 23 1170 7.0 4.4 2013 41 21 1 19 900 12 5.1 2.7 2014 42 16 6 237 301 5.6 4.7 2015 7 11 228 154 4.2 2.8 2016 17 4 20 694 486 2.6 2017 32 15 393 575 2.0

Incident Rates  

Closure Ratio 88% Overall

SAFE Results Indemnity claims cost an average of 40% less than indemnity claims for similar exposures in New York. 62% of our captive indemnity claims close in the 1st year as opposed to an industry average of 40%. Code Rule 60 Return to Work was approved for the first self insurer in NYS in 2017

SAFE Return To Work Program Below are the 10 steps to implementing your RTW Program. SAFE can provide and customize these procedures and provide forms to ensure your success: Step 1. A written employer’s statement of commitment to provide a safe, gainful, and meaningful employment to employees as soon as medically possible following an on-the-job injury or illness. Step 2. A written plan for communication will be developed that addresses all parties, including the employer, injured worker, supervisor and the treating physician, in order to facilitate an employee’s return to work. The communication must be made in accordance with applicable privacy laws. Step 3. The Development of Policy and Procedure’s for returning injured employees to the workplace that is communicated to all employees. This is achieved through various means including training sessions, poster placement and other systems of communication to all employees.

SAFE Return To Work Program Step 4. A procedure that focuses on returning the employee to his or her pre-injury employment in a safe and timely manner, accommodating the needs of that employee concerning a position with the employer, and which do not cause undue hardship on the parties. Step 5. A procedure for ensuring the involvement of the injured employee in all aspects of the return to work process. This is done through communication with an assigned Return to Work Coordinator. Step 7. A procedure for ensuring that the injured employee’s treating physician is, in a timely manner, given information which will assist in determining the injured worker’s ability to return to the pre-injury job, a modified job, or a short term suitable alternative work assignment at the employer.

SAFE Return To Work Program Step 8. A process for the development and implementation of a written individual return to work plan for each injured or ill employee, developed by the employer and the employee. Step 9. A procedure to return an injured worker to the pre-injury job as soon as it is medically determined by the treating physician that the employee is capable of performing the essential duties of their pre-injury or pre-illness job. A full duty release would be supplied by the treating physician when the employee is ready to resume full duty employment. Step 10. A procedure for monitoring the employee’s progress, recovery, and return to work, with notice to the employee’s treating physician. This is tracked through the employee RTW log to monitor physical progressive improvement to the pre-injury job. Injury Envelop should be utilized for each provider appointment. .