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Overview:

The State Compensation Insurance Fund (SCIF), also known as the State Fund, is the largest provider of workers’ compensation insurance in the state. It is considered the insurer of last resort and plays a key role in guaranteeing the availability of affordable workers’ compensation insurance in California. Small and medium-sized companies, which have a difficult time getting affordable, legally required workers' compensation coverage, often rely on the State Fund. The quasi-government organization is self-sufficient, funding its operations with insurance policy premiums and investments rather than taxpayer money. Its staff works for the government although it operates as a private company.

 

Office Locations (State Fund website)

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History:

California’s first workers’ compensation law, known as the Roseberry Act, was passed in 1911. It was a voluntary plan meant to help employers find protection from injury-related litigation, while providing workers with financial support as they recovered from work-related maladies.

Participation by employers was low. Two years later, a compulsory plan called the Workers' Compensation, Insurance and Safety Act of 1913 , or Boynton Act, was passed. The Boynton Act required employers to provide benefits for their employees on the job.  It also generally prohibited employees from suing their employers because of injuries. 

The act called for establishing a competitive state insurance fund, which led to the founding of the State Compensation Insurance Fund in 1914. Although the Boynton Act provided $100,000 to start the fund, the seed money wasn’t used. Instead, the fund financed itself with money received through premiums. 

Within a year of the State Fund’s formation, the state, through its Industrial Accident Commission, began contesting worker benefit claims because of increased costs. The commission recommended hiring a traveling medical inspector to “diminish the abuse, now frequent, of over-stay in hospitals” by injured workers although the hospital stays were often on the advice of doctors.

The Great Depression of the ‘30s took a heavy toll. Eighteen private workers’ compensation insurance carriers were declared insolvent and approximately $2 million in workers’ claims went unpaid. But the State Fund continued to make its payments.

In 1945, new state legislation created the fund’s board of directors to oversee the agency and provide it with a larger measure of independence from the state. Twenty years later the State Fund began decentralizing its operations by opening district offices and in 1968, it increased the authority of district managers.

Republican Governor Pete Wilson signed reform legislation in 1993 that partially deregulated workers’ compensation insurance rate by introducing an “open rating” plan for private insurers and repealing the law that set minimum rates. Private companies were free to provide under-priced premiums to employers. As these companies fought to undercut each other and gain market share, the State Fund held its rates steady and watched many of its employer/clients flee to the private market.

But many private companies couldn’t survive for long with the low rates and they closed. Market consolidation was followed by skyrocketing rates, costing workers and employers billions of dollars.

By 1996, the State Fund was still huge. It was by far the largest provider of workers’ compensation in California, picking up about 18% of the state’s total collections. Number 2 checked in at 7%. The fund covered almost all of the state’s 276,000-member workforce.

Governor Wilson had convened the Competitive Government Task Force to flesh out a policy one government official described as a move “back to the basics. To the extent that state government is involved in functions beyond its core functions, it needs to get out," he said. Wilson’s eventual blueprint for reform was called “Competitive Government: A Plan for Less Bureaucracy, More Results.”

“Privatizing” the State Fund was one of the task force’s suggestions. The idea had been floated in 1993, but had met resistance from organized labor and Democrats in the Legislature. Unlike many privatization debates, this one did not center around saving money because the State Fund was self-sufficient. It was part of a philosophical battle over the role of government.

Wilson maintained that the State Fund functioned like a private enterprise—even competed with the private sector—and laid out his plans in April 1996 to privatize it. He also proposed: abolishing 12% of the state’s 32,000 regulations; transferring a portion of highway planning to local agencies; transferring one of California’s law schools to a private or nonprofit entity; eliminating the Department of Boating and Waterways; and contracting out a significant portion of work done by the Department of Motor Vehicles.

 “He's a serial privatizer who can't help himself,” said Drew Mendelson, a spokesman for the California State Employees Association “This is political. This is more hot air than reality at this point.” 

This time, labor and Democrats were joined by business leaders in opposition to privatizing the State Fund and the proposal went nowhere.

By 2003, 28 companies operating in the new, deregulated environment had gone under. The fortunes of the State Fund fluctuated, depending on the state of the economy.

Shortly thereafter, the Legislature began changing workers compensation laws to lower costs to employers. As costs fell more companies were able to obtain private insurance and the State Fund began to lose part of its 52% market share.

In March 2007, the State Fund board of directors removed its president, James Tutor, and vice president of group insurance programs, Renee Koren, after an internal investigation turned up “unacceptable” operation of an administrative fee program. An independent investigation of the agency that involved the California Highway Patrol and the San Francisco District Attorney ensued but four years later the DA ended the probe and announced that no criminal charges would be filed.

In May 2009, Governor Arnold Schwarzenegger proposed selling some assets of the California Workers Compensation Fund to balance the state budget. State Insurance Commissioner Steve Poizner sued to stop the sale that would have netted $1 billion for the cash-strapped state. Schwarzenegger left office at the end of the year with a number of asset sale proposals unfinished.

The State Fund announced a reorganization plan in December 2010 that could save $200 million over two years by closing offices and relocating employees. Although the agency said it was not firing any of its employees, it made it clear the projected savings would only be attained with a smaller workforce.

Chief among its closures was the 16-story home office on San Francisco’s Market Street where 1,200 employees worked. According to its charter, the State Fund must keep its home office in that city, so plans were made to relocate some financial and legal staff to a smaller location.

In October 2011, State Fund President Tom Rowe announced plans to let go 1,800 employees by June 2012 at a savings of $350 million a year. Rowe cited a steady decline in business since legislative reforms began in 2004. State Fund’s market share fell from 52% in 2004 to 15% in 2010. By the end of 2011, 971 employees on the chopping block had elected to take a buyout package and give up preferential rights to other state government jobs.

In April 2012, Rowe announced that 1,300 workers had left and that he was sparing the remaining endangered staff.

 

History (State Fund website)

State Fund Plans to Lay Off Up to 1,800 Workers by June (by Marc Lifsher, Los Angeles Times)

Workmen's Compensation History and Overview (Institute of Governmental Studies at UC Berkeley)

Wilson to Unveil Major Privatization Proposal (by Dave Lesher, Los Angeles Times)

Governor Floats Proposal to Privatize Some State Services (by Greg Lucas, San Francisco Chronicle)

Workers Comp Scandals in other States (ReformRetro.org)

Inquiry into State Compensation Insurance Fund Ends (by Marc Lifsher, Los Angeles Times)

State Fund Board Opposes Sale of Entity (by Tom Abate, San Francisco Chronicle)

Poizner to Sue Governor Over Workers' Comp Sale (Associated Press)

Plan to Sell Piece of State Compensation Insurance Fund Collapses (by Marc Lifsher, Los Angeles Times)

State Compensation Insurance Fund Consolidating Operations (by Jon Ortiz, Sacramento Bee)

State Compensation Insurance Fund OKs Staff Bonus Program (by Jon Ortiz, Sacramento Bee)

California State Insurance Agency Cancels Layoff Plans (by Jon Ortiz, Sacramento Bee)

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What it Does:

The State Fund has the dual role of providing employees with benefits to compensate for the loss of work and protecting employers against losses caused by work-related accidents and other maladies. According to California state law, employers are required to provide workers’ compensation insurance at no cost to their employees.  If an employee is injured or becomes ill due to his or her job, workers’ comp helps provide medical care and income while the employee is out of work.

There are about 180,000 policy holders currently enrolled in the program, vastly outnumbering private injury claims agencies in the state. Insurance premiums top $1.3 billion and the fund has more than $20 billion in assets.

The quasi-government organization is self-sufficient, funding its operations with insurance policy premiums and investments rather than taxpayer money. Its staff works for the government although it operates as a private company.  

The governor appoints nine of the State Fund board of director’s 11 voting members, including one from organized labor, and selects its chairperson.  The state Assembly speaker appoints one member, who represents organized labor, while the state Senate Committee on Rules also appoints one member.  The Department of Industrial Relations director serves as a non-voting “ex-officio” board member.

Board members receive $50,000 in annual compensation.

It offers employers group insurance discounts using a merit plan, resulting in lower-than-average premiums in some classifications and industries.

The State Fund maintains a geographically diverse network of physicians and specialists for injured workers. It also operates the Return to Work Program that helps employers transition injured employees back to work.

The State Fund has a 32-member Special Investigation Unit that coordinates anti-fraud programs, training and educational materials for policyholders. The unit also reports cases of suspected fraud to the California Department of Insurance’s Fraud Division and district attorneys throughout the state. The unit is a member of the state’s Fraud Assessment Commission.

The agency’s Safety and Health Services offers assistance to policyholders at no charge. It provides ergonomic evaluations, air sampling and on-site inspections plus assistance in Cal/OSHA compliance. The unit also publishes publications and newsletters targeted at specific employment sectors (manufacturing, agriculture, public agency, construction, and trades and services).    

The State Fund’s Small Business Resource Center provides information to companies wishing to establish their own injury and illness prevention program. The center has Hazard Checklists, Loss Control Bulletins, an Experts’ Corner, safety catalogs and links to other ergonomic resources.

The agency’s Medical Provider Network provides employers with access to medical personnel who specialize in occupational injuries and illness as well as more general areas of medicine. It maintains a list of medical providers that is accessible online and a 24-hour claims reporting center.  

The State Fund’s stated mission is to provide businesses and employees with fairly priced workers’ compensation insurance and help get workers back to work after an injury or illness.

Under California’s Labor Code Section 3700, all employers must provide workers’ compensation insurance to their employees. There are five basic types of comp benefits:  medical care, temporary disability benefits, permanent disability benefits, vocational rehabilitation services and death benefits.

Workers' compensation premiums are calculated on how employees are classified according to their specific work duties and the rate assigned to each corresponding employee classification. Classifications are developed and assigned by the workers' compensation Insurance Rating Bureau (WCIRB) in most cases.

There are two sections, or “Parts,” that apply to either employees or employers under California state insurance law. Part One applies to workers’ injury claims, while Part Two protects employers when employee injuries or diseases are not considered work-related.

Since California employers are required to provide insurance to their employees, they must buy the premiums from either a licensed insurance company or the non-profit State Fund, which also acts as the insurer of last resort if private companies decline to offer workers’ compensation insurance.

 

Employers (State Fund website)

Employers’ Liability and Workers’ Compensation  (Allinsuranceinfo.org)

What You Should Know About Worker’s  Compensation and Employer’s Liability Insurance Coverage Before Buying  (Employers Liability Insurance)

Office Locations (State Fund website)

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Where Does the Money Go:

The State Fund provides workers compensation insurance for state employees as well as employees at private companies that choose to get their insurance from the state. It funds its activities through paid insurance premiums and investments. No money comes from state taxpayers or the federal government.

The State Fund’s official budget does not include information on the cost of benefits for State of California employees; those numbers are contained within the individual budgets of the responsible state agencies. But the State Fund budget does include estimated benefit numbers for state employees for informational purposes only.

Forty-seven percent of the State Fund’s $1.64 billion budget in 2011-12 is earmarked for non-state employee workers’ compensation benefits. The rest goes to administration of the program. Of the $871 million for administration, 68% is spent on personnel and the rest on operating expenses and equipment.

The State Fund administrative costs include salaries for about 500 attorneys who handle contracts, litigation and mediation.  

The 2011-12 budget also earmarked an estimated $540 million for state employees.  Around $96.7 million of that goes to administrative costs, $3.8 million is for policy premium costs and the rest pays for worker benefits.

 

3-Year Budget (pdf)

2010 Annual Report (State Fund website)

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Controversies:

Bonuses and Layoffs

The State Fund paid $30 million at the end of 2011 to 971 of its 7,300 employees who agreed to take a buyout, leave and give up preferential status in applying for other government jobs. Another 705 jobs remained on the chopping block while the agency projected a multi-year savings of $200 million. By April 2012 when State Fund President Tom Rowe cancelled the bloodletting, 1,300 of an anticipated 1,800 departees had left.

Although the layoffs—which were presented as necessary cost-cutting measures in difficult financial times—haven’t been completed, the State Fund’s board of directors moved ahead on another employee compensation issue: bonuses for those remaining.

The board approved the Performance Award Program in February 2012 that could provide employees with up to an additional 10% of their base pay. A spokeswoman for the fund said in an email that the bonuses are “an appropriate investment in strengthening and accelerating our transition to a performance-based culture.”

The bonuses are contingent upon negotiations with the union. Neither the bonuses nor the buyouts cost the taxpayer any money; the State Fund is funded solely by policyholder premiums and investments.

 

Read State Fund Chief's Layoff E-mail to Employees (Sacramento Bee)

State Fund “Transition” Contract Details Jobs Targeted for Layoffs (Sacramento Bee)

State Fund Pays Out $30 Million; 705 Jobs Still on Chopping Block (by Jon Ortiz, Sacramento Bee)

State Compensation Insurance Fund OKs Staff Bonus Program (by Jon Ortiz, Sacramento Bee)

 

State Fund Investigated

Scandal rocked the State Fund in 2007. The board of directors fired President James Tutor and the vice president of group insurance programs, Renee Koren, in March after an internal investigation turned up “unacceptable” operation of an administrative fee program.

State Insurance Commissioner Steve Poizner ordered an audit of the agency and a parallel criminal investigation ensued. Poizner’s Department of Insurance is charged with regulating the State Fund.

Poizner released his findings in December 2007, finding “serious structural and operational issues.” The audit said the board of directors was not up to the task of overseeing an agency the size of the State Fund; management lacked key positions, like a Chief Financial Officer and a Chief Operating Officer; and it cited a lack of controls over material expenditures and information technology.

But most damning was the audit’s finding of potential conflicts of interest involving hundreds of millions of dollars stretching over the previous decade.

More than $500 million had been paid for outside marketing help that often provided “minimal services.” About half the money was directed to organizations with financial ties to two State Fund board members, Frank DelRe and Kent Dagg, both of whom resigned in November 2006. Dagg was appointed by Republican Governor Arnold Schwarzenegger in 2004 and DelRe was appointed by Democratic Governor Gray Davis in 2003.

The State Fund paid $140 million in group administrative fees to DelRe’s company, Western Insurance Administrators, from 1996 to 2007. Building trade associations with ties to Dagg were paid $125 million during the same period.

A significant portion of State Fund policies are sold through group insurance programs run by third-party, for-profit administrators as well as professional associations and trade groups. According to the Insurance Department audit, State Fund's management and board didn’t complete any internal audits of fees paid to outside administrators of the group association programs.

In addition, the Insurance Department audit found: paid invoices without a purchase order or contract; 2,000 fleet vehicles that hadn’t been audited since 2003; lower-level employee access to the agency’s Oracle payment system; a lack of background checks on IT vendors; no check on what former employees did with equipment after they left; virtually no oversight of group administration fees.

Partially based on its findings, the Insurance Department joined with the California Highway Patrol, the San Francisco District Attorney’s office and the State Fund itself to further investigate. 

The investigation ended in 2011 with the DA announcing that no criminal charges would be filed.

 

Beleaguered State Fund to be Audited (by Matthew Yi, San Francisco Chronicle)

State Fund Severs Ties with Group Administrator; Issues Update on Audit (by Frederick L. Pilot, Insurance Journal)

Task Force to Investigate Former SCIF Employees (Insurance Journal)

California Insurance Commissioner Steve Poizner Releases Reports on Examination of State Compensation Insurance Fund (Department of Insurance)

Millions Wasted by State Fund (by Marc Lifsher, Los Angeles Times)

Calif. State Fund Investigation Closed (Insurance Journal)

 

Schwarzenegger Furloughs State Fund Workers

In the face of a growing fiscal crisis, Governor Arnold Schwarzenegger ordered furloughs for a number of state workers in December 2008. But he went too far when he included State Fund employees.

Shortly after the governor issued his furlough executive order, two separate lawsuits were filed on behalf of State Fund employees. One was for 500 legal professionals and the other for the remaining 7,400 workers.

The legal professional suit was filed in Superior Court by the California Attorneys, Administrative Law Judges and Hearing Officers in State Employment (CASE), which is the exclusive collective bargaining representative of 3,400 legal professionals throughout state government.

CASE contended that the furloughs were a salary-setting function and that only the Legislature could do that. It lost the argument, but the court said its ruling didn’t necessarily apply to furloughs for employees of any independently elected constitutional officers or other elected statewide officials.

So CASE refiled its suit based on a provision of Insurance Code Sec. 11873, which states: “the positions funded by the State Compensation Insurance Fund are exempt from any hiring freezes and staff cutbacks otherwise required by law.” This time the court sided with CASE.

After nearly two years of litigation, the case made its way to the state Supreme Court, which in a related decision—Professional Engineers in California Government v. Schwarzenegger—indicated an affinity for arguments similar to ones made by CASE and kicked it back to the appellate court. 

The appellate court found that “we find nothing in the Supreme Court decision inconsistent with our prior conclusions and therefore again affirm the trial court’s judgment.”

Case closed, almost.

The 7,400 State Fund workers who aren’t lawyers were represented in their lawsuit by the Service Employees International Union (SEIU), which wanted no part of the CASE suit. SEIU officials feared that CASE was making an argument that the State Fund was not a state agency, thus threatening future civil service protections for its members.

SEIU won its separate suit and received an award of back pay for its members. But while the CASE and SEIU suits successfully wended their way through the courts, SEIU signed a new labor agreement with the Schwarzenegger administration in late 2010 agreeing to what some considered furloughs (although others called it a personal leave program), but fewer furloughs than were being meted out to other state employees.

In February 2011, the Brown administration dropped the Schwarzenegger appeal of SEIU’s lower court win.

 

C.A. Rules Governor Cannot Order Furlough of Insurance Fund Workers (Metropolitan News-Enterprise)

Should SEIU Have Pressed for No Furloughs for SCIF Workers? (by Jon Ortiz, Sacramento Bee)

SEIU President Criticizes SCIF Lawsuit Win (by Jon Ortiz, Sacramento Bee)

Pay Cuts May Be Coming at State Fund (Workers’ Comp Executive)

California Court Finds Certain State Employees Exempt from Work Furloughs (Epstein Becker Green law firm)

Brown Drops Appeal of SCIF Furlough Win (SEIU Local 1000)

California Attorneys Administrative Law Judges, and Hearing Officers in State Employment v. Brown (pdf)

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Suggested Reforms:

Expand Reach to Out-of-State Employees

At the beginning of 2011, the State Fund pursued legislation that would permit it to insure out-of-state employees of California companies. Legislation to expand the agency’s reach was introduced in the California Assembly in February and could potentially affect up to 30,000 companies in the state.

The State Fund cited 16 of 26 state fund organizations, including those in Arizona, Oregon, Colorado and New Mexico, which have that capability. State Fund President Tom Rowe said the bill would “streamline” the insurance process for many companies that are presently forced to obtain coverage from two or more carriers if they want to use State Fund coverage.

The legislation is opposed by private insurers, which already feel that the State Fund unfairly competes with them for business. The Association of California Insurance Companies, a trade organization, argued that the bill would allow the State Fund to retain its preferential tax status while acting like a private enterprise.

The trade group made a long familiar pitch that the State Fund should privatize like Nevada’s state fund did a decade ago if it wants to act like a private company. Arizona is said to be in the process of making the switch. Governor Pete Wilson made a strong attempt to privatize California’s State Fund in the ‘90s, but failed.    

 

State Fund Seeks to Insure Out-of-State Workers (by Chris Rauber, San Francisco Business Times)

AB 228 (Around the Capitol)

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Debate:

Privatization

Like most businesses in California, the State Compensation Insurance Fund is constantly looking for ways to be competitive, retain its clients and maximize its profits. 

But the State Fund is not a private enterprise. It has built-in tax advantages its competitors lack, an enviable economy of scale, certain legal protections and a state support structure.

A few states in the country have a monopolistic state-run workers’ insurance program and don’t allow private companies to compete. Others have totally privatized the industry, with no public entity competing. California, like many other states, has a hybrid system with a large state-run entity that competes with private enterprises for business.

In recent years, some states have moved toward privatizing their state funds and away from government control. It has been a hot button issue in California for at least two decades. What should California do?

 

Privatize the State Fund

The State Fund functions like business, competes with other businesses, performs a traditional capitalist role of providing insurance and makes a profit. Yet, it remains under government control.

Supporters of privatization argue that the state should get out of the insurance business. They say the entire workers’ compensation insurance market is perverted by inclusion of a dominant state-supported entity. Other companies are hampered by the unfair competition. Insurance rates are distorted, coverage lacks diversity and innovation is stymied.

Meanwhile, a notoriously unsupervised multi-billion-dollar powerhouse with the state’s imprimatur is allowed to set standards for everyone else. The State Fund is among the most blatant examples, critics say, of government interfering in the private lives of its citizens. Insurance isn’t national defense. It’s not law enforcement or environmental protection. It’s a costly duplication of a private sector industry that has proven very successful at what it does.

Michigan privatized its State Fund in 1994. Nevada followed suit in 1999. West Virginia privatized its state fund in 2005. Arizona recently saw the light and will complete privatization of its state fund by 2013. Oklahoma and Colorado are strongly considering making the switch. Washington state voters rejected privatization in 2010 but the issue is expected to be back on the ballot in 2011.

California Governor Pete Wilson attempted to get the job done in the ‘90s, but objections from the usual suspects—organized labor, trial lawyers and liberal politicians—helped thwart his efforts. Privatizers say Governor Arnold Schwarzenegger was on the right track in 2009 when he attempted to sell $1 billion of State Fund assets.

States across the country are, of late, seeing the virtues of privatization in a number of traditional governmental functions. Privatizing the State fund will help right-size government through eliminating non-core functions, provide short-term financing for a cash-strapped state and stimulate the economy.

And then there is the argument that getting government out of people’s lives is in their best personal interest. Washington attorney Michael Myers believes the worst part of government-run workers’ compensation programs is the message it sends to workers.

“It reinforces the idea that injured workers have, e.g., by tearing a muscle or breaking an ankle, somehow gone through a life altering change and are incapable of being productive members of society without substantial retraining and assistance,” Myers wrote online.

“Not only does this mindset waste tax dollars, it really impacts injured workers when they pursue third-party claims. . . . Workers' compensation and the relationships our clients have with the Department of Labor and Industries make it almost impossible for these people to help themselves.”

 

Various State Funds Roll With the Market (Workers’ Comp Executive)  

Amid Fiscal Pressures, States Move to Privatize Workers Compensation Programs (by Leonard Gilroy, Governing.com)

The Handbook of Employee Benefits (Edited by Jerry S. Rosenthal)

Annual Privatization Report 2010: State Government Privatization (Edited by Leonard Gilroy, Reason Foundation)

Workers Comp Managers Say Privatization Beneficial (by Dale Wetzel, Bismarck Tribune)

Privatized Workers' Compensation: Toe the Party Line (by Michael Myers, attorney/blogger)

 

Don’t Privatize the State Fund

The State Fund was created a hundred years ago to fill a desperate need for protection from the forces of rapid industrialization that left injured and ailing workers to fend for themselves. Opponents of privatization say that need has been met by a public agency which has successfully provided for the people’s health care needs while remaining cost-efficient and financially stable.

Early attempts in California to enlist employers’ voluntary participation failed despite their need for protection from lawsuits. And the private sector failed to see the necessary profitability to establish a comprehensive workers compensation insurance industry that would serve large and small businesses alike.

That is why California mandated the purchase by companies of workers’ comp insurance and established the State Fund, with statutory protections that guarantee it as the insurer of last resort for companies. To this day, the overwhelming majority of State Fund clients are small and medium size businesses that have trouble finding insurance in the private market.

Without the state setting standards and anchoring prices, opponents of privatization argue, many companies would find insurance costs prohibitive and workers would find benefits reduced. Big insurance companies would be allowed to set rates, exclude companies and workers from coverage, deny claims, set up their own impenetrable bureaucracies, shield themselves from scrutiny and, in tough times, declare bankruptcy and walk away from their obligations.

This is an attempt to fix a system that works. The State Fund doesn’t use a dime of taxpayer money and stays in the black. In fact, it is that very success that serves as a prime motivation for other companies that want to carve up its lucrative market. 

Some defenders of the State Fund status quo say the push for privatization is ideologically driven by people who see government as the problem, not the solution, in almost every instance. Conservatives tout marketplace solutions for every problem, downplay the drawbacks of relying on a profit motive to set health care policy and ignore the success of well-regulated government social programs.

But some people think that talk of marketplace efficiencies simply masks the reality: privatization will only mean lower costs if there are fewer benefits. Workers’ compensation should be about getting people back to work, not corporate bottom lines and market share.

And should these marketplace inefficiencies prove ephemeral? If the private workers’ compensation industry proves as stable and reliable as the financial industry in 2008? Who picks up the tab?  The bailouts could be huge.

 

The Truth About Privatization (Gallon Takacs Boissoneault and Schaffer Co., L.P.A.)

Seek Legislative Improvements Rather Than Workers’ Comp Privatization (by Larry Post, Physical Therapy Association of Washington)

A Hostile Takeover (by David Groves, AFL-CIO)

Our State Workers’ Compensation Advantage (by David Groves, AFL-CIO)

The Privatization Movement in California (Millman & Roberts, Inc.) (pdf)

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Former Directors:

Tom Rowe, 2010-2013

Douglas V. Stewart (interim), 2010

Janet D. Frank, 2007-2009

Lawrence E. Mulryan (interim), 2007

James C. Tudor, 2005-2007. Tudor was removed by the board of directors after an internal investigation raised questions about corporate governance and management of the State Fund. The board said it found an “unacceptable” operation of the insurer’s administrative fee program that compensates organizations to place State Fund policies at discounted group rates.

Diane C. Oki, 2003-2005 The first female president of the State Fund, which is also where she worked for 37 years before retiring.

Kenneth C. Bollier, 1995-2002

John A. Webb, 1986-1995

E.A. Sandberg, 1976-1986

Robert F. Hassard, 1971-1976

Raymond A. Young, 1963-1971

Earl R. Howard, 1955-1963

Joseph J. Gallagher, 1944-1955

John C. Stirrat, 1939-1944

Clark Day, 1934-1939

Wesley G. Cannon, 1933-1934

Frank J. Creede, 1928-1933

Charles B. Morris, 1927

Clark Day, 1923-1927

Robert W. Pendegast, 1923

Claude Fellows, 1913-1922

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Founded: 1914
Annual Budget: $1.24 billion (Proposed FY 2012-13)
Employees: 4,204
Official Website: http://www.statefundca.com
State Compensation Insurance Fund
Steiner, Vernon
President and CEO

Six months after CEO and President Tom Rowe abruptly left the quasi-governmental State Compensation Insurance Fund without explanation, the board of directors named Vernon L. Steiner to replace him in May 2014.

Steiner, a 24-year veteran of the insurance industry, oversees an agency that has had three permanent bosses and two interim leaders since 2007, and was significantly downsized beginning in 2010. State Fund, as it is known, is California's largest workers' compensation provider. State employees manage a $20 billion fund, investing $1.2 billion in annual policyholder premiums.

Steiner, who holds a bachelor’s degree in philosophy from UCLA, worked on product development at Health Net in the mid-1990s. Afterward, he switched to claims for American International Group, Inc. (AIG) for nine years. He eventually became regional vice president of a multi-line claim operation for a 13-state territory.

Steiner left AIG to join CNA Financial Corp., where he held several leadership positions, including vice president for workers' compensation claims.

Steiner joined Zenith Insurance Company, a fire, marine and casualty insurance business in Woodland Hills (Los Angeles County), in 2007 and has been responsible for its national claims operation, with a special focus on California. He was senior vice president for claims when State Fund’s board of directors hired him.

Zenith was assigned a patent in January for the co-invention by Steiner and two others of a system that determines “likely outcomes of active insurance claims by calculating and examining aggregated outcomes of matching historic claims.”   

Steiner has been on the California Workers’ Compensation Institute’s Board of Directors since 2010 and is the incoming chairman. He has served on the Workers Compensation Research Institute’s advisory board since 2009.

The San Francisco-based State Fund competes with state-regulated private-sector insurers and also serves as the insurer of last resort for many small and medium-size employers. Those employers have historically had a hard time obtaining affordable, legally required coverage that provides medical care and compensation to victims of on-the-job injuries.

Steiner’s predecessor, Rowe, left last November after presiding over a major restructuring during his three-year tenure. His goal was to slice 1,800 workers from the payroll and reduce operating expenditures by $350 million. Rowe got a lot of that done, but it is not finished.

News stories about the agency for the decade preceding Rowe’s arrival often referred to it as “scandal-plagued.” President James Tutor and vice president of group insurance programs Renee Koren were ousted by the board in 2006 after an internal investigation turned up “unacceptable” operation of an administrative fee program. An external audit linked financial transactions of State Fund involving discounted policies to former board members. The California Department of Insurance said that as much as $1 billion may have been misappropriated.

Republican Governor Arnold Schwarzenegger tried to sell a piece of the agency’s business to private interests for $1 billion in 2009 to help cover a budget shortfall. Insurance Commissioner Steve Poizner, who sued to block the move, said, “A hasty or ill-considered sale could wreak havoc on the already volatile workers’ compensation market.” The effort was dropped six months later.  

State Fund gave Steiner a four-year contract with an annual salary of $450,000. He is also eligible for an annual 30% bonus and a monthly $1,500 retention payment. Additional perks include a $270,000 recruitment and retention bonus and state civil service benefits.

Interim CEO and President Carol Newman returned to her post as State Fund general counsel when Steiner assumed the position.

 

To Learn More:

State Compensation Insurance Fund Names New CEO, Seeks to Keep Him (by Chris Rauber, San Francisco Business Times)

New Leader Takes Over California Workers’ Compensation Fund (by Jon Ortiz, Sacramento Bee)

Biography (Claims & Litigation Management Alliance)

State Fund’s Board Names Vernon Steiner New President and CEO (State Compensation Insurance Fund)

Top Two Officials at State Workers Comp Insurer Abruptly Resign without Explanation (by Ken Broder, AllGov California)

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Rowe, Tom
Former President and CEO

Baltimore native Thomas E. Rowe, president and chief executive officer (CEO) of the State Fund since August 2010, abruptly resigned in November 2013.

Rowe received a bachelor of science degree in business administration from Maryland’s Towson State College (now Towson University) in the early ’70s. He is a chartered property and casualty underwriter.

Rowe worked for about 25 years with Fireman’s Fund Insurance Co., holding a variety of senior executive positions including responsibility for underwriting, marketing and policyholder services. He was named senior vice president of national accounts in 1986 and became president of Fireman’s Commercial Insurance Division six years later. He eventually joined Fireman’s board of directors and, after the company was purchased by Allianz Insurance Company, served on its board.

Rowe joined Trilogy Insurance Services in 2002 as general manager of the vendor's Financial Services Industry Group. He left in 2007 to become a senior official at Arthur J. Gallagher & Co., a multi-faceted international enterprise heavily involved in technological initiatives encompassing brokers, consultants and third-party administrators in the insurance industry.

Rowe struck out on his own a year and a half later and formed T. Rowe Strategies, a consulting firm that focused exclusively on the property and casualty insurance industry.

Rowe has a three-year contract with an annual salary of $450,000, bonus eligibility equivalent to 30% of salary, a monthly recruitment and retention payment of $1,500, and California state civil service benefits. He moved to Marin County, California, with his wife and four children in 1992.

 

Official  Bio  (State Fund website)

State Fund Board Names Tom Rowe President and CEO (State Fund website)

Fireman's Exec Joins Trilogy (by Greg MacSweeney, Insurance & Technology)

State Fund CEO Tom Rowe: Embrace Change and Don’t Look Back (by Nicole Zaro Stahl, Hacienda)

New State Fund President Passionate About the Business (Workers’ Comp Executive)

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Overview:

The State Compensation Insurance Fund (SCIF), also known as the State Fund, is the largest provider of workers’ compensation insurance in the state. It is considered the insurer of last resort and plays a key role in guaranteeing the availability of affordable workers’ compensation insurance in California. Small and medium-sized companies, which have a difficult time getting affordable, legally required workers' compensation coverage, often rely on the State Fund. The quasi-government organization is self-sufficient, funding its operations with insurance policy premiums and investments rather than taxpayer money. Its staff works for the government although it operates as a private company.

 

Office Locations (State Fund website)

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History:

California’s first workers’ compensation law, known as the Roseberry Act, was passed in 1911. It was a voluntary plan meant to help employers find protection from injury-related litigation, while providing workers with financial support as they recovered from work-related maladies.

Participation by employers was low. Two years later, a compulsory plan called the Workers' Compensation, Insurance and Safety Act of 1913 , or Boynton Act, was passed. The Boynton Act required employers to provide benefits for their employees on the job.  It also generally prohibited employees from suing their employers because of injuries. 

The act called for establishing a competitive state insurance fund, which led to the founding of the State Compensation Insurance Fund in 1914. Although the Boynton Act provided $100,000 to start the fund, the seed money wasn’t used. Instead, the fund financed itself with money received through premiums. 

Within a year of the State Fund’s formation, the state, through its Industrial Accident Commission, began contesting worker benefit claims because of increased costs. The commission recommended hiring a traveling medical inspector to “diminish the abuse, now frequent, of over-stay in hospitals” by injured workers although the hospital stays were often on the advice of doctors.

The Great Depression of the ‘30s took a heavy toll. Eighteen private workers’ compensation insurance carriers were declared insolvent and approximately $2 million in workers’ claims went unpaid. But the State Fund continued to make its payments.

In 1945, new state legislation created the fund’s board of directors to oversee the agency and provide it with a larger measure of independence from the state. Twenty years later the State Fund began decentralizing its operations by opening district offices and in 1968, it increased the authority of district managers.

Republican Governor Pete Wilson signed reform legislation in 1993 that partially deregulated workers’ compensation insurance rate by introducing an “open rating” plan for private insurers and repealing the law that set minimum rates. Private companies were free to provide under-priced premiums to employers. As these companies fought to undercut each other and gain market share, the State Fund held its rates steady and watched many of its employer/clients flee to the private market.

But many private companies couldn’t survive for long with the low rates and they closed. Market consolidation was followed by skyrocketing rates, costing workers and employers billions of dollars.

By 1996, the State Fund was still huge. It was by far the largest provider of workers’ compensation in California, picking up about 18% of the state’s total collections. Number 2 checked in at 7%. The fund covered almost all of the state’s 276,000-member workforce.

Governor Wilson had convened the Competitive Government Task Force to flesh out a policy one government official described as a move “back to the basics. To the extent that state government is involved in functions beyond its core functions, it needs to get out," he said. Wilson’s eventual blueprint for reform was called “Competitive Government: A Plan for Less Bureaucracy, More Results.”

“Privatizing” the State Fund was one of the task force’s suggestions. The idea had been floated in 1993, but had met resistance from organized labor and Democrats in the Legislature. Unlike many privatization debates, this one did not center around saving money because the State Fund was self-sufficient. It was part of a philosophical battle over the role of government.

Wilson maintained that the State Fund functioned like a private enterprise—even competed with the private sector—and laid out his plans in April 1996 to privatize it. He also proposed: abolishing 12% of the state’s 32,000 regulations; transferring a portion of highway planning to local agencies; transferring one of California’s law schools to a private or nonprofit entity; eliminating the Department of Boating and Waterways; and contracting out a significant portion of work done by the Department of Motor Vehicles.

 “He's a serial privatizer who can't help himself,” said Drew Mendelson, a spokesman for the California State Employees Association “This is political. This is more hot air than reality at this point.” 

This time, labor and Democrats were joined by business leaders in opposition to privatizing the State Fund and the proposal went nowhere.

By 2003, 28 companies operating in the new, deregulated environment had gone under. The fortunes of the State Fund fluctuated, depending on the state of the economy.

Shortly thereafter, the Legislature began changing workers compensation laws to lower costs to employers. As costs fell more companies were able to obtain private insurance and the State Fund began to lose part of its 52% market share.

In March 2007, the State Fund board of directors removed its president, James Tutor, and vice president of group insurance programs, Renee Koren, after an internal investigation turned up “unacceptable” operation of an administrative fee program. An independent investigation of the agency that involved the California Highway Patrol and the San Francisco District Attorney ensued but four years later the DA ended the probe and announced that no criminal charges would be filed.

In May 2009, Governor Arnold Schwarzenegger proposed selling some assets of the California Workers Compensation Fund to balance the state budget. State Insurance Commissioner Steve Poizner sued to stop the sale that would have netted $1 billion for the cash-strapped state. Schwarzenegger left office at the end of the year with a number of asset sale proposals unfinished.

The State Fund announced a reorganization plan in December 2010 that could save $200 million over two years by closing offices and relocating employees. Although the agency said it was not firing any of its employees, it made it clear the projected savings would only be attained with a smaller workforce.

Chief among its closures was the 16-story home office on San Francisco’s Market Street where 1,200 employees worked. According to its charter, the State Fund must keep its home office in that city, so plans were made to relocate some financial and legal staff to a smaller location.

In October 2011, State Fund President Tom Rowe announced plans to let go 1,800 employees by June 2012 at a savings of $350 million a year. Rowe cited a steady decline in business since legislative reforms began in 2004. State Fund’s market share fell from 52% in 2004 to 15% in 2010. By the end of 2011, 971 employees on the chopping block had elected to take a buyout package and give up preferential rights to other state government jobs.

In April 2012, Rowe announced that 1,300 workers had left and that he was sparing the remaining endangered staff.

 

History (State Fund website)

State Fund Plans to Lay Off Up to 1,800 Workers by June (by Marc Lifsher, Los Angeles Times)

Workmen's Compensation History and Overview (Institute of Governmental Studies at UC Berkeley)

Wilson to Unveil Major Privatization Proposal (by Dave Lesher, Los Angeles Times)

Governor Floats Proposal to Privatize Some State Services (by Greg Lucas, San Francisco Chronicle)

Workers Comp Scandals in other States (ReformRetro.org)

Inquiry into State Compensation Insurance Fund Ends (by Marc Lifsher, Los Angeles Times)

State Fund Board Opposes Sale of Entity (by Tom Abate, San Francisco Chronicle)

Poizner to Sue Governor Over Workers' Comp Sale (Associated Press)

Plan to Sell Piece of State Compensation Insurance Fund Collapses (by Marc Lifsher, Los Angeles Times)

State Compensation Insurance Fund Consolidating Operations (by Jon Ortiz, Sacramento Bee)

State Compensation Insurance Fund OKs Staff Bonus Program (by Jon Ortiz, Sacramento Bee)

California State Insurance Agency Cancels Layoff Plans (by Jon Ortiz, Sacramento Bee)

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What it Does:

The State Fund has the dual role of providing employees with benefits to compensate for the loss of work and protecting employers against losses caused by work-related accidents and other maladies. According to California state law, employers are required to provide workers’ compensation insurance at no cost to their employees.  If an employee is injured or becomes ill due to his or her job, workers’ comp helps provide medical care and income while the employee is out of work.

There are about 180,000 policy holders currently enrolled in the program, vastly outnumbering private injury claims agencies in the state. Insurance premiums top $1.3 billion and the fund has more than $20 billion in assets.

The quasi-government organization is self-sufficient, funding its operations with insurance policy premiums and investments rather than taxpayer money. Its staff works for the government although it operates as a private company.  

The governor appoints nine of the State Fund board of director’s 11 voting members, including one from organized labor, and selects its chairperson.  The state Assembly speaker appoints one member, who represents organized labor, while the state Senate Committee on Rules also appoints one member.  The Department of Industrial Relations director serves as a non-voting “ex-officio” board member.

Board members receive $50,000 in annual compensation.

It offers employers group insurance discounts using a merit plan, resulting in lower-than-average premiums in some classifications and industries.

The State Fund maintains a geographically diverse network of physicians and specialists for injured workers. It also operates the Return to Work Program that helps employers transition injured employees back to work.

The State Fund has a 32-member Special Investigation Unit that coordinates anti-fraud programs, training and educational materials for policyholders. The unit also reports cases of suspected fraud to the California Department of Insurance’s Fraud Division and district attorneys throughout the state. The unit is a member of the state’s Fraud Assessment Commission.

The agency’s Safety and Health Services offers assistance to policyholders at no charge. It provides ergonomic evaluations, air sampling and on-site inspections plus assistance in Cal/OSHA compliance. The unit also publishes publications and newsletters targeted at specific employment sectors (manufacturing, agriculture, public agency, construction, and trades and services).    

The State Fund’s Small Business Resource Center provides information to companies wishing to establish their own injury and illness prevention program. The center has Hazard Checklists, Loss Control Bulletins, an Experts’ Corner, safety catalogs and links to other ergonomic resources.

The agency’s Medical Provider Network provides employers with access to medical personnel who specialize in occupational injuries and illness as well as more general areas of medicine. It maintains a list of medical providers that is accessible online and a 24-hour claims reporting center.  

The State Fund’s stated mission is to provide businesses and employees with fairly priced workers’ compensation insurance and help get workers back to work after an injury or illness.

Under California’s Labor Code Section 3700, all employers must provide workers’ compensation insurance to their employees. There are five basic types of comp benefits:  medical care, temporary disability benefits, permanent disability benefits, vocational rehabilitation services and death benefits.

Workers' compensation premiums are calculated on how employees are classified according to their specific work duties and the rate assigned to each corresponding employee classification. Classifications are developed and assigned by the workers' compensation Insurance Rating Bureau (WCIRB) in most cases.

There are two sections, or “Parts,” that apply to either employees or employers under California state insurance law. Part One applies to workers’ injury claims, while Part Two protects employers when employee injuries or diseases are not considered work-related.

Since California employers are required to provide insurance to their employees, they must buy the premiums from either a licensed insurance company or the non-profit State Fund, which also acts as the insurer of last resort if private companies decline to offer workers’ compensation insurance.

 

Employers (State Fund website)

Employers’ Liability and Workers’ Compensation  (Allinsuranceinfo.org)

What You Should Know About Worker’s  Compensation and Employer’s Liability Insurance Coverage Before Buying  (Employers Liability Insurance)

Office Locations (State Fund website)

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Where Does the Money Go:

The State Fund provides workers compensation insurance for state employees as well as employees at private companies that choose to get their insurance from the state. It funds its activities through paid insurance premiums and investments. No money comes from state taxpayers or the federal government.

The State Fund’s official budget does not include information on the cost of benefits for State of California employees; those numbers are contained within the individual budgets of the responsible state agencies. But the State Fund budget does include estimated benefit numbers for state employees for informational purposes only.

Forty-seven percent of the State Fund’s $1.64 billion budget in 2011-12 is earmarked for non-state employee workers’ compensation benefits. The rest goes to administration of the program. Of the $871 million for administration, 68% is spent on personnel and the rest on operating expenses and equipment.

The State Fund administrative costs include salaries for about 500 attorneys who handle contracts, litigation and mediation.  

The 2011-12 budget also earmarked an estimated $540 million for state employees.  Around $96.7 million of that goes to administrative costs, $3.8 million is for policy premium costs and the rest pays for worker benefits.

 

3-Year Budget (pdf)

2010 Annual Report (State Fund website)

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Controversies:

Bonuses and Layoffs

The State Fund paid $30 million at the end of 2011 to 971 of its 7,300 employees who agreed to take a buyout, leave and give up preferential status in applying for other government jobs. Another 705 jobs remained on the chopping block while the agency projected a multi-year savings of $200 million. By April 2012 when State Fund President Tom Rowe cancelled the bloodletting, 1,300 of an anticipated 1,800 departees had left.

Although the layoffs—which were presented as necessary cost-cutting measures in difficult financial times—haven’t been completed, the State Fund’s board of directors moved ahead on another employee compensation issue: bonuses for those remaining.

The board approved the Performance Award Program in February 2012 that could provide employees with up to an additional 10% of their base pay. A spokeswoman for the fund said in an email that the bonuses are “an appropriate investment in strengthening and accelerating our transition to a performance-based culture.”

The bonuses are contingent upon negotiations with the union. Neither the bonuses nor the buyouts cost the taxpayer any money; the State Fund is funded solely by policyholder premiums and investments.

 

Read State Fund Chief's Layoff E-mail to Employees (Sacramento Bee)

State Fund “Transition” Contract Details Jobs Targeted for Layoffs (Sacramento Bee)

State Fund Pays Out $30 Million; 705 Jobs Still on Chopping Block (by Jon Ortiz, Sacramento Bee)

State Compensation Insurance Fund OKs Staff Bonus Program (by Jon Ortiz, Sacramento Bee)

 

State Fund Investigated

Scandal rocked the State Fund in 2007. The board of directors fired President James Tutor and the vice president of group insurance programs, Renee Koren, in March after an internal investigation turned up “unacceptable” operation of an administrative fee program.

State Insurance Commissioner Steve Poizner ordered an audit of the agency and a parallel criminal investigation ensued. Poizner’s Department of Insurance is charged with regulating the State Fund.

Poizner released his findings in December 2007, finding “serious structural and operational issues.” The audit said the board of directors was not up to the task of overseeing an agency the size of the State Fund; management lacked key positions, like a Chief Financial Officer and a Chief Operating Officer; and it cited a lack of controls over material expenditures and information technology.

But most damning was the audit’s finding of potential conflicts of interest involving hundreds of millions of dollars stretching over the previous decade.

More than $500 million had been paid for outside marketing help that often provided “minimal services.” About half the money was directed to organizations with financial ties to two State Fund board members, Frank DelRe and Kent Dagg, both of whom resigned in November 2006. Dagg was appointed by Republican Governor Arnold Schwarzenegger in 2004 and DelRe was appointed by Democratic Governor Gray Davis in 2003.

The State Fund paid $140 million in group administrative fees to DelRe’s company, Western Insurance Administrators, from 1996 to 2007. Building trade associations with ties to Dagg were paid $125 million during the same period.

A significant portion of State Fund policies are sold through group insurance programs run by third-party, for-profit administrators as well as professional associations and trade groups. According to the Insurance Department audit, State Fund's management and board didn’t complete any internal audits of fees paid to outside administrators of the group association programs.

In addition, the Insurance Department audit found: paid invoices without a purchase order or contract; 2,000 fleet vehicles that hadn’t been audited since 2003; lower-level employee access to the agency’s Oracle payment system; a lack of background checks on IT vendors; no check on what former employees did with equipment after they left; virtually no oversight of group administration fees.

Partially based on its findings, the Insurance Department joined with the California Highway Patrol, the San Francisco District Attorney’s office and the State Fund itself to further investigate. 

The investigation ended in 2011 with the DA announcing that no criminal charges would be filed.

 

Beleaguered State Fund to be Audited (by Matthew Yi, San Francisco Chronicle)

State Fund Severs Ties with Group Administrator; Issues Update on Audit (by Frederick L. Pilot, Insurance Journal)

Task Force to Investigate Former SCIF Employees (Insurance Journal)

California Insurance Commissioner Steve Poizner Releases Reports on Examination of State Compensation Insurance Fund (Department of Insurance)

Millions Wasted by State Fund (by Marc Lifsher, Los Angeles Times)

Calif. State Fund Investigation Closed (Insurance Journal)

 

Schwarzenegger Furloughs State Fund Workers

In the face of a growing fiscal crisis, Governor Arnold Schwarzenegger ordered furloughs for a number of state workers in December 2008. But he went too far when he included State Fund employees.

Shortly after the governor issued his furlough executive order, two separate lawsuits were filed on behalf of State Fund employees. One was for 500 legal professionals and the other for the remaining 7,400 workers.

The legal professional suit was filed in Superior Court by the California Attorneys, Administrative Law Judges and Hearing Officers in State Employment (CASE), which is the exclusive collective bargaining representative of 3,400 legal professionals throughout state government.

CASE contended that the furloughs were a salary-setting function and that only the Legislature could do that. It lost the argument, but the court said its ruling didn’t necessarily apply to furloughs for employees of any independently elected constitutional officers or other elected statewide officials.

So CASE refiled its suit based on a provision of Insurance Code Sec. 11873, which states: “the positions funded by the State Compensation Insurance Fund are exempt from any hiring freezes and staff cutbacks otherwise required by law.” This time the court sided with CASE.

After nearly two years of litigation, the case made its way to the state Supreme Court, which in a related decision—Professional Engineers in California Government v. Schwarzenegger—indicated an affinity for arguments similar to ones made by CASE and kicked it back to the appellate court. 

The appellate court found that “we find nothing in the Supreme Court decision inconsistent with our prior conclusions and therefore again affirm the trial court’s judgment.”

Case closed, almost.

The 7,400 State Fund workers who aren’t lawyers were represented in their lawsuit by the Service Employees International Union (SEIU), which wanted no part of the CASE suit. SEIU officials feared that CASE was making an argument that the State Fund was not a state agency, thus threatening future civil service protections for its members.

SEIU won its separate suit and received an award of back pay for its members. But while the CASE and SEIU suits successfully wended their way through the courts, SEIU signed a new labor agreement with the Schwarzenegger administration in late 2010 agreeing to what some considered furloughs (although others called it a personal leave program), but fewer furloughs than were being meted out to other state employees.

In February 2011, the Brown administration dropped the Schwarzenegger appeal of SEIU’s lower court win.

 

C.A. Rules Governor Cannot Order Furlough of Insurance Fund Workers (Metropolitan News-Enterprise)

Should SEIU Have Pressed for No Furloughs for SCIF Workers? (by Jon Ortiz, Sacramento Bee)

SEIU President Criticizes SCIF Lawsuit Win (by Jon Ortiz, Sacramento Bee)

Pay Cuts May Be Coming at State Fund (Workers’ Comp Executive)

California Court Finds Certain State Employees Exempt from Work Furloughs (Epstein Becker Green law firm)

Brown Drops Appeal of SCIF Furlough Win (SEIU Local 1000)

California Attorneys Administrative Law Judges, and Hearing Officers in State Employment v. Brown (pdf)

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Suggested Reforms:

Expand Reach to Out-of-State Employees

At the beginning of 2011, the State Fund pursued legislation that would permit it to insure out-of-state employees of California companies. Legislation to expand the agency’s reach was introduced in the California Assembly in February and could potentially affect up to 30,000 companies in the state.

The State Fund cited 16 of 26 state fund organizations, including those in Arizona, Oregon, Colorado and New Mexico, which have that capability. State Fund President Tom Rowe said the bill would “streamline” the insurance process for many companies that are presently forced to obtain coverage from two or more carriers if they want to use State Fund coverage.

The legislation is opposed by private insurers, which already feel that the State Fund unfairly competes with them for business. The Association of California Insurance Companies, a trade organization, argued that the bill would allow the State Fund to retain its preferential tax status while acting like a private enterprise.

The trade group made a long familiar pitch that the State Fund should privatize like Nevada’s state fund did a decade ago if it wants to act like a private company. Arizona is said to be in the process of making the switch. Governor Pete Wilson made a strong attempt to privatize California’s State Fund in the ‘90s, but failed.    

 

State Fund Seeks to Insure Out-of-State Workers (by Chris Rauber, San Francisco Business Times)

AB 228 (Around the Capitol)

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Debate:

Privatization

Like most businesses in California, the State Compensation Insurance Fund is constantly looking for ways to be competitive, retain its clients and maximize its profits. 

But the State Fund is not a private enterprise. It has built-in tax advantages its competitors lack, an enviable economy of scale, certain legal protections and a state support structure.

A few states in the country have a monopolistic state-run workers’ insurance program and don’t allow private companies to compete. Others have totally privatized the industry, with no public entity competing. California, like many other states, has a hybrid system with a large state-run entity that competes with private enterprises for business.

In recent years, some states have moved toward privatizing their state funds and away from government control. It has been a hot button issue in California for at least two decades. What should California do?

 

Privatize the State Fund

The State Fund functions like business, competes with other businesses, performs a traditional capitalist role of providing insurance and makes a profit. Yet, it remains under government control.

Supporters of privatization argue that the state should get out of the insurance business. They say the entire workers’ compensation insurance market is perverted by inclusion of a dominant state-supported entity. Other companies are hampered by the unfair competition. Insurance rates are distorted, coverage lacks diversity and innovation is stymied.

Meanwhile, a notoriously unsupervised multi-billion-dollar powerhouse with the state’s imprimatur is allowed to set standards for everyone else. The State Fund is among the most blatant examples, critics say, of government interfering in the private lives of its citizens. Insurance isn’t national defense. It’s not law enforcement or environmental protection. It’s a costly duplication of a private sector industry that has proven very successful at what it does.

Michigan privatized its State Fund in 1994. Nevada followed suit in 1999. West Virginia privatized its state fund in 2005. Arizona recently saw the light and will complete privatization of its state fund by 2013. Oklahoma and Colorado are strongly considering making the switch. Washington state voters rejected privatization in 2010 but the issue is expected to be back on the ballot in 2011.

California Governor Pete Wilson attempted to get the job done in the ‘90s, but objections from the usual suspects—organized labor, trial lawyers and liberal politicians—helped thwart his efforts. Privatizers say Governor Arnold Schwarzenegger was on the right track in 2009 when he attempted to sell $1 billion of State Fund assets.

States across the country are, of late, seeing the virtues of privatization in a number of traditional governmental functions. Privatizing the State fund will help right-size government through eliminating non-core functions, provide short-term financing for a cash-strapped state and stimulate the economy.

And then there is the argument that getting government out of people’s lives is in their best personal interest. Washington attorney Michael Myers believes the worst part of government-run workers’ compensation programs is the message it sends to workers.

“It reinforces the idea that injured workers have, e.g., by tearing a muscle or breaking an ankle, somehow gone through a life altering change and are incapable of being productive members of society without substantial retraining and assistance,” Myers wrote online.

“Not only does this mindset waste tax dollars, it really impacts injured workers when they pursue third-party claims. . . . Workers' compensation and the relationships our clients have with the Department of Labor and Industries make it almost impossible for these people to help themselves.”

 

Various State Funds Roll With the Market (Workers’ Comp Executive)  

Amid Fiscal Pressures, States Move to Privatize Workers Compensation Programs (by Leonard Gilroy, Governing.com)

The Handbook of Employee Benefits (Edited by Jerry S. Rosenthal)

Annual Privatization Report 2010: State Government Privatization (Edited by Leonard Gilroy, Reason Foundation)

Workers Comp Managers Say Privatization Beneficial (by Dale Wetzel, Bismarck Tribune)

Privatized Workers' Compensation: Toe the Party Line (by Michael Myers, attorney/blogger)

 

Don’t Privatize the State Fund

The State Fund was created a hundred years ago to fill a desperate need for protection from the forces of rapid industrialization that left injured and ailing workers to fend for themselves. Opponents of privatization say that need has been met by a public agency which has successfully provided for the people’s health care needs while remaining cost-efficient and financially stable.

Early attempts in California to enlist employers’ voluntary participation failed despite their need for protection from lawsuits. And the private sector failed to see the necessary profitability to establish a comprehensive workers compensation insurance industry that would serve large and small businesses alike.

That is why California mandated the purchase by companies of workers’ comp insurance and established the State Fund, with statutory protections that guarantee it as the insurer of last resort for companies. To this day, the overwhelming majority of State Fund clients are small and medium size businesses that have trouble finding insurance in the private market.

Without the state setting standards and anchoring prices, opponents of privatization argue, many companies would find insurance costs prohibitive and workers would find benefits reduced. Big insurance companies would be allowed to set rates, exclude companies and workers from coverage, deny claims, set up their own impenetrable bureaucracies, shield themselves from scrutiny and, in tough times, declare bankruptcy and walk away from their obligations.

This is an attempt to fix a system that works. The State Fund doesn’t use a dime of taxpayer money and stays in the black. In fact, it is that very success that serves as a prime motivation for other companies that want to carve up its lucrative market. 

Some defenders of the State Fund status quo say the push for privatization is ideologically driven by people who see government as the problem, not the solution, in almost every instance. Conservatives tout marketplace solutions for every problem, downplay the drawbacks of relying on a profit motive to set health care policy and ignore the success of well-regulated government social programs.

But some people think that talk of marketplace efficiencies simply masks the reality: privatization will only mean lower costs if there are fewer benefits. Workers’ compensation should be about getting people back to work, not corporate bottom lines and market share.

And should these marketplace inefficiencies prove ephemeral? If the private workers’ compensation industry proves as stable and reliable as the financial industry in 2008? Who picks up the tab?  The bailouts could be huge.

 

The Truth About Privatization (Gallon Takacs Boissoneault and Schaffer Co., L.P.A.)

Seek Legislative Improvements Rather Than Workers’ Comp Privatization (by Larry Post, Physical Therapy Association of Washington)

A Hostile Takeover (by David Groves, AFL-CIO)

Our State Workers’ Compensation Advantage (by David Groves, AFL-CIO)

The Privatization Movement in California (Millman & Roberts, Inc.) (pdf)

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Former Directors:

Tom Rowe, 2010-2013

Douglas V. Stewart (interim), 2010

Janet D. Frank, 2007-2009

Lawrence E. Mulryan (interim), 2007

James C. Tudor, 2005-2007. Tudor was removed by the board of directors after an internal investigation raised questions about corporate governance and management of the State Fund. The board said it found an “unacceptable” operation of the insurer’s administrative fee program that compensates organizations to place State Fund policies at discounted group rates.

Diane C. Oki, 2003-2005 The first female president of the State Fund, which is also where she worked for 37 years before retiring.

Kenneth C. Bollier, 1995-2002

John A. Webb, 1986-1995

E.A. Sandberg, 1976-1986

Robert F. Hassard, 1971-1976

Raymond A. Young, 1963-1971

Earl R. Howard, 1955-1963

Joseph J. Gallagher, 1944-1955

John C. Stirrat, 1939-1944

Clark Day, 1934-1939

Wesley G. Cannon, 1933-1934

Frank J. Creede, 1928-1933

Charles B. Morris, 1927

Clark Day, 1923-1927

Robert W. Pendegast, 1923

Claude Fellows, 1913-1922

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Founded: 1914
Annual Budget: $1.24 billion (Proposed FY 2012-13)
Employees: 4,204
Official Website: http://www.statefundca.com
State Compensation Insurance Fund
Steiner, Vernon
President and CEO

Six months after CEO and President Tom Rowe abruptly left the quasi-governmental State Compensation Insurance Fund without explanation, the board of directors named Vernon L. Steiner to replace him in May 2014.

Steiner, a 24-year veteran of the insurance industry, oversees an agency that has had three permanent bosses and two interim leaders since 2007, and was significantly downsized beginning in 2010. State Fund, as it is known, is California's largest workers' compensation provider. State employees manage a $20 billion fund, investing $1.2 billion in annual policyholder premiums.

Steiner, who holds a bachelor’s degree in philosophy from UCLA, worked on product development at Health Net in the mid-1990s. Afterward, he switched to claims for American International Group, Inc. (AIG) for nine years. He eventually became regional vice president of a multi-line claim operation for a 13-state territory.

Steiner left AIG to join CNA Financial Corp., where he held several leadership positions, including vice president for workers' compensation claims.

Steiner joined Zenith Insurance Company, a fire, marine and casualty insurance business in Woodland Hills (Los Angeles County), in 2007 and has been responsible for its national claims operation, with a special focus on California. He was senior vice president for claims when State Fund’s board of directors hired him.

Zenith was assigned a patent in January for the co-invention by Steiner and two others of a system that determines “likely outcomes of active insurance claims by calculating and examining aggregated outcomes of matching historic claims.”   

Steiner has been on the California Workers’ Compensation Institute’s Board of Directors since 2010 and is the incoming chairman. He has served on the Workers Compensation Research Institute’s advisory board since 2009.

The San Francisco-based State Fund competes with state-regulated private-sector insurers and also serves as the insurer of last resort for many small and medium-size employers. Those employers have historically had a hard time obtaining affordable, legally required coverage that provides medical care and compensation to victims of on-the-job injuries.

Steiner’s predecessor, Rowe, left last November after presiding over a major restructuring during his three-year tenure. His goal was to slice 1,800 workers from the payroll and reduce operating expenditures by $350 million. Rowe got a lot of that done, but it is not finished.

News stories about the agency for the decade preceding Rowe’s arrival often referred to it as “scandal-plagued.” President James Tutor and vice president of group insurance programs Renee Koren were ousted by the board in 2006 after an internal investigation turned up “unacceptable” operation of an administrative fee program. An external audit linked financial transactions of State Fund involving discounted policies to former board members. The California Department of Insurance said that as much as $1 billion may have been misappropriated.

Republican Governor Arnold Schwarzenegger tried to sell a piece of the agency’s business to private interests for $1 billion in 2009 to help cover a budget shortfall. Insurance Commissioner Steve Poizner, who sued to block the move, said, “A hasty or ill-considered sale could wreak havoc on the already volatile workers’ compensation market.” The effort was dropped six months later.  

State Fund gave Steiner a four-year contract with an annual salary of $450,000. He is also eligible for an annual 30% bonus and a monthly $1,500 retention payment. Additional perks include a $270,000 recruitment and retention bonus and state civil service benefits.

Interim CEO and President Carol Newman returned to her post as State Fund general counsel when Steiner assumed the position.

 

To Learn More:

State Compensation Insurance Fund Names New CEO, Seeks to Keep Him (by Chris Rauber, San Francisco Business Times)

New Leader Takes Over California Workers’ Compensation Fund (by Jon Ortiz, Sacramento Bee)

Biography (Claims & Litigation Management Alliance)

State Fund’s Board Names Vernon Steiner New President and CEO (State Compensation Insurance Fund)

Top Two Officials at State Workers Comp Insurer Abruptly Resign without Explanation (by Ken Broder, AllGov California)

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Rowe, Tom
Former President and CEO

Baltimore native Thomas E. Rowe, president and chief executive officer (CEO) of the State Fund since August 2010, abruptly resigned in November 2013.

Rowe received a bachelor of science degree in business administration from Maryland’s Towson State College (now Towson University) in the early ’70s. He is a chartered property and casualty underwriter.

Rowe worked for about 25 years with Fireman’s Fund Insurance Co., holding a variety of senior executive positions including responsibility for underwriting, marketing and policyholder services. He was named senior vice president of national accounts in 1986 and became president of Fireman’s Commercial Insurance Division six years later. He eventually joined Fireman’s board of directors and, after the company was purchased by Allianz Insurance Company, served on its board.

Rowe joined Trilogy Insurance Services in 2002 as general manager of the vendor's Financial Services Industry Group. He left in 2007 to become a senior official at Arthur J. Gallagher & Co., a multi-faceted international enterprise heavily involved in technological initiatives encompassing brokers, consultants and third-party administrators in the insurance industry.

Rowe struck out on his own a year and a half later and formed T. Rowe Strategies, a consulting firm that focused exclusively on the property and casualty insurance industry.

Rowe has a three-year contract with an annual salary of $450,000, bonus eligibility equivalent to 30% of salary, a monthly recruitment and retention payment of $1,500, and California state civil service benefits. He moved to Marin County, California, with his wife and four children in 1992.

 

Official  Bio  (State Fund website)

State Fund Board Names Tom Rowe President and CEO (State Fund website)

Fireman's Exec Joins Trilogy (by Greg MacSweeney, Insurance & Technology)

State Fund CEO Tom Rowe: Embrace Change and Don’t Look Back (by Nicole Zaro Stahl, Hacienda)

New State Fund President Passionate About the Business (Workers’ Comp Executive)

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