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This worksheet can be used to estimate cash flows under both insured and self-insured programs. The results can be useful in evaluating the feasibility of self-insurance for an employer.
| Self-Insurance Worksheet | 1st Year | 2nd Year | 3rd Year | |
|---|---|---|---|---|
| A. | If operating as an insured employer under the Act: | |||
| 1. Net amount payable in WC premiums | ||||
| 2. Amount of other WC payments and costs payable, e.g., safety violations and certain other penalties, WC related administrative costs, et cetera | ||||
| 3. Total amount payable as an insured employer, A(1) + A(2), above and compare with B(6) below | ||||
| B. | If operating as a self-insured employer under the Act: | |||
| 1. Medical, indemnity and other WC benefits payable by employer | ||||
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a. Medical, indemnity and other WC benefits payable by employer |
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b. Other amounts payable by the insurance company under the excess policy/policies |
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c. Present value of additional amounts payable by insurance company at end of year under excess policy/policies |
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d. Present value of additional amounts payable by employer at end of year |
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| 2. Other amounts payable under the WC act., e.g., assessments, safety violations and other penalties, et cetera | ||||
| 3. WC premiums payable for excess coverage and surety bond (bond required by Department) | ||||
| 4. Other WC payments and costs payable, i.e., claims service organization, employer's administrative costs for safety and health, claims handling, et cetera | ||||
| 5. Total Amounts payable during year - B(1)a + B(2) + B(3) + B(4), above = | ||||
| 6. Total amounts payable and present value of amounts payable at end of year by employer = B(1)d + B(5), above = | ||||
| C. | Extrapolate A(3) and B(6) for another seven years, and compare them; note the divergence | |||