Mason Contractors Association of America

Concrete Contractors Association of Greater Chicago

Mason Contractors Association of Greater Chicago

Fox Valley Associated General Contractors

A compliance audit checks factors that impact your premium – including your experience mod factor. We can help you optimize your mod [More]

In our experience, errors and overcharges occur a high percentage of the time, and can cost you a lot of money. [More]

• We audit the insurance carrier’s compliance with state rules regarding premium calculation, such as (but not limited to):
  • Correct application of experience modification factor
  • Correct application of miscellaneous debits and credits
• We will evaluate the accuracy of the experience modification factor by analyzing the carrier’s compliance with state rules regarding reporting of unit statistical data such as claims and payroll information.

Payment for Services Options:

• Strictly Shared Savings Agreement
  • Client provides policy data readily available for the audit
  • Synergetic Solutions makes a reasonable attempt to obtain the remaining data for the audit
• Hourly fee

Policy data typically requested from Client:

• Current and past four policies
• Final Premium Audit Statements (past four)

Some of our key employees believe that if you understand the founder, you will understand the company. Consequently, they asked me to publish my biographical information. With their request in mind, and in the interest of brevity, I will attempt to draw a parallel between my experience and the audit we provide.

• Five years auditing nuclear power plants and their suppliers.
  During this time, I learned to perform extremely detailed operational audits. As you can imagine, there was no room for error. Many of the operational auditing techniques I learned while in the nuclear field have been incorporated into our current audit.
• Ten years developing, negotiating, and administering multi-million dollar contracts.
  As you may know, insurance policies are contracts. In addition to identifying noncompliance with rules that govern your workers’ compensation insurance plan, our audit identifies contract issues. In fact, a high percentage of the overcharges we identify are the result of policy noncompliance. We have identified more than $18,500,000 in overcharges to date.
• Seven years in market research and development.
  While analyzing markets, developing programs, and implementing programs, I learned to match a product or service to a company having a need. We are a target marketing firm, and we are very good at identifying those companies that have the greatest need for our service.
• Fifteen years as President and CEO of Synergetic Solutions, Inc.
  In the early years of Synergetic Solutions, we hired people with extensive insurance industry experience. They had a list of professional certifications as long as your arm but it was difficult to train them as compliance auditors. They were good people, and I have little doubt they were great in their field, but they tended to accept what has “always been done.” We are compliance auditors, and in our company, “compliance auditors” may not determine the acceptability of an activity based on “the way it has always been done.” Our determinations are based on the specific “chapter and verse” of the applicable governing laws, rules, regulations, filed plans, and policy. We cannot – and do not – ignore noncompliance regardless of past industry practices.

• My formal education includes:
  • BA from Metropolitan State University (Minneapolis, MN)
  • MBA from University of St, Thomas (St. Paul, MN)

If you have any questions about our service, please contact us at 1-800-758-2941. You are welcome to ask for anyone in management, the auditing department, the sales department, or me.

Synergetic Solutions, Inc.
3890 Pheasant Ridge Drive Northeast, Suite 180
Blaine, Minnesota 55449
Phone: 763-331-3300 or 800-758-2941
Fax: 888-304-8961
E-mail: savings@synergeticsolutions.com

Throughout the entire process, we will update you on the status of your audit.

Audit duration will depend on the time it takes to obtain the audit data and the complexity of the issues identified.

A construction company contracted with us because they were concerned with increasing costs. Their premiums were increasing even though they had relatively low claims activity. The company’s concerns were valid. Our audit identified carrier errors resulting in inflated premiums. Below are the results of our audit.

09/05/03-04 Original mod rating 1.13 Revised mod rating 1.04 Returned premium $12,441
09/05/04-05 Original mod rating 0.93 Revised mod rating 0.83 Returned premium $14,073
09/05/05-06 Original mod rating 0.96 Revised mod rating 0.85 Returned premium $10,177

This company received a $36,691 refund check from the carrier within 90 days of signing the audit agreement.

Manufacturing

Our client recently purchased a manufacturing plant. Their insurance agent assured them the experience of the new plant was properly reflected on their experience modification factors. After reviewing the experience rating, we discovered the new data was incorrectly reported. As a result of our work, our client received improved experience ratings and refund checks.

01/01/03-04 Original mod rating 1.14 Revised mod rating 0.92 Returned premium $35,313
01/01/04-05 Original mod rating 1.09 Revised mod rating 0.95 Returned premium $15,551
01/01/05-06 Original mod rating 1.06 Revised mod rating 1.00 Returned premium $6,687

The total refund was $57,551

Health Care

We recently conducted an audit for a healthcare company. During the audit, we identified several less than obvious errors. For example, a claim was reported incorrectly on the loss run and on the experience mod worksheet. Consequently, when comparing the loss run to the experience mod worksheet there didn’t appear to be an issue. Only a comprehensive investigation could have revealed the claim had been subrogated. We identified the issue and worked with the carrier to obtain a correction to the experience rating. The corrected experience rating resulted in a premium refund of $31,257.

Analytical services include sensitivity analysis, plan comparisons, cost allocation, buy sell analysis, and experience modification factor projections.

• Sensitivity analysis are “what if” scenarios.
  • What happens to my experience modification factor if payroll assigned to a specific classification changes?
  • What happens if total claims increase (or decrease) by some amount?
• Plan comparisons
  • At what point is a different insurance plan financially attractive?
  • Is the plan I’m on currently the most attractive going forward?
• Cost allocation
  • Which company, division, state, etc. is experiencing the highest claim experience?
  • Which company, division, state, etc. is experiencing the least claim experience?
  • Is the cost associated with claims experience, safety program, and risk management costs properly reflected in the company, division, state, etc. profit and loss statement.
• Buy/Sell analysis
  • If we purchase a certain company; what will the impact be on our current mod? Future mod?
  • If we sell a company, division, etc; what will the impact on our mod be?
• Mod projections
  • What will our mod be next year assuming certain losses and payroll?