2017 Power Broker

Education

Meeting Needs Far Beyond Insurance

Alex Burton
Area Vice President
Arthur J. Gallagher

Several of Alex Burton’s higher ed clients needed more flexibility than what they were getting within their risk retention group.

But transitioning out of a risk retention group can be a complex and exhausting process. The groups house such a diversity of risks, ranging from football programs to art collections, to protection for boards of trustees.

Fortunately, Burton was there to lead the way, building each university a new program to cover its unique coverage, pricing needs and risk appetite.

“Risk is not something that a college wants, ever,” said Brooks Seay, CFO and vice president of finance and operations at Young Harris College in Young Harris, Ga.

Clients also value how Burton enhances their risk management efforts, bringing to the table the right resources and capabilities to manage their exposures.

One college experienced a domestic issue that led to the presence of an armed individual on campus. Thankfully, the situation was neutralized without injury to staff or students, but it was a wake-up call, said Dawn Nash, vice president for administration and CFO at Wesleyan College in Macon, Ga. She was grateful that Burton sped into action immediately and “totally stepped up,” she said.

By the end of that same day, she said, Burton put in place a suite of services and programs that bolstered the college’s level of preparedness and enabled the risk management department to be proactive.

A Champion for Student Health Care

Teresa Koster
Division Chairman
Arthur J. Gallagher

Massachusetts’ adaptation of ACA Medicaid expansion in 2014 profoundly impacted the student health insurance plan (SHIP) marketplace. A wave of students became eligible for state coverage, and SHIP enrollment plunged at public colleges.

Institutions struggled to keep their SHIP programs viable with smaller, more volatile pools of students. Arthur J. Gallagher’s Teresa Koster saw the impact this trend was having on her clients, and saw an opportunity to help not just her own clients, but all public colleges in her state.

Koster reached out to the state’s Medicaid department and health care exchange, proposing a plan that would encourage students to enroll in their school’s SHIP by allowing the use of Medicaid funds to pay premiums. The initiative, which required the approval of regulatory changes, came to fruition in Fall 2016. The SHIP Premium Assistance initiative was launched at all 30 Massachusetts public institutions of higher education.

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“It’s an idea that existed but Teresa is the one that brought it to Massachusetts and championed it,” said Ashley Hague, executive director of MIT Medical. “And everybody’s better off for it. … It’s a win-win-win solution.”

“It’s an example that other schools around the country can turn to,” said an executive at a prominent Midwestern university. “She’s helping shape the student insurance industry.”

Since the launch, the per-campus increase in school-based enrollment ranges from 24 percent to 30 percent.

Supporting Educators in Lean Times

Laurie Miller
President
Miller Services

The Illinois budget crisis hit rural school districts hard. Health care costs were on an upward trajectory, while property values were on the decline, shrinking school tax assessments.

So when a key health carrier lowered the threshold for self-funding groups, Laurie Miller pounced on the opportunity to organize a rural school-based purchasing pool. The Illinois Scholastic Cooperative launched Sept. 1, 2016, with seven districts and 1,000 lives.

“It was a huge cultural shift,” said Scott Bloomquist, superintendent of Winnebago Community Unit School District 323 in Winnebago, Ill. He said it was no small feat getting all the districts on the same page, but that if anyone could have made it happen, it was Miller.

“Everybody trusts her,” he said. “When she makes a recommendation, we almost immediately get buy-in. … She knows her stuff.”

The entire group realized an immediate 5 percent savings overall, and one district avoided an 18 percent stand-alone renewal hit. ISC is now getting the attention of other cash-strapped districts that typically operate with just a superintendent and a bookkeeper handling the programs. All of Miller’s school district clients say they rely heavily on her expertise and her deep commitment to helping rural schools succeed.

“I don’t think there’s ever been a year where she hasn’t done something innovative for us,” said Tom Mahoney, superintendent of Oregon Community School District 220 in Oregon, Ill.

Next-Level Solutions

Scott Wightman, ARM-E
Area Executive Vice President
Arthur J. Gallagher

Ithaca College implemented a strong ERM program in 2009. But by 2016, the organization felt that its program was in a rut.

“It got to a point that we were really at a loss for how to continue managing our data and make our program more robust,” said Kristine Slaght, the college’s risk manager. “We were stalling and no longer had the right tools for where we’d grown to.”

So the ERM committee was intrigued when Scott Wightman approached them about becoming a beta tester for an ERM software solution he was developing.

Wightman, an active proponent of the importance of ERM and compliance in college and university governance, had long since seen the need for ERM and compliance management to move beyond spreadsheets. He sought out a viable software solution and discovered Risk Wizard, an Australian firm with a promising solution for corporations.

Wightman partnered with Ithaca College to help adapt and customize the program for higher education. Using the software, Wightman created about 10 or 12 different templates for the committee to use, said Slaght, including one that would produce a heat map — something that the committee longed for.

“He did miracle work with it actually,” said Slaght. “He’s really moved us in a positive governance direction.”

Slaght said she’s pleased with everything the college has been able to accomplish over the past year. “We’ve really taken it to the next level,” she said.

Taking on the Toughest Challenges

Elizabeth Marshall, ARM,
Assistant Vice President
Marsh

One of Elizabeth Marshall’s university clients experienced a troubling — and very public — array of legal woes. As expected, renewal time brought yet more pain, with incumbent markets proposing alarming premium increases and retention levels.

Marshall, an education placement specialist with Marsh, was concerned that the situation could get even thornier, with the potential for hybrid claims creating turmoil between the general liability and educators legal liability carriers. She designed an alternative GL and excess liability proposal. The outcome? Significant cost savings, a lower attachment point for hybrid claims, and a crisis management program independent of a liability occurrence or wrongful act.

“She was a pillar,” said a top risk officer for the university. Marshall was able to secure significant savings on the university’s excess casualty program, allowing it to purchase higher educator’s legal limits without impacting the overall insurance budget for the year.

Another university client needed to roll coverage for an acquired facility into its primary program despite it being a wholly different operation and class of business. It also needed to keep its automotive policy outside the primary program, even though only a limited number of insurers were willing to write automobile liability risk on a stand-alone basis. A tall order all around, but she got the organization exactly what it needed and then some.

“She found solutions and resources that I could not have found,” said the university’s risk manager, a veteran of the brokerage side as well.

Undaunted by the Impossible

Courtney Hensley, CRM, CISR
Account Executive
Aon

Almost immediately upon becoming the broker for a large university, Aon’s Courtney Hensley was presented with an unusual challenge: To secure a large federal contract, a division of the university needed coverage for providing prescribed burn services. But “intentional fire” was expressly excluded by the markets.

“These things, when they go bad, can go really, really bad,” said the university’s top risk management professional. Damages can run into the millions. Securing coverage was practically impossible, she said. “It was really nail-biting.”

But Hensley isn’t the type to be bested by a difficult exposure. “We can do better than this,” she told her client. An initial attempt to knit together several partial solutions came to naught because of exorbitant pricing and high retentions. As the clock ticked on the federal contract, Hensley kept working the problem and identified a viable Plan B.

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Her team was able to manuscript a program using a wholesaler to place general liability, professional liability and contractors’ pollution liability together, specific to the university’s operations, incurring only minimal deductibles and a cost-effective premium. The burn exposure was contained within a separate tower that would protect the university’s other exposures in the event of an unexpected loss related to activities under the federal contract.

“She created a whole separate insurance tower for that department,” said the risk professional. “I was so amazed.”

Finalists:

Kate Kenny
Vice President
Marsh
Chicago

Tyler LaMantia
Area Senior Vice President
Arthur J. Gallagher
Chicago

Robert DeVilbiss
Vice President
Aon,
Grand Rapids, Mich.

Shelley Levine
Area Executive Vice President
Arthur J. Gallagher
New York

More from Risk & Insurance

More from Risk & Insurance

Workers' Comp

Keeping Workers on Their Feet

Slip and fall prevention programs must interweave all of the factors contributing to the risk.
By: | July 6, 2017 • 11 min read

If you peruse the last decade’s worth of literature from the CDC, NIOSH, or numerous other agencies or organizations, you’re bound to come across the “good news” that slips, trips and falls are largely preventable.

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So it’s frustrating, then, that slip, trip and fall injuries consistently account for more than a quarter of all nonfatal occupational injuries, and at least 65 percent of those injuries happen on same-level walking surfaces. And those figures just don’t budge all that much from year to year.

According to the “2016 Liberty Mutual Workplace Safety Index,” falls on same level currently rank as the second highest cause of disabling injuries in the U.S., with direct costs of $10.17 billion, accounting for 16.4 percent of the total national injury burden.

“Not only are they still happening often, but they tend to be very significant injuries,” said Mike Lampl, director of research at the Ohio Bureau of Workers’ Compensation.

“We’ve seen these trends grow over the years,” said Wayne Maynard, product director, risk control, with Liberty Mutual. “Bottom line is, it’s a real, real big problem.”

So why are preventable falls so hard to prevent? This stubborn status quo, say experts, is that the causes of slips and trips are typically far more complex than they seem. There are nearly always multiple factors in play, from footwear and flooring and the interplay of both, to cleaning procedures, lighting, housekeeping, weather, and workers’ mental or physical conditions as well as overall awareness.

And all of these factors are being exacerbated by the fact that incidents often go unreported.

“Slips, falls — people get up, move on, they don’t report it,” said Maynard.

“When somebody’s injured and files a claim — in the workers’ arena, how many are behind the scenes that may have happened that are not reportable? …. The unreported number is considerable in my opinion.”

The key to making any headway in reducing slips and falls on the same surface, say experts, is to have a comprehensive fall prevention plan that addresses all possible factors. No small task.

Engineering Solutions

Flooring conditions are often the most obvious starting point. Ideally, said Maynard, all the right choices are made at the planning and design stage. But sometimes mistakes are made, and in other cases, a business may be inheriting an older space with floor chosen for a different purpose.

Patricia Showerman, senior loss control consultant, Arthur J. Gallagher & Co.

So even flooring in good condition may be the wrong type of material and may not have the necessary coefficient of friction (slip resistance) needed for the work being done.

If companies want to drill down into all the details of the surfaces in their facilities, a friction coefficient study is always an option, said Patricia Showerman, senior loss control consultant at Arthur J. Gallagher & Co.

But if a company doesn’t want to take that step, she said, it may be a simpler matter of saying, “Let’s look at what you’ve got. Let’s look at your floor surfaces and how you’re maintaining them.”

A lot of people want that “shiny grocery store glam look,” she said. “And if you can do it properly, and maintain it properly and keep that coefficient of friction and have the shiny look, that’s great. That’s what everybody wants but how do they get there?”

Certain surfaces may start out with an adequate coefficient of friction when they’re clean and dry. But add even an invisible layer of dust or debris, “and it’s like microscopic little BBs that you slide across,” said Showerman. “So if you have dust on your floor, you are dramatically reducing your slip coefficient.”

For companies that do have flooring surfaces in need of improvement, ripping up the floor and replacing it isn’t typically a feasible option. Fortunately there are more budget-friendly ways to get the maximum slip resistance from existing flooring, such as coatings and etchings.

A coating adds a microscopic layer on top of the flooring that creates a grip surface while maintaining the shine. Showerman likened the effect to the way that Velcro fasteners work.

“You want that hook effect … sharp points are going to microscopically stick into the soles of your shoes, rather than rolling off the top.”

Etching can work in a similar way, chemically altering the existing surface to make it imperceptibly gritty. Etching can also be used to create pores in an existing surface, which is useful for areas such as machine shops, she said.

Be Smart With Surfactants

While keeping floor surfaces clean is one of the best ways to remove slip and fall hazards, cleaning them the wrong way can actually do more harm than good.

Failure to follow appropriate cleaning procedures can severely diminish a surface’s coefficient of friction.

Experts suggest that companies engage with their chemical suppliers, and discuss their flooring as well as the types of dirt or grease removal and disinfectant needs. Detergents – which can contain different types of surfactants — aren’t a one size fits all solution.

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Sometimes purchasers might be inclined to try to cover all their bases by buying the strongest product on the market, but that might mean adding unnecessary surfactants that make surfaces less slip resistant.

“Clearly identify the types of surfaces you’re using it for, the type of oil or dirt or debris you have, and whether or not you need a sanitizing step,” said Showerman.

“You’ve got to find the right balance.”

But that’s only half the battle. A significant problem experts see time and time again is that companies don’t understand how their flooring is being maintained on a day-to-day basis by front-line employees. Failure to follow appropriate cleaning procedures can severely diminish a surface’s coefficient of friction.

“This is where you’re seeing someone with a mop and bucket and they are just re-smearing that grease from one place to another. They put the dirty mop in the dirty bucket, the mop gets full of that emulsified grease and you’re smearing it across the room. In high grease areas, you have to replace with clean water consistently.”

In other cases, a worker without the proper training may grab the first detergent he finds, even if it’s meant for the equipment rather than the floor. Or perhaps he mixes equal parts detergent and water when he was supposed to only use 8 oz. of detergent for every five gallons of water.
Sometimes people will even over-concentrate the detergent on purpose, she added.

Peter Koch, safety management specialist, The MEMIC Group

“I see that in the food industry frequently,” said Showerman. “They find that the more detergent they leave on the floor, the easier it is to clean up next time … but then everyone’s slipping and falling like in a cartoon.”

A company could invest a significant amount in flooring improvements, only to have the benefits undone by improper detergent use or failure to follow recommended rinsing procedures.

It’s incumbent upon safety managers to reinforce that maintaining floor surfaces isn’t just a matter of housekeeping, but a key part of the company’s workplace safety program.

The Human Factor

When you’ve done everything possible to address hazards in the physical work environment, workers themselves remain the wildcard. Most employers routinely include slip and fall hazards in their safety awareness training or toolbox talk programs. But that training should go well beyond a general “watch where you walk” message, say experts.

“One of the most overlooked parts for employee safety is actually employee training,” said Peter Koch, safety management specialist at  The MEMIC Group.

“How do you train an employee to not slip and fall? I think many times that is wrapped in a “you have to be more careful” message, which is valid but nebulous and not very helpful — it means something different to everyone based on your risk tolerance as an individual.”

Koch’s employee training regimen revolves around four elements: surfaces, awareness, footwear and environment (SAFE).

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The first goal of the surface portion is just to get employees to start thinking about the different types of surfaces they walk on and how it can change throughout the work day. Koch said he likes to ask: “How many different types of surfaces did you have to walk on the get to this training room?”

The footwear piece of it is the most straightforward. Are your shoes designed for the work that you’re doing and the surfaces you’re walking on? Are they in good condition? Are the soles worn out?

There is no ASTM standard for measuring the performance of slip-resistant footwear, added Gallagher’s Showerman. So workers should be reminded that wearing the right shoe isn’t a guarantee — it’s just one piece of the solution.

Awareness, said Koch, may be the most challenging piece of the puzzle — helping people to think about their gait, what they’re carrying, what they’re doing, and simply where their heads are at any given moment.

“If you’re thinking about 15 things you have to get done by the end of the day, or you have a particularly challenging employee interaction coming up that day, or you had a fight with your girlfriend last night— or whatever it is — you’re not focused. Then you take that step through the icy patch, and now it relies completely on your athletic ability and luck to stay upright.”

Workers may not necessarily make the connection between personal factors and fall risk. Someone who has an ear infection or is taking certain medications, for example, may not even be aware that their balance might be compromised, putting them at higher risk for a fall.

Employees also should be reminded of how even normal daily stressors can contribute to risk. Everyone is under pressure to deliver more in less time. Everyone is rushing, everyone is stretched to their limits. Add the ever-present cellphone beeping and buzzing and demanding our attention and perhaps it’s a wonder slips and falls don’t happen even more often than they already do.

We’re so conditioned to react when the vibration goes off or the tone chimes in our pockets that we just grab it without thinking, Koch said.

“If you knowingly put yourself at risk by knowingly going quickly through an area with slip and fall exposures, it’s just Russian roulette – at some point you’re going to get broken.” — Peter Koch, safety management specialist, The MEMIC Group.

“Even that, in certain conditions, is going to be enough to put you on the ground.”

Awareness of environmental factors should also be part of the training, Koch said, especially in terms of what workers can’t control, like inclement weather.  He said the main thing he tries to impress upon people is to slow down in a high-risk environment.

“If you knowingly put yourself at risk by knowingly going quickly through an area with slip and fall exposures, it’s just Russian roulette – at some point you’re going to get broken.”

Koch says that getting people to put all of these facets of awareness together is where the training can really click.

The goal is that when they approach an area with a higher-risk surface, employees are thinking “for those few seconds or minutes that I’m going to be walking through it, I need to have a greater sense of awareness, I need to put away the mental [distractions] and focus on what I’m doing – don’t answer your phone, don’t answer your texts.”

Some employers are looking to address the human piece of the slip and fall puzzle by using training that goes far beyond hazard awareness. Active slip-prevention training focuses on body mechanics and teaches workers how to respond when they feel themselves begin to slip.

One such program revolves around the Slip Simulator, technology born of a research partnership between Virginia Tech researchers and UPS. The simulator that creates slippery and hazardous conditions in a controlled environment while participants walk in a harness so they can slip safely. An instructor offers real-time guidance on how to alter their movements to avoid falling.

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After mastering the initial technique, trainees face additional challenges related to their specific work environments, such as walking up ramps or turning wheels. A New Mexico security team practiced drawing firearms while standing on the simulator, which led to a change in how they wear their weapons. Workers at an Ohio refinery practiced stepping over pipes and turning large valves.

Clients of the program are reporting 60 to 80 percent reductions in accident rates.

The Road Ahead

A comprehensive slip and fall prevention plan is a must for employers, experts agreed, with clear, consistent procedures that empower employees to be a part of the solution.

“Employees play a very critical role,” said Liberty Mutual’s Maynard. “If they see a slip risk or a slipperiness issue, they need to be able to report it and they need to be able to get that corrected immediately. They have an important role in maintaining a safe facility and reducing risk themselves — be proactive, don’t walk by, clean it up.

“Any time you can involve the employee in solutions …. the likelihood of success of that intervention is higher.”

Maynard added that the best prevention plans will also be forward-looking.

“Understand where current safety performance is. Then make a roadmap to get better,” he said. “Emphasize where you’re doing well,” then identify opportunities to effect improvement, now and over the next three, four or five years.

“Prevention is too often reactive,” Maynard said. “We’ve got an issue and now what do we do? The goal is for companies to be proactive.” &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]