This article is about Justworks PEO. What product am I using?
Workers' compensation and Justworks
This article is intended to convey the basics of workers’ compensation. Workers’ compensation rules and terminology vary from state to state. If you have questions about a specific policy or claim, you should contact a lawyer or your workers’ compensation insurance provider.
Visit our Video Library for more tutorials
What is workers’ compensation insurance?
Workers’ compensation insurance (commonly known as workers’ comp) is provided to employees whose injuries or illness arise out of the course and scope of their employment. An employee's beneficiaries may also receive benefits in a situation where a claim involves the death of an employee.
Workers’ comp provides disability benefits and medical benefits. Disability benefits compensate workers for time missed from work and in the case of permanent disability, they may provide compensation for future lost earning capacity. Medical benefits provide medical treatment and rehabilitation treatment for covered injuries.
Is workers’ comp required?
Workers’ comp is required for all employees in all states pursuant to the laws of each state. Once you sign up with Justworks PEO, you and your employees will be covered under the Justworks workers compensation policies, with some exceptions..
Under the Justworks Payroll product you are able to purchase workers compensation through Justworks, or through an outside provider.
If your business is required to have workers’ comp coverage and does not have coverage, you could be liable for fines and penalties. States routinely audit businesses to ensure that appropriate coverage is in force.
Check out our Workers' Compensation Insurance Primer to learn about what workers' comp covers, which businesses are required to have it, what the benefits are, how charges are calculated, and more.
Monopolistic workers’ comp policies
In North Dakota, Ohio, Washington and Wyoming, workers’ comp policies must be issued through the state government instead of private insurance companies. Justworks will reach out to walk you through the application and setup process. In Washington, premiums are charged directly as a payroll tax, but you still need to apply for coverage. Policy renewals happen directly with the workers’ compensation agencies in these states.
What is covered by workers' comp?
On a basic level, workers' comp covers injuries employees sustain on the workplace premises or anywhere else (e.g., if traveling for work-related purposes) while acting in the course and scope of their employment. In addition to injuries from accidents, workers' comp covers injuries employees may sustain from other events that may occur while they are working, including workplace violence, terrorist attacks, and natural disasters. Workers' comp insurance also covers certain illnesses and occupational diseases contracted as a result of employment. For example, an employee who works with toxic chemicals and becomes ill from exposure to those chemicals may receive benefits.
Workers' comp does not cover injuries sustained from accidents while driving to and from work. It also won’t necessarily cover injuries that, while sustained at the workplace, are not within the course and scope of employment. For example, if you’re a graphic designer, and you bring your unicycle to the office and ride it down the stairs, your claim may be denied since the injury is unrelated to your job.
I work in an office, do I still need workers' comp?
Offices aren’t typically very dangerous, so why does the state require workers’ comp insurance for office workers? Well, even office employees have a substantial number of claims. However, since office jobs are obviously less dangerous than most other jobs, the charges for employees doing office work are typically lower than other types of jobs.
How does workers' comp work when you're using a PEO?
A Professional Employer Organization (PEO) provides workers’ comp insurance and related administration services for its customers. Workers’ comp is a key component of what a PEO does. As mentioned earlier: if you have employees, you need workers’ comp.
How does workers' comp work when you're using Justworks.
As a PEO, we are the employer of record for administration purposes of all employees on our platform, so they all must be on our workers’ comp policy, provided that they work in a state that does not administer workers’ compensation at the state level. That is a requirement of working with Justworks. It also means you don't need to deal with it! Every time you make a payment through the system, we automatically calculate your workers' comp charges and display them on your invoices. If you have a covered claim, it will be on our master policy and we’ll help you sort everything out. We'll also take care of the annual renewals.
What if I already have workers' comp insurance?
If you work with Justworks, you will automatically be enrolled and charged for our worker’s comp policy. You cannot opt out*. If you already have a worker’s compensation policy, it’s highly likely that you will be charged twice. Think about whether keeping both policies is right for your business.
*In very limited circumstances, Justworks will allow a carve out policy that is managed outside of Justworks.
Justworks can provide proof of coverage for customers
Your Justworks plan includes workers’ comp coverage and as such, we are able to provide you with a certificate of insurance (COI) as necessary. Your COI is available in your company’s ‘Documents’ Center and if you need a specific certificate holder listed, you can request this directly through your account on Justworks. For more information visit: Workers' Compensation Insurance: Related Documents.
Additionally, our workers’ comp carrier will provide you with posting notices at the start of your policy as well as each year, when the policy renews. These notices are sent to each office location (but not to remote employees). You are required to display and maintain these posters in the workplace, where all employees can clearly and easily see them.
Helpful to know: workers’ comp is issued for a company, not a person
Even if your business has only unpaid owners and partners but no employees, your business may be required to have workers’ comp. You should consult your attorney or insurance broker for how this affects you and your business.
Because workers’ comp policies are issued at the company level that also means COIs apply at the company level and are not specific to a state. Meaning if you operate in several states, you do not need a different COI for each state where you have coverage.
Does my policy renew?
On Justworks, your workers’ comp policy renews annually in June.
Do I need to do anything during the renewal process?
No action is required to renew your policy as this is all handled by Justworks. We will keep you updated throughout the process and send you communications. Additionally, Justworks will provide you with updated certificates of insurance (COI) and posting notice. As a reminder, you are required to display and maintain these posters in the workplace where they are clearly visible to all employees.
How do I file a workers’ compensation insurance claim under the Justworks policy?
|
IMPORTANT Should the incident or accident be serious in nature, dial 911 immediately. Should the incident be non-life threatening, have the injured party seek medical attention with an Urgent Care or designated medical provider. When the injured employee arrives at a medical provider or service, the employee should not use their standard health insurance. Instead, for first services in response to an incident, the employee should present the Optum card they receive after the Workers’ Compensation Claim has been submitted on their behalf. As an HR administrator for an employee, this means it is important to fill out an incident report as quickly as possible so that you can receive the Optum card for your employee. |
If an employee informs you of an incident that occurred in the workplace, and the employee is covered under Justworks’ workers’ compensation master policy (i.e. not in a monopolistic state), you can report a claim directly through your Justworks account.
When an incident occurs at work, always fill out a report so we can process a claim for your impacted employee - even if they were not in need of medical attention at the time of the incident.
We will ask you for thorough information about what happened, what care was received, and who was contacted during the incident. Be sure to fill out a report as soon as possible after an incident. Please note, all incidents should be reported within 24 hours.
You can access the workers’ compensation claims flow two ways.
- Navigate to the employee’s profile through Manage > Employees and select Report a workplace incident.
- Go to the Incidents tab from the company benefits center (HR > Benefits > Incidents).
Once on the landing page, click Begin claim to launch the accident reporting form. Complete the form in its entirety including date of the incident, location of the incident, details of the injury, response and treatment for the injury, required documents, and more.
The final step is to review your submission before clicking Submit Report.
Important Tips:
- We recommend including the injured employee’s personal email so they can receive updates on the claim if they are on leave from work.
You can find your Employer Policy Number from the Posting Notices or Certificates of Insurance you have under this policy but it is not required to complete the claim
You can exit the form at any time and come back to complete it, your progress will automatically be saved. To come back to the form, navigate to the Drafts section of the workers’ compensation claims landing page.
What happens next?
Your claim will be submitted to our workers’ compensation claims administrator and you will receive an email confirmation along with guidance on how to assist your employee.; we will follow up if any additional information is needed.
The injured employee will also receive an email to the email provided with information on the claim and care, which may include an auto generated Optum card that should be presented for initial care and initial prescription fills. Your employee should not use their standard health insurance card at this time, as applicable care in response to this incident will be handled uniquely by Optum at first.
Once your employee has received any medical attention needed, you may want to follow up with the employee directly for any doctors’ notes regarding work restrictions etc. If you need to do so you can provide us with more information or updates on their healthcare needs through our support team.
The claim will be sent to the insurance carrier, and additional information will be provided to your employee when ready. The insurance carrier will communicate directly with your employee once they have set up and begun processing the claim.
Additional Questions and Support
Please note that you do not need to add individuals to your workers' compensation policy provided by Justworks. Once you hire a new employee and onboard them within the Justworks platform our team will take care of the rest!
If you have questions or need assistance please contact your dedicated Customer Success Manager or the Justworks Customer Support team.
Disclaimer
This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for accounting, legal or tax advice. If you have any legal or tax questions regarding this content or related issues, then you should consult with your professional legal or tax advisor.