Texas Star NetworkTexas Star Network®® OptionOption

““Making the Right Choice”Making the Right Choice”

Today’s FocusToday’s Focus

► Texas Star Texas Star NetworkNetwork®®

► Network BenefitsNetwork Benefits► Network Network

ResponsibilitiesResponsibilities► Agent InvolvementAgent Involvement

Workers’ Comp Health Care Workers’ Comp Health Care NetworksNetworks

► Carriers chose whether to offer Network Carriers chose whether to offer Network optionoption

► Employer election into NetworkEmployer election into Network► Texas Star NetworkTexas Star Network®® certified certified

Texas Star NetworkTexas Star Network®® Availability Availability

► 99% of policyholders99% of policyholders► All major metropolitan All major metropolitan

areasareas► Up to 12% annual Up to 12% annual

Network discountNetwork discount

Texas Star NetworkTexas Star Network® ® Service AreaService Area

As of 1/2010 – 231 Counties Certified

Accessibility RequirementsAccessibility Requirements

► Treating doctorsTreating doctors Urban – 30 milesUrban – 30 miles Rural – 60 milesRural – 60 miles

► Specialty careSpecialty care Urban – 75 milesUrban – 75 miles Rural – 75 milesRural – 75 miles

Network BenefitsNetwork Benefits

► Quality of CareQuality of Care Employees select from listEmployees select from list

►Network designates Network designates specialtiesspecialties

Providers versed in Providers versed in occupational medicineoccupational medicine

Providers focused on Providers focused on return-to-workreturn-to-work

Texas Mutual Network ResultsTexas Mutual Network Results

► Final conclusions are premature, but early Final conclusions are premature, but early indications suggest:indications suggest: Network claims have fewer days of lost Network claims have fewer days of lost

time than non-network claimstime than non-network claims Network claims have lower severities than Network claims have lower severities than

non-network claimsnon-network claims Texas Mutual will continue to analyze Texas Mutual will continue to analyze

network data as claims maturenetwork data as claims mature

Employer ResponsibilitiesEmployer Responsibilities

► Provide network noticeProvide network notice► Obtain signed Obtain signed

acknowledgment formacknowledgment form► Facilitate claim Facilitate claim

investigation and return-to-investigation and return-to-workwork

Texas Mutual will provide both the notice and Texas Mutual will provide both the notice and acknowledgment formacknowledgment form

Notice Distribution OptionsNotice Distribution Options

► EmailEmail► Staff or safety Staff or safety

meetingsmeetings► Obtain electronic Obtain electronic

signaturesignature► MailMail

Notice RequirementsNotice Requirements

► Employer must provide notice atEmployer must provide notice at Time of acceptance Time of acceptance ANDAND Time of injuryTime of injury

► Notice must be posted at each Notice must be posted at each locationlocation

Required RecordkeepingRequired Recordkeeping

► Must have standard Must have standard delivery processdelivery process Delivery methodDelivery method RecipientRecipient LocationLocation Date(s)Date(s)

► Retain copies of signed Retain copies of signed formsforms

Use this form to record your distribution of the notice of network requirements and employee signature of the network acknowledgment form

Initial/ Post-Injury Employee# Last Name, First Name

Delivery method(Paper, electronic) Recipient

Location (Home, business, other) Delivery Date

Form signed/ refused Signed/refused date

Initial 1234 Jones, Bob Paper Bob Jones Home 2/27/2006 Signed 2/27/2006

Employee Acknowledgment Form

Network Notice/Acknowledgment Form Log

Notice of Network Requirements

Company Name: Texas Mutual Policy#:

Employee RequirementsEmployee Requirements

► Select from network listSelect from network list► If not, employee may be required to payIf not, employee may be required to pay► ExceptionsExceptions

EmergenciesEmergencies Employee lives out of service areaEmployee lives out of service area HMO doctorHMO doctor Referral to specialistReferral to specialist

Must comply with requirements to receive benefitsMust comply with requirements to receive benefits

Agent InvolvementAgent Involvement

► Educate eligible policyholders regarding benefits Educate eligible policyholders regarding benefits and responsibilitiesand responsibilities

► Does it make sense for their operations/area?Does it make sense for their operations/area?► Submit endorsement request online at Submit endorsement request online at

www.texasmutual.comwww.texasmutual.com

Texasmutual.com ToolsTexasmutual.com Tools

► Notice of Network requirementsNotice of Network requirements► Acknowledgment formAcknowledgment form► Notice and acknowledgment form logNotice and acknowledgment form log► Helpful hints for employersHelpful hints for employers

Texasmutual.com ToolsTexasmutual.com Tools

► Presentations for agents, Presentations for agents, employers and employers and employeesemployees

► Provider searchProvider search► Service area mapService area map► Provider nominationsProvider nominations

QuestionsQuestions