Oregon Workers’ Compensation Insurance: Top Providers & Rules

Workers’ compensation insurance is a policy that pays for employees’ medical bills and lost wages if they suffer work-related injuries or illnesses. Oregon laws make business owners get coverages when they have one or more full- or part-time employee. Oregon employers typically pay between $0.83 – $10.46 per $100 of payroll for workers’ comp.

Oregon Workers’ Compensation Insurance Providers

Oregon has over 400 approved carriers that sell workers’ compensation insurance, including a state-run fund. Employers can pick from these carriers, or they can choose to self-insure, meaning they take on the cost of paying injured employees’ claims. Generally, employers should look for financially-strong carriers that specialize in small businesses or workers’ compensation.

The Hartford

The Hartford has a dedicated team of insurance specialists that’s been helping small businesses for over 30 years. In that time, the company has developed affordable products focused on the unique risks small business owners face. Moreover, they can provide workers’ compensation quotes in most industries they serve.

The Hartford’s basic workers’ compensation policy includes six unique coverages, including payment for reasonable expenses a business owner incurs while defending their case. Employers can bind policies with The Hartford in under five minutes, and discounts are available for in-full payments and for buying multiple policies, making them ideal for business owners who want the right amount of coverage quickly and at the right price.

AP Intego

AP Intego offers small business owners a streamlined platform that makes getting workers’ compensation insurance easy for small business owners. It starts with a short application that takes less than five minutes to complete. From there, the system returns quotes instantly.

On top of providing an exceptional online experience, AP Intego is a leading small business insurance brokerage that offers pay-as-you-go workers’ compensation insurance that integrates with your payroll service to automatically deduct the appropriate premium every month. This feature makes it an excellent choice for business owners who want to save time and money while also making their premium audit simpler.

SAIF Corporation

SAIF Corporation is Oregon’s not-for-profit, state-sponsored insurance fund. It was established by the state legislature to provide affordable workers’ compensation insurance for all business owners in Oregon. Overall, SAIF collects over half of all the workers’ compensation premiums in the state.

While SAIF competes against private insurance carriers, they also write coverage for businesses that private insurers typically decline. This pool is comprised of businesses that have been declined workers’ compensation insurance coverage by private carriers. As a result of SAIF’s safety training programs, many hard-to-insure businesses reduce their claims and move on to traditional coverage.

Employers

Employers is a carrier that only writes workers’ compensation insurance for small business owners. They do not provide any other insurance. Their focus on workers’ compensation allows them to offer competitive rates, especially for targeted businesses like restaurants, retailers, and architects.

Employers’ focus on workers’ compensation and risk management makes them ideal for small business owners who want to reduce their premium by keeping workers safe. The company’s loss control services are free of charge for policyholders and include hazard analyses and safety training

Premier Northwest Insurance

Premier Northwest Insurance is a family-owned, independent insurance agency with access to top carriers like Travelers and Nationwide. This enables them to write workers’ compensation policies for business of all sizes anywhere from Portland to Medford. Premier Northwest agents also have extensive experience navigating Oregon workers’ compensation insurance regulations.

Small business owners who want to compares workers’ compensation quotes should work with Premier Northwest. Since the agency is independent, their agents can quote a wide range of carriers to find the workers’ compensation policy that fits their clients’ budgets and specific needs.

What Workers’ Compensation Insurance Is

Workers’ compensation insurance, is coverage many employers must carry to cover medical treatments, partial lost wages, and survivor’s death benefits when employees suffer work-related injuries and illnesses. State law governs the coverage, and so who needs it, how they get it, and the specific injuries or illnesses covered depends on the location of your business.

Many workers’ compensation policies also include employer’s liability coverage, which is also known as part two of workers’ compensation insurance. Employer’s liability insurance pays for a business owner’s legal defense if an injury isn’t covered by state workers’ compensation statutes.

What Workers’ Compensation Insurance Covers

Without workers’ compensation insurance, employers would be on the hook for injured employees’ medical bills and lost wages. Workers’ compensation covers these expenses even if the employer is responsible for the injuries. However, injuries have to happen in the scope of the employee’s work for the employee to be compensated.

Employees typically aren’t covered if injuries happen during certain activities, such as:

• Roughhousing: A Salem restaurant owner probably wouldn’t have to cover kitchen workers injured in a prank.
• Working under the influence of drugs or alcohol: That same restaurant owner most likely wouldn’t be on the hook if their server tripped after a couple of shots with customers.
• Wearing inappropriate safety gear: A construction worker in Eugene might not get benefits if they suffer a head injury but weren’t wearing their hardhat.
• Participating in voluntary work-sponsored events: Injuries suffered during a company picnic in Portland usually aren’t covered.

In general, workers’ compensation insurance covers injuries and illnesses that are the result of a particular job. Individual circumstances are critical to determining whether benefits are appropriate, so immediate investigation is essential. This is just one of the workers’ compensation deadlines employers need to know.

Workers’ compensation insurance does not cover injuries to non-employees, such as customers. Those injuries are typically covered by general liability insurance, which most small business owners get in a business owner’s policy.

What Oregon Workers’ Compensation Insurance Covers

Oregon workers’ compensation insurance typically covers most injuries and illnesses that are caused by, or occur in, the course normal work activities. This can include repetitive motion injuries or the worsening of pre-existing conditions, as well as immediate trauma.

When an insurer accepts an Oregon workers’ compensation claim, they pay expenses including:

• Medical treatments for work-related illnesses and injuries: These treatments can include doctor and hospital visits, physical therapy, prescriptions, and rehabilitation.
• Incidental costs associated with treatment: Insurers may reimburse workers for transportation, lodging, and meals, when appropriate.
• Portions of the employee’s lost wages: Insurers pay a portion of the employee’s lost wages. How much the insurer pays depends on the injury. For instance, an injury that causes temporary disability receives two-thirds of the employee’s gross weekly wages.

In Oregon, workers typically receive workers’ compensation benefits for any injury or illness related to their work. However, they still need to demonstrate that the injury resulted from a legitimate work-related task before insurers will accept the claim.

Oregon Workers’ Compensation Insurance Costs

Insurers base workers’ compensation premiums on the work performed, payroll, and losses because these are a good indicator of whether an employer will file a claim. The average Oregon employer pays $1.12 per $100 of payroll, according to the National Association of Social Insurance, but premiums range between $0.83 and $10.46 per $100.

To determine Oregon workers’ compensation premiums, carriers start by assigning business class codes according to industry. The state publishes the rates for every class code in January. This “pure rate” is multiplied by a loss cost multiplier (LCM) that is developed by each insurer and filed with the state. This is why workers’ compensation premiums often vary greatly among insurers.

Employers who pay $2,500 in premium for two consecutive years or $5,000 for one year also qualify for an experience modification. An experience modifier is a number that represents a business’ loss history in comparison to similar businesses. Businesses with comparatively fewer claims can end up paying less for their workers’ compensation insurance.

Oregon Workers’ Compensation Insurance Audit Requirements

Payroll and staff are the basis of workers’ compensation insurance premiums. Because these can change during the life of a workers’ compensation insurance policy, most insurers require a premium audit at the end of the policy period. In some cases, insurers may even audit businesses that have closed or dropped their coverage.

Business owners can prepare for their premium audit by gathering relevant documents, including:

• Payroll register
• State and federal quarterly tax reports
• Federal 1099, W-2, and W-3 transmittals
• Overtime payroll records
• Job contracts and invoices
• Employee time cards and position descriptions
• Contract labor agreements
• Bank records

Premium audits can result in a business owner owing additional premium, but working with a broker like AP Intego can help. They offer pay-as-you-go workers’ compensation that syncs with your payroll service. Your premium is based on your actual payroll rather than an estimate, so you won’t be surprised with an extra bill at the end of your policy term.

Oregon Workers’ Compensation Insurance Laws

Most states require workers’ compensation, but each has different laws governing the coverage. In Oregon, business owners must buy workers’ compensation insurance when they have one or more employees. This regulation includes full-time and part-time employees unless they meet one of 30 or so exemptions.

According to the Oregon Workers’ Compensation Division, state law exempts the following individuals:

• Sole proprietors: Sole proprietors without employees don’t have to get coverage for themselves, but some may want a self-employed workers’ compensation policy.
• Partners: Business owners who’ve formed a partnership, limited partnership, or LLP are not required to insure themselves. Major exceptions include construction and landscaping, which are limited to two exemptions unless all partners are family members.
• Domestic workers: Individuals are not required to provide workers’ compensation for nannies, cleaners, and other domestic workers in their private residences.
• Casual laborers: Oregon law defines casual laborers as workers who earn less than $500 in a 30-day period. These employees are not subject to workers’ compensation requirements unless they work in construction and landscaping.
• Corporate officers: Corporate officers do not need workers’ compensation if they serve on the board and own 10% of the stock in the business. Landscaping and construction are limited to two exempt officers unless the business is run by immediately family.
• Limited liability corporation members: LLC members are typically exempt from Oregon workers’ compensation insurance requirements unless it’s a construction business, where LLCs can only exempt two members or one member for every 10 employees.

There are several other types of employers who are exempt from Oregon workers’ compensation requirements. The most common example is an out-of-state employer who is temporarily working in Oregon. They are not required to get Oregon’s workers’ compensation insurance if their employees are covered by a policy in their home state, their home state recognizes Oregon workers’ compensation when Oregon workers are employed there, and they do not hire non-exempt employees while in Oregon.

Oregon Workers’ Compensation Insurance Deadlines

The most important deadline for Oregon business owners is to get workers’ compensation insurance as soon as they hire an employee, whether that person works full- or part-time. Some owners even get workers’ compensation coverage prior to hiring simply to ensure they have it when they need it.

Other key workers’ compensation insurance deadlines for employers and employees to know include:

• Employers must report injuries that require medical treatment to their insurer within five days of being made aware of them.
• Employees must notify their employer in writing of a workplace injury or illness within 90 days of an incident.
• Employees must notify their employer in writing of occupational disease within one year of connecting the disease to the workplace.
• Insurers must deny or accept workers’ compensation claims within 60 days of being notified.

While many of these deadlines apply to employees, it’s good for business owners to know what to expect so they can make sure their employees get the compensation they are owed.

Oregon Workers’ Compensation Insurance Requirements

In addition to covering full- and part-time employees, Oregon workers’ compensation insurance laws place other responsibilities on employers. Many of these requirements protect workers’ rights, while others govern workplace communication. Employers need to follow these requirements or risk fines and other penalties.

Some workers’ compensation insurance requirements for Oregon employers include:

• Provide workers’ compensation insurance even when work is exchanged for something other than money.
• File proof of coverage with Oregon’s Workers’ Compensation Division.
• Make sure subcontractors have workers’ compensation insurance when you contract with them.
• Allow employees to file workers’ compensation claims.
• Offer workers a Report of Job Injury or Illness from (Form 801) and send a copy to their insurer.
• Notify their insurer within five days of becoming aware of a workplace injury or illness.
• Display this notice of compliance in a central gathering area.
• Include employer and insurer information on the notice of compliance.
• Reinstate recovered workers if the business has 21 or more employees at the time of injury and recovery.

Employees have their own responsibilities under Oregon workers’ compensation law. For instance, they must fill out either Form 801 from their employer or a Worker’s and Physician’s Workers’ Compensation Report (Form 827) from their doctor. Either of these forms can be used to initiate the claims process.

Oregon Workers’ Compensation Insurance Penalties for Noncompliance

Oregon employers who fail to comply with the state’s workers’ compensation insurance requirement face stiff fines. For the first violation, business owners can be fined up to twice their required premium with a minimum fine of $1,000. Fines increases by $250 for each additional day of noncompliance.

Noncompliant employers are also responsible for compensating injured workers, and it is required that they hire a certified examiner to process the claim. The cost of reimbursing insured workers and paying a professional claims examiner can quickly escalate to hundreds of thousands of dollars.

Oregon Workers’ Compensation Self-Insurance Requirements

Oregon employers who don’t want to purchase workers’ compensation insurance from the state fund or a private carrier can choose to self-insure against workers’ compensation claims. This means they take on the responsibility of compensating injured employees. Employers must apply with the Department of Consumer and Business Services before they can self-insure.

Items that must be submitted to self-insure against workers’ compensation claims include:

• A completed application
• Proof of your ability to process claims
• Three years of annual or audited financial statements
• A completed SEC Form 10-K (if applicable)
• Evidence of an occupational safety and loss control program
• Your most recent experience rating modification worksheet
• Types and retention levels of excess insurance, which is a policy Oregon requires self-insureds to purchase to protect against catastrophic loss
• A security deposit from either a surety bond company or an irrevocable standby letter of credit
• Signed service agreements between you and all service companies (if applicable)

Additionally, anyone forming a self-insurance group needs to show evidence of a common claims fund.

SAIF Corporation: Oregon State-Run Workers’ Compensation Insurance Provider

SAIF is a not-for-profit insurance company that was established by the Oregon legislature to provide affordable workers’ compensation to all Oregon businesses. The company competes with private insurers, so employers may opt for a SAIF policy if it fits their individual needs, but they aren’t required to use SAIF for their workers’ compensation coverage.

SAIF often works with employers who have been denied coverage by private insurers. However, any employer can purchase workers’ compensation insurance through SAIF. According to the company website, SAIF serves over 50% of the state’s workers’ compensation market and insures 35% of Oregon employees.

How to File an Oregon Workers’ Compensation Insurance Claim

Oregon workers’ compensation claims are initiated by employees because they’re the ones who suffered harm and are requesting benefits. However, employers play an important part in the process and are subject to certain responsibilities, too. Knowing these steps allows employers to assist their employees when necessary.

The steps for filing an Oregon workers’ compensation insurance claim are:

• Employee notifies their employer of an injury in writing: Workers should inform their employer of an injury immediately, but no later than 90 days after the incident. They can get Form 801 from their employer or Form 827 from their doctor.
• Employer or doctor submits the notification to their insurer: A business owner needs to forward their employee’s notification form to the insurer within five days. Physicians must submit the document within three days.
• Insurer accepts or denies a claim within 60 days: If a claim is accepted, the insurer sends a Notice of Acceptance listing the medical conditions they will cover. A denial comes with a letter of explanation that includes information about appeals.

If an employee’s claim is denied, they have the right to appeal. The Oregon appeals process starts with a Request for Reconsideration. This form can be submitted by fax or mailed to the division office in Salem.

Tips on Getting Oregon Workers’ Compensation Insurance

Some tips for getting workers’ compensation insurance in Oregon include:

Compare Quotes from Multiple Carriers

Workers’ compensation insurance premiums vary because every carrier uses its own loss cost multiplier (LCM). When it’s factored into the rates assigned to each class code, the rates adjust. Since LCMs vary by carrier, you should get more than one quote to find the most affordable workers’ compensation policy for your small business.

Pay Close Attention to Classification Codes

Classification codes apply to a business overall. If you’re in construction, then all of your employees are classified as construction workers. However, there are standard exemptions for employees who are in low-risk positions, such as office work or sales. Using these exemptions can lower your premium because low-risk jobs have lower rates.

Implement Safety Procedures to Reduce Workers’ Compensation Claims

Businesses with more workers’ compensation claims usually pay higher premiums, so taking steps to reduce risks and protect employees can save you money in the long run. Establish safety protocols and provide regular training to make sure workers use them. If an employee is injured, get them the medical treatment they need immediately.

Use Oregon Workers’ Compensation Return-to-Work Programs

Oregon workers and employers pay a tax to support return-to-work programs for injured employees. These programs help employers develop transitional work plans and encourage other businesses to hire workers who can no longer perform their original jobs. This can help reduce costs by reducing the amount of time workers’ compensation benefits are paid.

Oregon Workers’ Compensation Insurance Frequently Asked Questions (FAQ)

Employers need workers’ compensation insurance that fits their business, budget, and state law. Sometimes unique situations can make that tricky. Below we’ve answered some of the most frequently asked questions about Oregon workers’ compensation insurance.

1. Do I Have to Buy Workers’ Compensation from SAIF?

Oregon employers who need workers’ compensation insurance have the option of buying a policy from SAIF, the state-sponsored workers’ compensation fund. However, Oregon is not a monopolistic state, so employers also have the option of buying workers’ compensation insurance from a private insurer if they prefer.

2. Do I Need Workers’ Compensation Insurance if I Don’t Have Employees?

Oregon doesn’t require business owners without employees to get workers’ compensation insurance. However, business owners may still want to buy coverage for themselves or buy a policy in case they hire staff. These policies are called “if any” or ghost policies. They don’t cover any individual worker but can provide temporary protection for any new hires.

Bottom Line

Workers’ compensation insurance pays medical bills, partial lost wages, and survivors’ benefits when an employee suffers a work-related illness or injury. Oregon state law mandates that employers get coverage even if they have only one employee. Failure to get workers’ compensation in Oregon can result in fines and penalties.

The Hartford is the best choice when it comes to value for workers’ compensation. Their standard policy has coverages you won’t find with other insurers, plus you can opt for the expanded coverage and add individual riders to fit your particular needs.

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