Purpose 1—Leading Insurer

Working with employers and employees to minimise harm in workplaces, support return to work and recovery at work, and deliver sustainable management of the fund

PBS—Scheme is fully funded by 1 July 2020 (that is, the percentage of premium-related assets to premium-related liabilities)

Corporate Plan—The insured scheme is fully funded by 1 July 2020, measured by regular valuations of liabilities and assets, to ensure the scheme remains financially sustainable.

SOURCETARGET
PBS component 1.4
Corporate Plan
85 per cent or higher by 30 June 2017

In 2016–17 Comcare achieved a funding ratio of 102 per cent. Comcare’s premium scheme has returned to a fully funded position three years ahead of the target date of 2020

PBS—Scheme liability is reduced by $1 billion by 1 July 2018

Corporate Plan—Reduce the insured scheme liability to $1.9 billion, a reduction of $1 billion from the baseline at 30 June 2014, to ensure the scheme remains financially sustainable.

SOURCE TARGET
PBS component 1.4 $2.3 billion or lower by 1 July 2017
Corporate Plan Scheme liability is reduced to $2.3 billion by 30 June 2017

In 2016–17 Comcare’s scheme liabilities reduced from $2.7 billion to $2.4 billion.

The reduction was driven by improved claims management practices, reduction in the number of claims received and accepted, improved continuance rates and changes in economic assumptions.

PBS—Premiums are at an optimal level (that is, average premiums as a percentage of payroll)

Corporate Plan—The average Commonwealth premium rate reduces to 1.1 per cent of payroll (excluding GST) by 2018–19, to ensure the scheme remains financially sustainable.

SOURCE TARGET
PBS component 1.4 1.3 per cent or lower by 1 July 2017
Corporate Plan Average Commonwealth premium rate = 1.3 per cent of payroll

The average Commonwealth premium rate decreased from 1.8 per cent of payroll (excluding GST) in 2015–16 to 1.72 per cent for 2016–17.

Comcare’s 2017–18 premium rate is 1.23 per cent. Comcare has exceeded its target of 1.3 per cent for average premium rate for 2017–18.

PBS—Reduce administration costs

Corporate Plan—Reduce the administration cost ratio to 20 per cent by 2018–19, measured by Safe Work Australia’s comparative performance monitoring methodology, to ensure cost effective management of the fund.

SOURCE TARGET
PBS component 1.4 Corporate Plan Administrative cost ratio is 21 per cent or lower by 1 July 2017

In 2016–17, Comcare’s administrative cost as a percentage of claims expenses was 22.6 per cent. This is a reduction on the 2015–16 year administrative costs as a percentage of claims expenses of 25.7 per cent.

PBS—Early return to work of employees (that is, per cent and number of employees on reduced income continuance. Reported by time period: 4, 13, 26 and 52 weeks)

Corporate Plan—Increase the proportion of employees who have returned to work, measured by duration on incapacity benefits, to facilitate recovery and reduce liability. (reported by time period 13, 26 and 78 weeks)

SOURCE TARGET
PBS component 1.4 Reduction in trends over time
Corporate Plan Accrued incapacity duration
13 weeks—71 per cent
26 weeks—80 per cent
78 weeks—90 per cent

In 2016–17, the percentage of claims with four weeks of incapacity that continued to 13 weeks or more of incapacity was 59 per cent. This is the difference between the number of employees on reduced income at 4 weeks (640) compared to 13 weeks (379) as a percentage of claims.

Table 12: Percentage and number of employees on reduced income 2016–17

Time period of reduced income Percentage Number of employees
>1 day 100 1 067
4 weeks 60.2 640
13 weeks 35.5 379
26 weeks 20.9 223
52 weeks 12.9 138
78 weeks 10.2 109
 

PBS—Satisfaction with services (that is, percentage and number of employers and employees satisfied with the quality of services provided to case managers in agencies)

Corporate Plan—A sustained high level of satisfaction and engagement with the services provided, measured by survey, to ensure services are appropriate, responsive and relevant.

SOURCE TARGET
PBS component 1.4 85 per cent or higher
Corporate Plan 80 per cent or higher

In 2016–17, 72 per cent (N=325) of employees indicated satisfaction with the quality of claims management service from Comcare staff. This Result is consistent with the 2015–16 Result and is from the 2016–17 Comcare Return to Work Survey conducted in March 2017.

In 2016–17, 63 per cent (N=176) of employers reported satisfaction with the quality of service from Comcare staff. This Result is from the 2016–17 Employer Case Management Survey conducted in May 2017. Employer satisfaction has risen from 58 per cent in 2015–16, largely driven by increased satisfaction with Comcare’s responsiveness to queries, knowledgeable staff and sharing information about employee’s claims.

Note: N is the number of people who answered the questions.

Premium claims—Timely processing of claims

SOURCE TARGET
PBS component 1.4 Target 100 per cent

For 2016–17, 95 per cent of claims were determined within the agreed timeframe. This result includes claims determined by the Australian Taxation Office and the Department of Human Services as part of the Claims Management Initiatives Programme. This also includes claims that have previously been withdrawn where the counter does not reset if the claim later becomes compliant.

This is consistent with the result of 95 per cent in 2015–16 and is a significant improvement on Comcare’s performance of 77 per cent in 2014–15.

Premium claims—Accurate processing of claims (percentage and number of sampled payments processed in accordance with agreed standards)

SOURCE TARGET
PBS component 1.4 Target 100 per cent

For 2016–17, based on sample data, processing on premium claims achieved 98.2 per cent accuracy.

Premium claims—Reasonable cost to process claims (average cost per claim processed)

SOURCE TARGET
PBS component 1.4 Reduction in trends over time

In 2016–17 the average cost per claim processed was $2 936.32.

Pre-premium claims—Timely processing of claims (Claims with a date of injury before 1 July 1989 for the Australian and ACT Governments)

SOURCE TARGET
PBS component 1.5 Target 100 per cent

In 2016–17, Comcare determined seven pre-premium claims. Six of these claims were determined within agreed timeframes. This equates to 86 per cent. These claims relate to injuries prior to 1 July 1989 and delays in obtaining and validating information for an accurate determination influence the result.

Pre-premium claims—Timeliness of accurate processing of payments (percentage and number of sampled payments processed in accordance with agreed standards)

SOURCE TARGET
PBS component 1.5 Target 100 per cent

Based on a review of sample data, no pre-premium claims contained errors which equates to 100 per cent accuracy rate for 2016–17.

In 2016–17, Comcare processed 80 per cent of non-incapacity payments within the timeframe. This performance result includes both premium and pre-premium claims.

This is an improvement on the 2015–16 result of 68 per cent within the timeframe.

Asbestos claims—Timeliness of claims resolution (percentage of primary asbestos claims resolved within 180 calendar days)

SOURCE TARGET
PBS component 1.6 Target 80 per cent

For the 2016–17 year, timeliness of claims resolution was at 63 per cent. This is an increase from 52 per cent in 2015–16.

The nature of the conditions and the need to substitute the estate can result in lengthy delays when resolving asbestos claims.

Asbestos claims—Third party recovery rate (percentage of the value of asbestos claims settlements recovered from third parties)

SOURCE TARGET
PBS component 1.6 Target 10 per cent

For the 2016–17 year, recoveries against third parties were at 14 per cent, meeting our target.

Analysis of performance against Purpose 1

Comcare’s Corporate Plan set out ambitious objectives for Comcare’s workers’ compensation scheme for the public sector. To achieve an effective and sustainable scheme our Corporate Plan focused on working with employers and employees to minimise harm in workplaces, support return to work and recovery at work, and deliver robust and transparent management of claims.

The funding ratio of the workers’ compensation scheme for the public sector (premium scheme) increased to 102 per cent in 2016–17 from 84 per cent in 2015–16.

Premium rates are falling with the average Commonwealth premium rate decreasing from 1.8 per cent (excluding GST) of payroll in 2015–16 to 1.72 per cent (excluding GST) in 2016–17. Comcare premiums will also reduce again in 2017–18 with our average premium rate of 1.23 per cent. Comcare remains focused on our objective of returning premiums to an optimal level of 1.1 per cent of payroll (excluding GST) by 1 July 2018. The decrease of the overall scheme premium rate is the result of continued improvement in claim frequency, claims acceptance rates and duration of incapacity benefits.

At the 2016 Comcare National Conference, we launched the new online Premium Calculation Tool to help premium paying agencies within the Comcare scheme better understand the premium calculations. The tool shows how changes in agency claims experience and payroll size, both for a single year and up to four future year, can impact premium projections. It assists agencies to gain a better understanding of how investment today may impact future premiums through varying agency claims experience and payroll over a forecast period of up to five years.

In 2016–17, Comcare consolidated the enhancements to our claims management model by supporting injured employees to return to work and health through a refined focus on early intervention. We help employees return to work sooner through greater collaboration with employers, rehabilitation case managers, medical providers and rehabilitation providers. This has been important in reducing our liabilities, increasing return to work rates and delivering excellent customer service.

Comcare’s Health Benefits of Work Programme is centred on the ever-increasing pool of evidence that good work, in general, is good for health and wellbeing. Research has also demonstrated health benefits associated with participating in work while recovering from an injury or illness, particularly for those who have acquired a mental health illness. Employers and employees are central to promoting the health benefits of work and improving recovery at and return to work.

Over the last 12 months Comcare has led work to develop the Collaborative Partnership for work participation (the partnership). The partnership is an exciting opportunity to drive improvements in work participation and productivity. It is the first real attempt to work across multiple sectors and benefit structures to improve return to work opportunities and service delivery.

The partnership is a national collaboration between public, private and not-for-profit organisations, aiming to achieve sustainable improvements in working-age population health and workplace productivity. The workers’ compensation, superannuation, life insurance, employment and disability support sectors are coming together to collaboratively address work participation and productivity. Five strategic projects have been identified, three of which have been endorsed to progress to design and implementation; (initiatives 1, 2 and 5):

  1. cross sectoral system participation
  2. employer mobilisation and capability
  3. employee awareness
  4. rehabilitation services
  5. GP support.

In 2016–17, we worked with the ACT Government and general practitioners (GPs) and employers in the ACT and surrounding region to implement our Certificate of Capacity. It promotes the role of good work in recovery and focuses on what the employee can do at work, rather than what they can’t do. Comcare is continuing to support GPs to focus on capacity and provide information about return to work through the certificate of capacity and case conferencing.