Surviving Your Workers Compensation Audit

If Benjamin Franklin were around today, he might change his famous quote to, “In this world, nothing is certain but death, taxes, and a workers compensation audit.”

Why Is Your Policy Audited?

The premium for workers compensation insurance is based on the payroll to employees and the cost of uninsured contractors during the policy period. At the beginning of the policy term, your policy is set up based on a projection of your payroll. It makes sense that at the end of the policy term, an adjustment will then be made. It’ll be either up or down based on your actual payroll.

Another way to think of this is that payroll is the unit that the insurance mechanism uses to measure your exposure to loss in workers compensation insurance. A payroll audit must be done to make sure that your small business does not pay the same premium that a much larger company would pay.

What Information Is Required?

The insurance company will ask you to produce certain documentation so that your payroll levels and cost of sub-contractors can be validated. Here is a list of the most common items that you will be asked to produce.

  • A payroll report (from your payroll service, if possible) showing a summary of gross wages by employee for the policy period. The summary should include regular time wages and overtime wages.
  • Copies of your Federal payroll tax filings—941 Forms and your State payroll tax filings—and WR 30 Forms that correspond to the quarters that encompass most of your policy period. Don’t worry if your policy dates do not match the quarters perfectly as that is normally the case.
  • The insurance company will typically ask for evidence of your gross sales for the policy period. You can provide this with a balance sheet/profit-and-loss statement that matches the policy period (if you can generate this internally). If you cannot do a policy period statement, do the closest year end statement that you can. While your gross sales are not used in determining your premium for workers compensation, they will ask for this as a check on the overall size of your business.
  • Statement of sub-contractors used during the policy period. The best way to do this is to track these expenses during the year in your accounting system and to print a report that shows each sub-contractor and the checks written to them during the policy period. The entry should show a date of the check and the amount of the check. If you cannot show a report for the use of sub-contractors, the insurance company will ask to see your general ledger or your checkbook. They’ll then search for all expenditures to sub-contractors during the policy term.
  • Copies of Certificate of Insurance for each sub-contractor shown on your sub-contractor report.
  • Copies of your 1099 report for the most current year end.

Sub-Contractors and Workers Comp

An insured sub-contractor does not add any premium to your workers compensation policy. However, an uninsured sub-contractor will generate a charge just as if it was payroll. This is a double penalty because your cost of sub-contractors includes labor and materials.

It is very important that you collect insurance certificates from all sub-contractors. We recommend that you have a written agreement with all sub-contractors to outline the coverage that is required, as well as including indemnification, hold harmless, and additional insured requirements.

G.S. Newborn & Associates, Inc. Adds Value To Your Insurance Program

We can help you institute a certificate management and a sub-contractor agreement program, and are happy to help you administer this program. You should never have to pay a premium for an uninsured sub-contractor! We include this service for our commercial clients at no charge to you.

Do Your Audit Promptly

The insurance company is not going to chase you to do your workers compensation audit. Under a new regulation in New Jersey, an unaccomplished audit results in an estimated audit with a much higher premium level than your projection. So, if you do not complete your audit in a timely manner, you will receive a large additional premium audit invoice based on an arbitrary payroll level increase.

We urge you to respond right away to an audit request. If you cannot reach the auditor, please contact our office and we can intercede for you.

After The Audit

Once the audit is complete, you will receive an audit endorsement to the expired policy. There are three possible results: no change, additional premium, or return premium.

If you owe additional premium, the insurance company will send you an invoice for that premium. Keep in mind that this premium will be billed in one installment. Most of our carriers will agree to spread out this premium over two or three months depending on the size of the audit premium. You just need to contact us to arrange this for you.

If they owe you a return premium, you will receive a credit or check for this amount from the carrier.

When your audited payroll levels were much higher than your projected payroll, you will obviously have an audit premium due. Most insurance companies will also adjust the payroll levels on your current policy, which has already been issued, which will generate an additional premium invoice as well. This is a bit of a double hit so we suggest you try to make your payroll projection for your policy as accurate as possible since understating your payroll can do a number on your cash flow.

G.S. Newborn Is Here To Help

We are available to help you with all phases of this process. Please contact us if you have any questions about your workers compensation audit or any aspect of your insurance program.