Frequently Asked Questions

  • Who has to carry workers compensation insurance?


    Businesses with five or more employees are required to carry workers compensation insurance. This requirement includes part-time employees.

    Contracting businesses with one employee are required to carry workers compensation insurance. This requirement includes part-time employees.

    Sole proprietors and partners are excluded under the workers compensation law unless they choose to be included.

    LLC members and corporate officers are considered employees in Missouri and are included in workers compensation coverage. LLC members have the option to exclude themselves from coverage in Missouri, but to do so, each LLC member must complete one of the LLC Rejection of Coverage forms, depending on whether the LLC Operating Agreement is an oral or written agreement.

    A general contractor is liable for any injuries to uninsured subcontractors or their uninsured employees and can require that subcontractors carry workers compensation insurance. 

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  • How do I obtain workers compensation insurance?


    Contact your local insurance agent and tell them you’d like Missouri Employers Mutual Insurance as your workers compensation carrier. They’ll take it from there.

    Don’t have an agent? Use our Find an Agent tool.

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  • What can I do to bring down the cost of workers compensation insurance?


    The best way to reduce your workers compensation insurance premium is with a long-term commitment to workplace safety. Safety can have a significant impact on premium.

    For example, an account paying premium of $18,510 had an e-mod of 1.27. After experiencing no claims for the next four years, the account’s e-mod went down to .91, and premium went down 28 percent from the reduced e-mod alone. 

    MEM policyholders with premium $1,000–$10,000 may also receive up to a 5 percent credit for being injury-free with MEM for five years.  

    Policyholders with premium greater than $10,000 can receive up to a 10 percent credit for having a full-time, trained safety coordinator.

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  • What is a certificate of insurance?


    A certificate of insurance is a way to verify insurance coverage. It shows the name of the certificate holder, policyholder, insurance company, policy number, type of insurance coverage and policy effective dates. For workers compensation, it also indicates whether the owner is included for coverage on the workers compensation policy; the certificate holder should be sure this section is completed.

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  • What is remuneration?


    Remuneration is commonly called payroll. It includes wages, commissions, bonuses, overtime pay, holiday pay, vacations and sicknesses, payment for piecework, value of housing, cafeteria plans and other substitutes for money.

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  • What is the Second Injury Fund?


    The Second Injury Fund is a fund administered by the state of Missouri to help compensate employers for injured employees with disabilities related to the combination of a work-related injury and a pre-existing condition. A current employer would only be liable for the degree or percentage of disability that resulted from the latest injury had there been no pre-existing condition.

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  • What is a security deposit, and why do I have to pay it?


    A security deposit is necessary on reporting policies to protect MEM from the credit risk of providing coverage for which premium has not yet been collected. With reporting policies, an employer pays premium on a periodic basis, after the employer confirms what the actual payroll was for that period. The security deposit serves as collateral for the coverage during that time period. For policyholders who would rather not pay a security deposit, MEM offers annual pay policies and installment billing options.

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  • What is automatic electronic funds transfer?


    Auto EFT refers to the electronic transfer of funds from one bank account to another, on a one-time or recurring basis. Auto EFT provides you with the most payment plan options and more flexibility. Learn more about Auto EFT.

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  • How is payroll calculated for owners or officers?


    Missouri
    For policy terms beginning Jan. 1, 2017, the payroll to be used by all owners/officers in Missouri is $40,600 with 10 percent of that amount allocated to either 8810-Clerical or 8742-Outside Sales. This applies to sole proprietors, partners, corporate officers and LLC members.

    Note: The payroll amount used for owners and officers is indexed to the average weekly wage determined by the Missouri Department of Labor and Industrial Relations and may be adjusted each year.

    Kansas
    For policy terms beginning Jan. 1, 2017, the payroll to be used by all corporate officers in Kansas is $850 weekly ($44,200 annual) minimum and $3,300 weekly ($171,600 annual) maximum. The payroll amount for sole proprietors, partners and LLC members is $43,500.

    Note: The payroll amount used for owners and officers is indexed to the average weekly wage determined by the Kansas Insurance Department.

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  • If sole proprietors or partners acting as a subcontractor have no employees and have not elected to be insured for workers compensation coverage, why am I being charged for their exposures?


    If uninsured subcontractors and their employees are injured, they will be treated as the general contractor’s employees for workers compensation purposes. While sole proprietors and partners are not required by law to carry insurance on themselves, they may submit a claim under a general contractor’s policy in the event of a work-related injury. Therefore, employers are charged a premium for the amount paid to any sole proprietors or partners who cannot provide a certificate of insurance showing they have workers compensation insurance.

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  • How should policyholders report overtime payroll?


    Overtime payroll should be reported at the normal hourly rate. The proper way to report time-and-a-half payroll is to divide the total overtime payroll by 3 and subtract that amount from gross payroll. To report double time payroll, divide the payroll by 2 and subtract that amount from gross payroll.

    Example:
    A policyholder has gross payroll of $55,335, including overtime at time-and-a-half of $2,670 and overtime at double time of $3,990. How much is included in the premium base?

    Answer:
    The premium portion of the time-and-a-half overtime is $890 ($2,670/3) and the premium portion of the double time overtime is $1,995 ($3,990/2), for a total of $2,885.

    $55,335-2,885=$52,450

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  • If overtime is not summarized, can I still deduct it from my gross payroll?


    Overtime records must show overtime pay separately by employee or in summary by classification to be deducted.

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  • If my employees do more than one type of work, can I assign their payrolls to separate classifications?


    If the employees are not engaged in construction work, they will be classified in the highest-rated classification for the work they perform. When engaged in construction work, employees’ wages may be divided into the appropriate construction classifications, provided the division is reflected in the original payroll records, in dollar amounts. If wage divisions aren’t reflected in the original payroll records in dollar amounts, employees’ wages will be classified in the highest-rated classification for the work they perform.

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  • Can payroll be divided if employees spend part of their time doing clerical work?


    The clerical classification code (8810) is a standard exception code. Division of payroll is not allowed. The only exception to this rule is payroll for a covered business owner, in which case 10 percent of their payroll can be allocated to the clerical class code.

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  • Do sole proprietors have to pay premium for an unpaid family member working for them?


    Yes, unless an endorsement is requested to exclude a family member. If the family member is injured while working for the sole proprietor, the policy would have to respond to the family member’s injuries. Non-salaried or unpaid family members can be excluded from coverage by endorsement. If they are not excluded by endorsement, a replacement wage will be charged for the hours worked.

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  • What does NOC mean?


    NOC means “Not Otherwise Classified.” Each classification code in the Scopes Manual includes a “phraseology,” which is the code’s description or definition.

    For example, classification codes for types of store exposures have the following descriptions or definitions:

                    8001 Store: Florist & Drivers
                    8006 Store: Dairy Products—Retail
                    8010 Store: Hardware

    When classifying a risk, the business operation should match the classification code. When there is no code that describes the operation, use an NOC classification.

    For example:
    8017 Store: Retail NOC

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  • Why does MEM conduct premium audits?


    MEM conducts premium audits—physical examinations of policyholders’ business operations and financial records—to verify reported payroll and classification information. When policyholders estimate their payroll at the beginning of a policy year, it is often impossible to foresee changes in the business, such as employee turnover. A year-end premium audit helps assure you are paying the correct premium for your workers compensation coverage.

    In some cases, MEM’s Premium Consultants will perform a new business consultation within three months of a policy’s inception. This affords the policyholder an opportunity to ask questions regarding proper classifications and payroll segregation to prevent surprises at the final audit.

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  • What records are needed for an audit?


    Records are important to the audit process because they provide and verify information, save time and can minimize your insurance costs. MEM Premium Consultants will let policyholders know which of the following records will be needed for the audit when they make the appointment.

    Payroll records: Includes payroll journal and summary, federal tax reports (941s and 1099s), state unemployment reports and individual earning records. Totals should be kept for overtime, when applicable.
    General ledger: May be used to verify other records
    Checkbook: May be used to verify other records
    Cash disbursements: Shows subcontractor names and costs, costs of materials and casual labor
    Certificates of insurance: For subcontractors used during the audit period for construction, erection and/or structural alteration

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  • If I don't have certificates of insurance by the time of the scheduled audit, will I be given time to obtain them?


    Premium Consultants will allow up to two weeks for you to get certificates of insurance, but it is in your best interest to request a certificate from a subcontractor at the time the work is performed, rather than at the time of the audit. You will be charged for those subcontractors not providing valid workers compensation certificates of insurance.

    An easy method of obtaining certificates is to ask subcontractors the names and phone numbers of their insurance agents. Call the agents and request certificates of insurance.

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  • When will I receive the results of the premium audit?


    At the time of the phone or field audit, an auditor will explain any differences in audited payroll versus estimated or reported payroll. Policyholders are encouraged to ask questions to understand any discrepancies.  Once the audit is submitted, processing will take a few days in order to generate a statement with the final premium determination. For all audit methods, including voluntary, a copy of any adjustments to payroll or class codes will be mailed to the policyholder as well as the producer.  A billing statement with premium results will also be mailed to the policyholder.

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  • If an injury occurs while working, is it automatically covered by workers compensation?


    In order for an injury to be covered under an employer’s workers compensation policy, the injury must arise out of and have occurred during the course and scope of the employee’s employment with the employer.

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  • Are occupational diseases covered by workers compensation?


    For occupational diseases to be covered by a workers compensation policy, the occupational disease must arise out of and have occurred during the course and scope of employment. It is compensable if the work-related exposure is the prevailing factor causing the condition and meets the requirements of an injury. It is not compensable merely because work was a triggering or precipitating factor.

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  • Do minor injuries have to be reported?


    All work-related injuries, regardless of how minor they are, need to be reported to MEM. MEM is then required to report injuries to the state. This allows the state to accurately track workplace injuries. In Missouri, you may choose to pay claims out of pocket if: they are equal to or less than 20 percent of the split point applicable on the effective date of the policy during which the date of injury occurred and do not have more than three days of lost time. Please contact MEM Claims Services at claims@mem-ins.com or 1.800.442.0593 if you need assistance calculating the threshold applicable to your specific claim. 

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  • What is an e-mod?


    An experience modification factor, or e-mod, is a factor calculated by the National Council on Compensation Insurance based on your actual loss experience compared to the expected loss experience for your industry type over the past three years, not including the most recent year. If you qualify for experience rating and your losses are lower than expected within your industry, your e-mod factor will be less than 1.00, which will reduce your premium. If your losses are higher than expected within your industry, your e-mod factor will be greater than 1.00, which will increase your premium. 

    To qualify for an e-mod factor, you must have premium of at least $7,000 for one year or an average premium of $3,500 for two consecutive years.

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  • How will a claim affect a company's e-mod factor?


    E-mod factors are based on a company’s losses for the past three years, not including the most recent year. For example, a claim occurring in 2003 will not impact the e-mod factor until 2005. It is difficult to estimate the exact effect an injury will have on an e-mod factor because the National Council on Compensation Insurance adjusts e-mod calculations each year to anticipate not only a company’s expected losses, but the losses of all businesses within that industry, as well.

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  • How quickly do workers compensation claims have to be reported?


    MEM encourages employers to report injuries within 24 hours. Prompt injury reporting can have a significant effect on returning an injured employee back to work safely and successfully while reducing workers compensation costs. Missouri law requires employers to report injuries to their insurer within five days of the occurrence or their notice of the occurrence. The insurance carrier must report an injury to the Division of Workers' Compensation within 30 days of occurrence.

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  • How should a workplace injury be reported?


    Injuries can be reported online 24 hours a day using MEM’s electronic claims reporting tool, eClaim. Injuries can also be reported by calling MEM any time at 1.800.442.0593 or faxing the injury report to us at 1.800.442.0597.

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  • What information is needed to report a workplace injury?


    Initially, all MEM needs to know is the:

     • Basic contact information for the company.
     • Injured employee’s name, social security number, state of hire and phone number.
     • Date the injury occurred.
     • Brief description of what happened.
     • You can follow up later with injury details, the injured employee’s employment status and treatment information.

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  • How long does temporary total disability (TTD) continue?


    Temporary total disability (TTD) is given to employees who suffer a disabling workplace injury or occupational disease exposure that temporarily prevents their return to work. It is awarded for the time the employee is receiving medical treatment and is restricted from returning to work by their physician, but cannot exceed 400 weeks. TTD benefits are 66.66 percent of the employee’s average weekly wage and cannot exceed $799.11 per week.

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  • How is temporary total disability (TTD) affected if an employee goes back to work half days?


    This situation is called temporary partial disability (TPD). If the authorized treating physician releases an employee to work fewer hours than they would normally work on a temporary basis, they will be paid by their employer for the hours they work and 66.66 percent of the difference. TPD benefits cannot be paid for more than 100 weeks.

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  • Can employees collect benefits when they have had the same injury before?


    Medical and temporary disability benefits start anew for a new injury, even to a body part previously injured. The employer is entitled to a credit for any pre-existing permanent partial disability.

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  • How is an employee's average weekly wage calculated?


    In most situations, the employee’s wages for the 13 weeks immediately preceding the injury are averaged to calculate the average weekly wage. However, there are exceptions to just computing the 13 weeks prior to the date of injury.  For example, if an employee does not work during one or more of the weeks for the 13 weeks prior to the date of injury, we are required by statute to exclude those weeks from the AWW computation.

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  • Why does an injured employee's prescription eligibility have to be updated every month?


      An injured employee’s prescription eligibility is reviewed each month to make sure they are receiving the needed medications for his or her recovery. Should an employee’s condition or medications change, the pharmacy is notified, avoiding any delays in receiving prescribed medications.

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  • Why should employees get a settlement from an injury when they are back to work?


    The workers compensation statute calls for the payment of permanent partial disability (PPD) to compensate an injured employee for the permanent effects of a work injury. It is common for employees to have permanent partial disability even though they are able to return to their previous job.

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  • Is temporary total disability (TTD) for sole proprietors based on the cap for their payroll or actual wages earned?


    TTD benefits are based on the average weekly wage of sole proprietors, not the cap for their payroll.

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  • How does MEM pay disability benefits?


    MEM issues disability benefits on a weekly basis in seven-day increments, according to Missouri’s workers compensation statute.

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  • Can an employer pay an employee's salary to avoid paying temporary total disability (TTD)?


    No. Court cases have held that the insurer’s responsibility to pay TTD benefits is contractual and owed to injured employees even if the employer continues to pay their salary during the disability period.

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  • What happens to an employee's temporary total disability (TTD) if their employment is terminated?


    This must be determined on a case-by-case basis by the employer and MEM, but generally the obligation to pay TTD during the period of disability continues even if the injured employee no longer works for the employer. The policyholder should also review this with their corporate counsel.

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  • What is the benefit of transitional duty?


    Transitional duty allows injured employees to transition back to work safely and successfully by modifying their job duties. The employee enjoys the self-esteem that comes from working and may be able to return to full salary, while the employer is able to curb claims costs. 

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  • Should employers keep in touch with injured employees while they are off of work due to a workplace injury?


    Yes. Not only does this convey a sense of caring, it also keeps employers up to date on the injured employee’s progress and anticipated return to work date.

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  • What do injured employees do after their doctors release them back to work?


    They should notify their employer that they have been released back to work, even if it is for modified duty. If there are any job restrictions mandated by the physician that the employer is able to accommodate, the employer should accommodate them. Once the doctor releases the injured employee back to full work duty, they are no longer eligible for workers compensation benefits.

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  • Where does an employer send an injured employee for treatment?


    Employers in Missouri have the right to direct medical care for their employees. Before an injury occurs, employers should designate a company physician within their endorsed Dimensions Partner network, and communicate the decision to all employees. Even if no physician has been designated before an injury, the employer should still direct medical care at the time of the injury. By using a network physician, employers will ensure injured employees are treated by someone familiar with occupational injuries while reducing claims costs.

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  • How do employers keep their claims costs low once a workplace injury has occurred?


    Choosing an in-network provider is just one way to decrease the claims costs and ensure that the injured employee receives a high quality of care.

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  • What is workers compensation abuse and fraud?


    Workers compensation abuse is any practice that uses the workers compensation system in a way that is contrary to the intended purpose of the system or statute. Fraud is committed by someone who knowingly makes or causes to be made any false or fraudulent statement or representation for the purpose of obtaining or denying any benefit. Workers compensation fraud includes employer fraud, injured employee fraud, producer fraud and several other forms.

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  • How can employers prevent workers compensation fraud and abuse?


    Employers can play a significant role in preventing and detecting workers compensation fraud and abuse. They can:

    • Verify all certificates of insurance with subcontractors to ensure they are valid and have been properly issued.
    • Investigate all causes of work-related injuries.
    • Report work comp claims immediately to their insurance company.
    • Check in with injured employees on disability at different times of the day to ensure they are home.
    • Ensure their agent is listing proper job classifications and payroll accurately.
    • Encourage their employees to report suspected cases of fraud.

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  • How does an employer or employee report suspected workers compensation fraud?


    An employer or employee should alert MEM as soon as possible by calling our Fraud Hotline at 1.800.442.0592 or reporting the suspicion online. They may also call the Fraud and Noncompliance Unit of the Missouri Department of Labor and Industrial Relations at 1.800.592.6003.

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  • Can an employer do surveillance on an injured employee?


    This is not recommended. The average employer rarely knows how to conduct appropriate surveillance and usually the tapes are inadmissible in court. Surveillance should be left to the insurance company or a hired contractor.

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  • Does an injured employee get medical attention, disability benefits or a settlement even if they have committed workers compensation fraud?


    The only time workers compensation fraud defeats a claim is when it is found that the employee suffered no injury or the injury didn’t occur within the scope and course of employment.

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  • Can employers determine whether someone has filed a workers compensation claim before they hire them?


    No. After a person is hired, employers can request an employee’s records from the Division of Workers’ compensation with the employee’s approval in the form of a notarized signature. There is a $5 charge for the records.

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  • How can an employer check the criminal record history on a prospective or current employee?


    Employers can request a statewide criminal record history on any prospective or current employee from the Missouri State Highway Patrol’s Criminal Records and Identification Division. No permission is needed from the person of whom you are checking. Employers can also use a private vendor to complete the check. Record checks by phone are not possible.

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  • Can an employer terminate an injured employee for suspected workers compensation fraud and abuse?


    It isn’t advisable. Our legal system is based on the notion that a person is innocent until proven guilty. This includes allegations that they have committed workers compensation fraud or abuse. Employers should discuss termination with their company’s attorney, as well as MEM, before they take any action.

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  • How can an employer verify certificates of insurance?


    The employer should call their producer or carrier listed on the certificate of insurance and verify that coverage is still effective at the time the subcontractor's services are used and paid for.

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  • What should an employer do if they suspect a fraudulent certificate of insurance?


    Employers should contact MEM’s Special Investigative Unit at fraud@mem-ins.com or 1.800.442.0592. MEM will conduct an investigation and keep the employer advised of progress on the case.

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  • What are the benefits of attending a WorkSAFE seminar?


    The benefits of MEM’s WorkSAFE seminars are numerous. You can:

    • Increase your safety awareness both on the job and in your personal life.
    • Receive resources to write company safety policies, and develop and present safety materials.
    • Learn basic safety principles and hazard identification, elimination and control.
    • Obtain training and certification in OSHA, National Safety Council and American Red Cross courses.
    • Understand OSHA's purpose, regulations and penalties.
    • Meet MEM’s safety consultants.
    • Network with other local businesses.
    • Understand MEM policies and procedures.
    • Earn credit for educational requirements.

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  • Will you ever offer a seminar in my location?


    Seminar locations and frequency are based on participant attendance in prior years and feedback from MEM’s Safety and Risk Consultants. Topic selection is based on the types of injuries employees are experiencing and other timely issues, such as OSHA revisions.

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  • What other safety resources are available to policyholders?


    Each workplace is unique, and we know there is no one-size-fits-all safety solution. Our Safety and Risk Consultants partner with policyholders to find innovative solutions to difficult safety problems.

    MEM’s Safety and Risk Services staff are located throughout the state to provide immediate attention to your safety concerns. Our training courses, designed to provide specific safety education to meet your unique needs, are offered regionally for convenience.

    Contact us to learn more about customized training for your workplace by contacting WorkSAFE@mem-ins.com or 1.888.499.SAFE (7233).

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  • Are my employees covered by my workers compensation policy if they work in a another state?


    Missouri employees (those who are hired out of and work predominantly in Missouri) are covered under an MEM policy for work in other states, but only for temporary employment that is incidental to Missouri operations. In some cases, an employee injured outside of Missouri may choose the benefits of the state where the injury occurred, which may be higher than Missouri benefits. Under the temporary and incidental endorsement, MEM will pay benefits required by the workers compensation law of any state other than Missouri. 

     

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  • How do I know when I have an out-of-state exposure that needs to be handled through other states coverage?


    If you have permanent or ongoing operations in states other than Missouri in which your employees are hired and predominantly work, you may need to purchase other states coverage separately. There are many different circumstances that would require you to have coverage for your employees in other states. Have your producer contact MEM with questions regarding your out of state coverage needs.

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