WHCA Retro Program

Washington Health Care Association Information 

The Washington Health Care Association (WHCA) is a statewide non-profit organization representing over 400 assisted living and skilled nursing facilities.

• How Does The WHCA Retro Program Work?
• L&I tracks the group members' premium and claims costs during a twelve month period of time known as a Plan Year.
• L&I makes the 1st Adjustment Refund Calculation 10 months after the end of the Plan Year by subtracting the group members' actuarial adjusted claims from their retro premiums.
• L&I makes the 2nd Adjustment Refund Calculation 22 months after the end of the Plan Year by subtracting the group members' actuarial adjusted claims from their retro premiums.
• L&I makes the 3rd and Final Refund Calculation 24 months after the end of the Plan Year by subtracting the group members' actuarial adjusted claims from their retro premiums.

What Are The Risks?

Retro is not without risk. If the group's actuarial adjusted claims exceed the group's retro premiums then the group members may be assessed additional premium, up to a predetermined amount. The WHCA assessment is limited to 10% of the members' plan year premium. In order to minimize the chance of assessment, WHCA has taken steps to eliminate employers who have a history of high losses and provide education and assistance to control the costs of claims.

What Are The Program Fees?

WHCA directly bills participants in the program on a monthly basis in an amount equal to 5.5% of the premium each account pays to L&I. Members entering the program after the plan year has begun will be charged with service fees for only the time in which they are enrolled in the program.

The fees cover the costs of program administration, group-sponsored events, loss control services, and claims management.

WHCA Retro Plan Design For The 2004 Plan Year

• WHCA's Plan "B" is a moderately conservative program, which allows the group's losses to reach 100% without assessment
• Any assessment is limited to 10% of the members' plan year standard premium.
• WHCA may withhold up to 10% of any refund to fund programs for participants of the program.
• Member refunds will be distributed based on a performance-based refund formula.
• The lower a member's plan year loss ratio, the greater percentage of refund they will receive.

Retro Participation Does Not Change

• Who you send your premiums to (they still go to L&I)
• When you send your premiums to L&I
• The per hour rate you pay L&I
• The benefits your employees receive should they be injured on the job
• Your company's experience modification factor (premium rate multiplier)