Clear Spring Property and Casualty Group (“CSPCG”) created a Claims Kit that provides its policyholders with a comprehensive description of the procedure involved following a claim; the forms that must be completed at the time of hire; and the forms that must be completed following a work-related injury. In addition, this Claims Kit includes information regarding the utilization of designated medical providers and CSPCG’s pharmacy benefit manager. The Pennsylvania Workers’ Compensation Act requires an employer to post the LIBC 500 form. This form advises employees to report their work-related injuries to you and provides employees with the contact information for CSPCG. The Workers’ Compensation Employee Notification and the Workers’ Compensation Information Form must be signed by the employee at the time of hire. A second copy of the Workers’ Compensation Employee Notification and the Workers’ Compensation Information Form must be signed by the employee when a work-related injury is reported.

Claims Submission
The First Report of Injury Form can be submitted through CSP&C Gateway. This form must be completed and reported immediately after an injury occurs. For fatal work-related injuries, the form must be completed and reported within 8 hours.

OSHA Reporting Eligibility
Employers are required to notify OSHA when an employee suffers a work-related fatality or suffers a work-related hospitalization, amputation, or loss of an eye. A fatality must be reported to OSHA within 8 hours. An in-patient hospitalization, amputation, or eye loss must be reported to OSHA within 24 hours.

Designated Provider Panel Program
The Pennsylvania Workers’ Compensation Act gives employers the right to establish a list of designated healthcare providers. When the list of designated healthcare providers is properly posted and the employer provides a clearly written notice to employees of their rights and duties at the time of hire and at the time of a reported work-related injury, an employee must seek treatment with one of the designated providers for ninety (90) days from the date of the first visit.

As part of its commitment to unparalleled service, CSPCG provides its policyholders with assistance in the creation and/or maintenance of a designated provider panel to meet a policyholder’s specific needs. In addition, CSPCG can schedule physician, physical therapy and/or diagnostic study appointments. Please contact a member of your Claims team to utilize this service.

Pharmacy Benefit Program
CSPCG utilizes the services of a pharmacy benefit manager. Injured employees are automatically enrolled into the program once a claim is submitted and open.

Policyholders are eligible for added benefits associated with this partnership. Information is provided in the Claims Kit detailing the process to access this valuable service.

Return to Work Program
By returning an injured employee to work in a modified/restricted duty capacity, employers can improve an employee’s recovery rate and outcome following a work-related injury. Moreover, a modified/restricted duty program can reduce overall workers’ compensation costs; avoid costs of hiring/training a replacement worker; reduce fraud; and promote employee morale. Accordingly, CSPCG encourages its policyholders to develop a meaningful and functional modified/restricted duty program to facilitate an injured employee’s return to work.

The Pennsylvania Department of Labor & Industry Workers Compensation Services provides Pennsylvania employers with the process of establishing Return-to-Work programs; Return-to-Work; A Model for Pennsylvania Business & Industry.