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PREMIUM AUDIT

An opportunity for LWCC to understand your business operations so that you are charged the correct premium.

or individual

LWCC covers only Louisiana businesses and organizations

workplace safety

Guaranteeing your workplace is as safe as possible for your workforce is the best way to minimize risk and decrease chances of workplace injury.

system of free resources

A vast online library of regularly-updated safety resources, tools, and references made available to policyholder for free.

safety experts

LWCC’s Consultants on Call are dedicated to understand your operations and customizing safety solutions to meet your needs.

mutual insurance company

We are mandated to serve the mutual benefits of its members.

personalized service

Our Agency Relations representatives are available to partner with you to serve your policyholders through in person or virtual visits, depending on your preference.

underwriting team

Specialized team with in-depth knowledge of the unique needs of companies of various sizes and specialties.

tools and information

The team assists agents in connecting to relevant department contacts, as well as resources, tools, guides, and educational materials available from LWCC.

dedicated agent resource

LWCC Agency Relations are here to serve agents and their staff only.

compassionate care

Genuine compassion requires the experience to know what matters and what help is actually needed.

plan development

WorkAction plans are customized to the injured workers’ needs by vocational rehabilitation specialists.

early intervention

Our WorkAction return-to-work program capitalizes on the window of opportunity right after an employee is injured to help create a return-to-work plan that works for you.

return-to-work program

Our experienced team helps design the right program for individual claims, or assist you in creating a proactive program to safely get your employee back to work — all at no cost.

quality medical care

Including hospitals, clinics, specialists, pharmacies, physical therapists, chiropractors, diagnostic testing, durable medical equipment vendors, rehabilitation, and home healthcare providers.

skilled providers

LWCC has selected providers across the state based on their expertise in occupational medicine, professional credentials, use of established treatment guidelines, and effective return-to-work practices.

prompt access

With OMNET®, injured employees are guaranteed appointments with specialists on a priority basis.

statewide

The first of its kind in Louisiana, OMNET includes providers across the state, even in rural areas.

strong financial results

Dividends are made possible through the sound counsel of agent partners, employees’ dedication to excellence in execution, and policyholders’ continued commitment to safety and wellness.

policyholders

Returns are maximized by long-term policyholders who become fully vested in the dividend program.

shared

A unique benefit for policyholders of a mutual insurance company.

workers’ compensation related

Provide a broad range of litigation services in the workers’ compensation arena.

provides counsel

The team handles cases of all sizes, regardless of the complexity of the dispute at issue.

in-house legal team

The Johnson, Rahman & Thomas team has approximately 19 lawyers, paralegals and legal assistants.

correct premium

Per the policy, the final premium is determined after the policy ends by using the actual premium (validated at the audit), along with proper classifications and rates.

charged

May help identify gaps in coverage or discounts or credits that may apply to your policy.

opportunity

The audit is an important step in the workers’ comp insurance process.

financial gain

Can include paid benefits, unnecessary treatment or prescriptions, misrepresenting business details, and more.

intentional deception

Deception by a member of the workforce, a company leader, or a healthcare provider.

fully protect

Workers’ compensation is a form of insurance providing wage replacement and medical benefits to employees injured on the job.

assist employers

Agents solicit and negotiate insurance contracts for the best fit between an insurer and a business or organization.

valuable resource

LWCC does not write workers’ comp policies directly with employers. We are proud to partner with agents across the state to provide outstanding service to our policyholders and their workers.

business, organization,

LWCC covers only Louisiana businesses and organizations

insurance policy

Our focus always has and always will be workers’ comp insurance

business or individual

LWCC covers only Louisiana businesses and organizations

injured workers

LWCC understands the difficulty of being injured on the job and is there to help those requiring assistance in recovery and return to work.

workers’ compensation

A form of insurance providing wage replacement and medical benefits to employees injured on the job.

private, nonprofit

We are mandated to serve the mutual benefits of its members.

evaluate corporate performance

The broader impact a company is having on the community and the world.

Non financial factors

Environmental, social, and governance

safety resources

Training, information, and experienced professionals made available to policyholders to prevent workplace accidents and improve overall workplace safety.

THE BASICS OF PREMIUM AUDIT

When and How Audits Occur

Depending upon your policy’s premium size and class of business, audits may be performed annually, every other year, or as needed. Audits may be conducted physically at your place of business, virtually, by telephone, or by mail.

Pre-Audits

Conducted near policy inception to verify payroll information and to ensure business risks match those analyzed during the underwriting process

Interim Audits

May be performed periodically to address mid-term changes in business and/or operations

Anniversary Audits

Conducted at the end of your policy year to obtain actual payroll for your exposure, since this may vary from the estimate upon which your premium was based

Cancellation Audits

Conducted upon policy cancellation to obtain actual exposure

Guide to Premium Audit Preparation

The better prepared policyholders are, the quicker and easier the audit will be. The best time to start gathering the necessary materials is now. Take a moment to review the required items for premium audit in our Guide to Audit Preparation.

Additional Audit Information

Disputing an Audit

In the event you do not agree with the findings on the audit statement, we encourage you to contact your agent for assistance in notifying LWCC. Notification of the audit dispute must be in writing and should provide specifics (e.g. payroll amounts, class code issues, etc.) of what is being disputed. It is also important to remember that payment is expected on the undisputed portion of the audit.

Click here to access the Audit Dispute Form
Audit Handling

Audits are handled by one of LWCC’s staff auditors or an audit firm with whom LWCC contracts services. Accounts under $5,000 in annual premium are typically assigned to a vendor. It is likely that the auditor will vary each year.

Audit Results

Upon completion of your audit, you and your agent will receive a payroll audit statement outlining any premium changes that have occurred as a result of the audit. This is not a bill. You will be responsible for any additional premium charges once they are reflected on your invoice. Due to the confidential nature of the information obtained during your audit, written or verbal consent is required prior to the release of your audit information to your agent.

Avoid Owing Additional Premium

It’s much less disruptive to cash flow if premium is paid as costs are incurred rather than making up for any discrepancies after an audit. There are several things you can do during the year to minimize the chance of owing additional premium at audit:

  • Give your agent detailed information about your business and the types of work employees will perform so the proper class codes are chosen.
  • If you pay premium via payroll reports, do so as accurately as possible and always complete and submit them by the due date. Be sure to include uninsured contractors and subcontractors when reporting employee payroll monthly.  Maintain copies of these reports as well as any worksheets or information used in your calculations. 
  • No what your policy payroll estimates and class codes are.  Periodically compare your actual payroll figures to the estimated payroll figures.  If you see that your actual payrolls are higher than what was estimated, you should reach out to your agent to increase your estimates.
  • Notify your agent immediately anytime your operations change in size or nature. For example, if you are awarded a large contract during the year, your policy estimates may need to be reviewed and increased to account for the increase in payroll exposure.

Questions about your premium audit?

We're here to help.

225-924-7788
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audits@lwcc.com

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Frequently Asked Questions

Can an audit be performed with my CPA?

The audit may be performed with a CPA or at a CPA’s office. You (the insured) should be aware of the time and date of the audit so you can be available to the CPA if the auditor has questions that the CPA cannot answer or if the auditor needs documents the CPA does not keep at their site.

How are payroll or remuneration given to a worker?

Payroll or remuneration is usually given in the form of a check but may be paid in cash. LWCC does not encourage the use of cash for payroll or remuneration purposes. If you (the insured) pay your workers in cash, strict record-keeping requirements must be met.

What is payroll?

The National Council on Compensation Insurance defines payroll as money or substitutes for money. Payroll may sometimes be referred to as “remuneration.”

How do I dispute an audit if I do not agree with the codes or payroll included on the audit?

To dispute an audit, you should submit an audit dispute form through your agent to the LWCC Audit Department via e-mail to audits@lwcc.com or via fax to 225-231-6542. In the form, you should include the exact reason for the dispute including codes, payrolls or individual workers whose code or payroll with which you do not agree. Attached to the form should be copies of payroll journals, invoices, etc. that support the position taken.

I have met with the LWCC auditor but have received notice that the audit was “unproductive” and also have received a notice of cancellation. Why is that?

If records are not available at the time of the audit, the auditor will request that you provide the necessary records in a reasonable period of time. If those records are not provided, and depending upon the relative importance of the records, the auditor may return the audit marked as unproductive, or the premium audit reviewer or underwriter at LWCC may decide to classify the audit as unproductive after review. The information concerning the audit’s unproductive status will be communicated to you by the auditor. If you do not provide the information after being informed that the audit was unproductive, a notice of cancellation may be sent. The types of missing information that could cause an audit to be unproductive include, but are not limited to, the following:

  • Missing verification documents. For example, 941 Federal Quarterly Reports; 1096/1099 forms for contract or subcontract labor; tax returns
  • Missing information about entities, officers, locations, or operations
  • Missing payroll or wage source information
  • Missing information for cash labor
Is overtime included in a worker’s payroll for audit purposes?

Yes, overtime is included in the gross payroll calculation at audit. A credit of the “premium portion” of the overtime is made by the auditor if you have maintained records in a manner that allows the auditor to easily identify overtime and make the proper deduction.


What is the premium portion of overtime?

The premium portion of overtime is the amount of overtime paid that is in excess of the worker’s hourly rate of pay. The premium portion of overtime is broken out as a percentage of the amount paid for overtime depending on whether or not the overtime is paid at a rate of time-and-a-half per hour or double-time per hour.


For example: Joe is paid $10 per hour for a 40-hour week. This week Joe works 42 hours. Joe is paid overtime at time-and-a-half for the two additional hours. To determine how much of Joe’s payroll this week is included as gross payroll, multiply $10 by 40 hours to equal $400. Half of Joe's hourly pay rate is $5. For the two additional hours Joe worked, he would be paid two hours times $15 plus $400 to equal $430. At audit, the auditor will determine Joe’s gross pay for the week to be $430. However, the auditor will calculate Joe’s auditable payroll to be $420. The $30 overtime pay is divided by 3 to determine the premium portion of the overtime, and a deduction is made in the audit for $10.



Is the audit based on gross payroll or net payroll and what is the difference?

The audit is based on gross payroll. Gross payroll is the entire payroll of the worker before taxes or other deductions are made. Net payroll is the amount of payroll that remains after taxes and deductions such as medical insurance, life insurance, any Cafeteria 125 plan deductions, and 401K or qualified retirement plan deductions.


What documents are needed to complete an audit?

The documents needed for an audit can be verified when you (the insured) or the auditor call to confirm the audit appointment. You should ask specifically what documents are needed and discuss which documents you will have available at the appointment with the auditor. The records required for the audit will depend on the type of business being audited. 


For example: The documents needed to audit a doctor’s office that utilizes only W-2 payroll will be different from the documents needed to audit a construction general contractor who utilizes W-2 employees, contract labor, and subcontractor labor.


For the doctor’s office, the documents required at a minimum are: a payroll journal, Federal Quarterly Reports (941s), State Unemployment Reports (SUTAs), a general ledger or bank statements and cancelled checks, and the most recent tax return filed for the business.


For the construction contractor, the documents required at a minimum are: a payroll journal, Federal Quarterly Reports, SUTAs, a general ledger or bank statements and cancelled checks, cash disbursements journal, Form 1096 with 1099s, certificates of workers’ compensation insurance for the subcontractors, and the most recent tax return filed for the business.



What is a certificate of insurance?

A certificate of insurance (COI) is a document that shows that a business has workers’ compensation coverage. The COI will show the name of the business, the coverage dates, the policy number, the carrier providing workers’ compensation coverage, the insurance agent for the business, and the name of the business receiving the certificate. COIs are commonly used for businesses that are subcontracting their services to another business.


For more information on certificates of insurance, please click here.



What is an “executive supervisor”?

An executive supervisor is a supervisory person in the construction industry. The class code 5606 is used to classify project managers, construction managers, or construction superintendents on construction sites. There are specific requirements that must be met to use this code:

  • Used for construction or erection risks only
  • The executive supervisor must exercise control through superintendents or foremen of the employer and cannot have direct control over the workers at the construction or erection site


What items are not included in gross payroll?

Tips or gratuities, severance pay, payments for active military duty, work uniform allowances, employer contributions to retirement plans, or Cafeteria 125 plans are not included in gross payroll.


What other items are included in gross payroll besides payroll and overtime?

Payroll includes bonuses, holiday, vacation and sick pay, meals and lodging if those items are provided to the worker as part of his or her wages.


What records are needed for the audit?

The insured should receive a letter or phone call from the auditor assigned to perform the audit. The letter will include a list of documents needed for the audit. If the auditor makes contact by phone, the auditor should inform the insured of the documents needed and answer any questions the insured may have about the upcoming audit.


Who needs to be present at the audit?

LWCC prefers that the audit be performed with an owner or officer of the company. If an owner/officer is not available, then the audit should be conducted with an individual who is knowledgeable about the company’s operations, the employees and their job duties, whether the insured uses contract or subcontract labor, and the accounting system that is used to record payroll or non-employee exposure.



Whom should I contact if I have questions about my insurance, codes, audits, or claims?

The person to contact is the agent who wrote the policy. The agent will know whom to contact at LWCC for the answers to your questions.


If I have workers who perform different types of work during a workday or a work week, can their payroll be split into different class codes?

The general rule is payroll cannot be split. The exception is if you have workers who have an interchange of labor during a workday or work week, the payroll may be split between different codes, especially if you are a construction contractor. In order for the split to be given at audit, you must keep separate records of the activities of the workers. The separation of payroll should show the date, the hours worked in that activity, and the amount paid to the worker for the different types of work performed.


Caution: Payroll cannot be split if one of the codes for work done is a standard exception code. Standard exception codes include Clerical Work (8810); Sales (8742); Clerical Telecommuting (8871); Automobile Sales (8748); and Drivers, Chauffeurs & Helpers (7380). In some situations, Drivers (7380) can be split with another code if proper records are kept.