Middlesex County Municipal Joint Insurance Fund Saves Taxpayers $13 Million in Workers’ Compensation Claims Over Five Years
NEW BRUNSWICK – The latest report shows the Middlesex County Municipal Joint Insurance Fund (MCMJIF) has saved $13 million in workers’ compensation claims through its managed care provider, Qual-lynx of Piscataway, over the past five years.
Moreover, through negotiated rates with in-network health care providers, the MCMJIF is able to save 68% in medical care costs, on average, from standard rates. One key reason is the ability to use in-network health care providers for 95% of claims, as opposed to relying on expensive out-of-network care.
The savings, compiled through the end of 2022, are used to drive down insurance premiums to the direct benefit of taxpayers in municipalities that are self-insured through the MCMJIF.
“Our ongoing mission is to provide quality workers compensation to our members at the lowest cost,” said Glen Kurtz, acting administrator of the MCMJIF. “Moreover, we are able to offer the highest level of care to government workers who are injured on the job with a full array of services and benefits.”
For example, the network offers MCMJIF members access to more than 100 hospitals, 200 ambulatory surgery centers, 160 occupational medicine and urgent care providers, and more than 86,000 physician and ancillary provider locations. The network has more than a 99% retention rate for participating providers.
Kurtz noted that MCMJIF not only saves money for municipalities but also helps raise the standards of workplace safety through employee-focused, on-demand help in case there is an accident.
“Employees are the most valuable asset of any public service, such as government,” Kurtz said.
“Our job is to take care of them so that they can better take care of the public.” Donna Setzer, client services manager for Qual-lynx of Piscataway, said the company has been working with the MCMJIF since 2001, providing consistent savings year after year. “There is peace of mind among the employees if they happen to get injured,” Setzer said. “They know we will be there for them.”
When a worker is injured, a nurse manager is immediately assigned to the case and follows the claim through to the end, coordinating care with such professionals as physicians, therapists, radiologists and any other specialists required.
“Our nurses have cell phone numbers for specialists and surgeons and talk with them directly,” Setzer said. “There is no need to go through office staff. If someone gets injured, he or she is seeing a doctor that day or within 24 hours. If a specialist is needed, we provide the initial appointment within 48-72 hours.”
In addition, the provider conducts out-of-network bill negotiations. “If a catastrophic injury occurs, and an employee must go to the emergency room and need surgery, it is reported to us,”
Setzer said. “If a large bill comes in from an out of network provider, we will call the provider and negotiate the bill on behalf of the MCMJIF. We are often successful based on our experience.”
In a five-year period, ending December 2022, Qual-Lynx received and repriced more than 12,000 medical bills on behalf of MCMJIF, totaling more than $19 million in provider charges.
Qual-lynx also offers pharmacy benefits at a significant cost savings to JIF members. It also makes sure that prescriptions are only dispensed in response to the specific injury, eliminating the potential of unauthorized prescription dispensing.
“The MCMJIF continually pursues programs based on collaboration and strong provider networks,” Kurtz said. “MCMJIF is committed to being a proven differentiator in the self-insurance space, continually pursuing opportunities to reduce taxpayer costs while providing quality medical services to employees when incidents may arise.”
Learn more at www.mcmjif.com
