Wisconsin workers' compensation insurance

Although the Wisconsin Workers’ Compensation Act provides near-universal coverage, the state allows a few exemptions based on the type of work performed. It excludes:

• Domestic servants
• Some farmworkers
• Volunteers, including those in nonprofit organizations receiving money or other items of value worth $10 or less per week
• Some religious sect members
• Employees of Native American tribal enterprises (including casinos), unless the tribe decides to waive its sovereign immunity and participate voluntarily in state workers’ comp
• Most real estate brokers, agents, and salespersons
• Certain workers covered by federal workers’ comp programs

It depends on your ownership status. For example, sole proprietors, partners, and members of limited liability companies (LLCs) are exempt from workers’ compensation. However, they can still choose to purchase coverage. This can be a smart financial decision, as health insurance providers can deny work-related injury claims.

Corporate officers in Wisconsin are considered employees and thus must participate in their firm’s workers’ comp plan. However, if their company is closely held and has no more than 10 stockholders, one or two corporate officers may opt out of the firm’s workers’ comp insurance coverage.

Corporate officers who opt out must have their name displayed on the workers’ comp insurance policy endorsement page.

Just because a sole proprietor, partner, or LLC member does not participate in workers’ comp does not mean other firm employees are exempt. If they fail to qualify for a work exemption, they must be covered even if the business owner isn’t.

No, but the state of Wisconsin enforces a strict, nine-part test to determine whether the person is a legitimate independent contractor.

Additionally, here's what your workers' comp policy won't cover:

• Injuries caused by intoxication, drugs, or company policy violations
• Injuries claimed after a firing or layoff
• Wages for a replacement worker
• Occupational Safety and Health Administration (OSHA) fines

Insurance providers use a specific formula for calculating workers' comp premiums:

To save money on workers' comp insurance, it's important to make sure you classify your employees correctly. Employees with desk jobs or other jobs with a low risk of injury cost less to insure. This also helps you avoid misclassification fines.

In some cases, Wisconsin employers can choose to buy pay-as-you-go workers' compensation. This type of workers' comp policy has a low upfront premium, and lets you make payments based on your actual payroll instead of an estimated payroll. It's useful for businesses that hire seasonal help or have fluctuating numbers of employees.

A ghost policy is a cheap option in some states, although this policy is not permitted in Wisconsin. A ghost policy is a workers' comp policy in name only. It provides no protection or medical benefits, but can fulfill contractual requirements for a workers' comp certificate at a reduced price.

Finally, a documented safety program can help lower workers' comp costs. A safer workplace means fewer accidents, which helps keep your premium low.

When an employee suffers a workplace injury or an occupational disease, workers' compensation covers the cost of medical care. It also provides wage loss benefits equal to two-thirds of the employee's average weekly wage.

Workers' compensation benefits in Wisconsin include:

• Coverage for the injured worker's medical expenses
• Temporary partial disability (TPD) benefits
• Temporary total disability (TTD) benefits
• Permanent partial disability (PPD) benefits
• Permanent total disability (PTD) benefits
• Vocational rehabilitation and retraining
• Death benefits and burial expenses

Policies usually include employer's liability insurance, which helps cover legal expenses if an employee blames their employer for an injury. Once they accept workers' compensation benefits, employees give up the right to sue their employer for the injury under the exclusive remedy provision in most workers' comp policies.

For details, visit the Department of Workforce Development's Workers' Compensation Division.

The spouse, children, and other dependents of a Wisconsin employee who died as a result of a job-related injury or illness may qualify for death benefits under state law. The benefit includes:

• Weekly payments for those who depended financially on the employee
• Payment for burial expenses

Death benefits first go to wholly dependent family members, including a surviving spouse, a registered domestic partner, or surviving children under age 18 or who are physically or mentally disabled.

Partially dependent family members may qualify for death benefits only when there are no wholly dependent family members.

The total death benefit for all beneficiaries will be no more than four times the deceased employee’s annual pay.

Under state law, workers’ comp insurance must pay for burial expenses up to $10,000.

A workers’ compensation settlement is an agreement between the injured employee, employer, and insurer that closes out a workers’ compensation claim. This benefits both the employee and the employer.

In Wisconsin, most workers’ comp claims end in settlements. This means all involved parties – the injured worker, the employer, and the insurance companies – agree on a lump-sum settlement amount in exchange for the employee (or their survivors) agreeing not to pursue any future benefits.

Settlement amounts may cover payments for past or future medical bills. They may also include employer penalties for things like safety violations, payment delays, or bad faith.

The settlement agreement, which must be in written form and signed by the injured or ill worker, a representative of the employer, and the insurance company, must be filed with the Wisconsin Department of Workforce Development and approved by one of its judges.

Under Wisconsin law, employees with injuries must file a workers’ comp claim no later than two years after the injury or within 12 years if the employer knew about the injury (or should have known).

No statute of limitations applies to occupational diseases and some traumatic injuries.

If you are ready to buy a workers' compensation policy, start a free application with Insureon to compare quotes from top-rated insurance carriers. A licensed insurance agent will help answer your questions and explain your coverage options.

Once you find the right policy, you can usually begin coverage and get your certificate of insurance in less than 24 hours.