Quality care for the worker and control over district funds
The SISC I Workers’ Compensation JPA was established in 1978 and currently services 94 California school districts, covering over 51,000 employees in 13 counties. SISC I self-administers this program with an in-house staff of 36 employees. This is the most effective arrangement to assure both quality care to injured employees and control over school district funds. The staff consists of 17 examiners, all of which are state certified by Self-Insurance Plans, averaging 13 years of experience; 10 claims assistant’s; 3 safety and loss control specialists; a secretary; a contract review analyst; 2 claims supervisors; claims coordinator and an executive director of the program. There is no third-party administrator. Member districts deal directly with SISC claims staff.
Our Philosophy – “Schools Helping Schools”
SISC I focuses on using managed care to treat employees’ injuries promptly and appropriately so the employee will return to work as soon as possible. We have created a customized Medical Provider Network (MPN), which was implemented on 10/1/07. We are partnered with the Kern Foundation and California Foundation for Medical Care, who acts as our MPN Coordinator, ensuring that any new physicians are properly credentialed and all existing MPN physicians fulfill their contractual obligations.
SISC I is a paperless operation, allowing for real time adjusting.
Our program also has many cost-containment programs, including Utilization Review and preferred providers for Nurse Case Management, Diagnostic Services, Investigation Services, and a Pharmacy Benefit Management program.
Each member district is fully covered for work related injuries sustained by district employees. Our JPA covers the first layer up to $1,000,000. Claims that exceed this retention level are then covered under our excess carrier, Safety National, up to statutory limits.
SISC I is able to provide our member districts the best coverage at the best rates due to the pooling of resources; our cost containment programs, which includes our MPN; and aggressive, yet fair, handling of losses by competent, well- seasoned examiners with manageable caseloads.