Background
Data on agent performance and financial incentives provided to agents. The information does not purport to be all-inclusive or contain all information which employers may require to make an informed assessment as to the selection of an agent. Agent performance on specific criteria is significantly impacted by the different sectors present within their employer portfolios.
Employers should make their own independent assessment of the capabilities of each agent and, where appropriate, seek professional advice. The market allocation of agents may differ between years due to employers transferring agents and/or from entries or exits to self-insurance or other schemes. These movements can impact the performance trend indicated here.
Agent fees
The authorised agents operate under an Instrument of Appointment issued by WorkSafe pursuant to the Workplace Injury Rehabilitation and Compensation Act 2013. They are remunerated for acting on behalf of WorkSafe in the issuing of WorkCover insurance, collection of premium and the administration of claims. The agent remuneration model includes performance-based components and also allows for the reduction of an agent’s remuneration upon the occurrence of an event such as a failure to meet performance criteria.
Fees paid to agents are disclosed as authorised agent fees in the financial statements in the comprehensive operating statement and at note [2.4] to the comprehensive operating statement.
Agent incentives for 2023-24
Each year, WorkSafe sets a number of performance measures for the agent panel. These measures are intended to align agent performance with WorkSafe’s goals of delivering improved outcomes for injured workers including improvements in return to work and service, while driving quality case management.
Agents can earn payments capped at a specified level for achieving the targets for the defined measures. The payments are measured as a percentage of the A gent Premium Fee Base which agents are paid for the portfolio of WorkCover registrations they manage for the year.
Where an agent does no t meet the set targets, they may incur a remuneration reduction. Conversely, where an agent exceeds the targets, they may receive an incentive payment.
For the 20 23-24 year, WorkSafe offered agents potential financial bonuses of up t o 20% of their Agent Premium Fee Base for achieving the maximum performance results against all the performance measures. The total penalty that could apply (by way of remuneration reduction) where an a gent failed to achieve the minimum requirements of all measures was 10% of the Agent Premium Fee Base.
As a guide , a one per cent incentive or penalty equates to approximately $2 million a cross all four agents collectively. The amount that agents will either earn in incentives or repay in remuneration reductions will depend on their Agent Premium Fee Base and their performance.
WorkSafe had three focus areas for 2023-24 in which incentives were offered to agents: recovery and return to work, service and scheme sustainability.
To measure agent performance in relation to service, an independent provider is engaged to conduct a survey of injured workers and employers each year. This measure sets a minimum expectation on positive feedback received from injured workers and provides agents a financial incentive to exceed that minimum standard.
Agent service is also measured by a number of other indicators (shown later in this appendix), however the independent survey is the only measure used to determine if agents receive an incentive payment for this focus area. The use of an independent provider ensures results are objective.
The tables below show the service results as at 30 June 2024 compared to those in the previous year.
Scheme service results for 2023-24 remained broadly consistent when compared with the prior year’s results. Individual agent results for service to injured workers in 2023-24 indicated more consistent levels of service for all workers.
All agents exceeded the corporate target for service to employers in 2023-24, with the scheme result also an improvement over the previous financial year.
Results for the year ended 30 June 2024
| Agent | Service to injured workers | Service to long-term injured workers* | Service to employers* | |||
|---|---|---|---|---|---|---|
| Result | Target^ | Result | Target^ | Result | Target^ | |
| Allianz | 84.2% | 84.0% | 74.1% | 74.7% | 86.4% | 83.1% |
| DXC | 83.3% | 84.0% | 73.7% | 74.7% | 84.7% | 83.1% |
| EML | 85.8% | 84.0% | 76.0% | 74.7% | 89.1% | 83.1% |
| GBS | 84.0% | 84.0% | 80.5% | 74.7% | 84.4% | 83.1% |
| Scheme | 84.3% | 84.0% | 76.4% | 74.7% | 86.1% | 83.1% |
Results for the year ended 30 June 2023
| Agent | Service to injured workers | Service to long-term injured workers* | Service to employers* | |||
|---|---|---|---|---|---|---|
| Result | Target^ | Result | Target^ | Result | Target^ | |
| Allianz | 84.3% | 84.0% | 72.2% | 73.1% | 86.4% | 83.1% |
| DXC | 82.9% | 84.0% | 77.1% | 73.1% | 81.6% | 83.1% |
| EML | 86.8% | 84.0% | 77.1% | 73.1% | 89.0% | 83.1% |
| GBS | 83.4% | 84.0% | 75.3% | 73.1% | 85.0% | 83.1% |
| Scheme | 84.3% | 84.0% | 75.3% | 73.1% | 85.6% | 83.1% |
* Long-term injured workers are those who have been unable to work due to their workplace injury for more than 670 days.
^ Agent results shown against Service Delivery Corporate KPI. The agent remuneration model utilises performance-based components which may differ from the Corporate KPI target.
Sustainability
To address WorkSafe’s sustainability focus area, agents are required to collect premium amounts billed to employers. This measure provides agents with an incentive to collect premium on time and work constructively with employers to manage any overdue debt.
This measure assesses the level of premium collected by each agent as a proportion of the amount of premium billed to employers, for the year ending 30 June 2024.
There was a decline in the scheme debt collection average for 2023-24 compared to the previous year’s premium collection results. Despite the more challenging economic climate, which has seen a growth in the number of smaller debts, all agents achieved the minimum collection target for the year.
Results for the year ended 30 June 2024, including a June 2023 comparison
| Agent | Minimum premium collection target | Maximum premium collection incentive target | Premium collected by agent as at 30 June 2023 | Premium collected by agent as at 30 June 2024 |
|---|---|---|---|---|
| Allianz | 97.5% | 99.5% | 99.5% | 99.2% |
| DXC | 97.5% | 99.5% | 99.5% | 99.2% |
| EML | 97.5% | 99.5% | 98.9% | 98.6% |
| GBS | 97.5% | 99.5% | 98.8% | 98.3% |
| Scheme | 97.5% | 99.5% | 99.1% | 98.8% |
Agent performance outcomes for 2023-24
The following charts show agent performance for 2023-24 for each of the WorkSafe focus areas.
Readers should note that the outcome/final assessment of performance against the targets had not been completed at the time of presentation of the Annual Report, because a number of these measures have criteria requiring some time to assess. Final results are provided to agents once they are determined.
Remuneration reductions applicable to 2023-24
Gallagher Bassett Services incurred a remuneration reduction of $294,691.85 for the agent’s failure to meet the Minimum Compliance Standard for Data Integrity in the 2022-23 year.
Agent incentives for 2024-25
The following chart provides a comparison of how the measures for 2023-24 and 2024-25 are aligned to WorkSafe’s focus areas of recovery and return to work, service and sustainability.
The horizontal axis shows each of WorkSafe’s focus areas, comparing the weighting of incentives between 2023-24 and 2024-25. The vertical axis shows the maximum potential incentive an agent can receive in relation to each focus area, as a percentage of the Agent Premium Fee Base.
For the 2024-25 year, an additional sustainability measure will be introduced targeting Medical and Like Entitlements 52 weeks after weekly compensation ceases. The purpose of this new measure is to improve agent decision making when determining an injured worker’s ongoing entitlements in line with the legislation.
Other agent performance metrics
The following metrics are closely monitored, and reported on yearly, but are not part of the agent financial incentive model.
Duration for which injured workers remain in receipt of weekly payments
This assesses the proportion of injured workers who after lodging an accepted claim, remain in receipt of weekly payments after 13 weeks, 26 weeks, 52 weeks and 134 weeks.
| Agent | Duration - % of workers on weekly payments at: | |||
|---|---|---|---|---|
| 13 weeks | 26 weeks | 52 weeks | 134 weeks | |
| Allianz | 51.2% | 34.6% | 14.8% | 6.8% |
| DXC | 54.8% | 36.5% | 14.3% | 5.5% |
| EML | 53.3% | 36.8% | 16.0% | 7.1% |
| GBS | 52.1% | 34.0% | 14.1% | 6.1% |
| Scheme | 52.8% | 35.6% | 14.9% | 6.4% |
Note: a lower percentage represents higher performance.
Conciliation complaints upheld
This sets out agent performance in relation to the number of valid complaints made by injured workers in a financial year, where the agent has failed to comply with an outcome issued by the Workplace Injury Commission within a reasonable timeframe.
| Conciliation – non-compliance complaints Number of valid complaints | |
|---|---|
| Allianz | 0 |
| DXC | 3 |
| EML | 4 |
| GBS | 1 |
| Scheme | 8 |
Quality decision making
The quality of agent decisions is reviewed/audited in relation to whether those decisions:
- are supported by reasonable, appropriate and sufficient evidence
- afford injured workers procedural fairness in assessing entitlements
- have not wrongfully disentitled injured workers
- are communicated to the injured worker accurately, clearly and in a timely manner.
The table below records the proportion of the adverse decisions which pass the quality decision making review. An adverse decision is one that does not favour the worker. Note that where a decision fails a review, it is reassessed.
In 2023-24, WorkSafe audited 2,125 scheme decisions across all agents. The decisions reviewed encompassed initial eligibility, medical, second entitlement reviews (130 weeks) and pre and post 130-week decisions. A sample of adverse decisions from each of these areas is examined each month and reviewed against the legislative requirements and the prescribed principles of decision making to determine if a quality decision has been made. The reviews found 97.1% of decisions (compared to 96.2% in 2022-23) were ‘good quality’ decisions, in line with the quality decision making principles. The outcome of the reviews and key learnings are provided to agents to enhance future decision making.
Year ended 30 June 2024
| Quality decision making (QDM) % of decisions that passed QDM audits | |
|---|---|
| Allianz | 95.3% |
| DXC | 97.8% |
| EML | 97.7% |
| GBS | 97.3% |
| Scheme | 97.1% |
Timeliness
This measures the proportion of agent determinations of requests for reinstatement of weekly payments and for decisions regarding medical and like treatments that are completed within 28 days.
Year ended 30 June 2024
| Agent | Timeliness of reinstatement decisions with 28 Days | Timeliness of medical and like decisions with 28 Days | ||
|---|---|---|---|---|
| Result | Target | Result | Target | |
| Allianz | 97.0% | 95% | 98.5 | 95% |
| DXC | 98.1% | 95% | 98.5% | 95% |
| EML | 98.7% | 95% | 97.9% | 95% |
| GBS | 97.7% | 95% | 96.3% | 95% |
| Scheme | 97.9% | 95% | 97.8% | 95% |
Payment processing
This measures the proportion of agent payments to injured workers, providers and employers made within specific timeframes.
Year ended 30 June 2024
| Agent | Timeliness % of payments direct to injured workers | Timeliness of employer reimbursements | ||||
|---|---|---|---|---|---|---|
| Weekly payments - % paid within 7 days | Medical reimbursements - % paid within 11 days | Calendar days to pay 75% of employer reimbursements | ||||
| Result | Target | Result | Target | Result | Target | |
| Allianz | 98.9% | 98.0% | 87.7% | 84.0% | 87.0% | 11 |
| DXC | 99.0% | 98.0% | 89.7% | 84.0% | 81.8% | 11 |
| EML | 97.8% | 98.0% | 87.8% | 84.0% | 68.4% | 11 |
| GBS | 98.0% | 98.0% | 86.1% | 84.0% | 78.4% | 11 |
| Scheme | 98.6% | 98.0% | 86.9% | 84.0% | 79.0% | 11 |
| Agent | Timeliness of processing provider accounts | |||
|---|---|---|---|---|
| % paid within 30 days of receipt of invoice | % paid within 70 days of service | |||
| Result | Target | Result | Target | |
| Allianz | 96.7% | 95.0% | 89.4% | 75.0% |
| DXC | 97.2% | 95.0% | 88.2% | 75.0% |
| EML | 97.5% | 95.0% | 89.0% | 75.0% |
| GBS | 96.9% | 95.0% | 88.1% | 75.0% |
| Scheme | 97.7% | 95.0 | 88.8% | 75.0% |