Summary of Findings Labor Code Section 4612, adopted in 1992 and amended in 1993, established three year pilot programs of 24 hour health care in California. These programs were set up to test the administrative efficiencies, cost control potential, and service capabilities of having a single system provide health care for occupational and nonoccupational injuries and illnesses. Under traditional workers' compensation law, workers often have different sources of medical care, depending on whether an injury occurred at work or was not work-related. When injured on the job, employers typically determine the primary care provider.
Employees have a choice as to whether to enroll or maintain their traditional system.
By 1995, when the program was getting underway statewide, overall compensation costs had dropped dramatically, back below the 1988 levels. Many employers were reluctant to attempt a conceptually interesting but largely untested program when premium discounts were already readily available. In addition, the new product combination proved to be more complex to market than separate group health and workers' compensation policies, requiring increased coordination between insurance brokers familiar with workers' compensation or nonoccupational health benefits. Four individual pilot program designs were approved after the application period in 1994. Since their approval, one of the four has dropped its participation, and another has experienced low enrollments.