Claims volume and payments rise; board hears program-use data and asks for deeper analysis

At the June 11 meeting, claims administration staff presented program-use metrics showing year‑over‑year growth in claims and higher weekly payment volumes.

“The 3 month claims filed trend is 30,399 claims received with a monthly moving average of 10,133 claims,” the claims presenter said, reporting a year‑over‑year increase in claims filed. Staff described the year‑over‑year growth as roughly 9.6–14.6 percent depending on counting conventions and said the program now shows more open and pending claims, which has increased incurred reserves.

Staff reported approval rates increased when the bonding segment of pregnancy cases is counted separately, with approved claims rising and approval rates reported around 80.9 percent in that counting convention; the denial rate correspondingly was reported near 19.1 percent. The presenter said the number of unique employees paid has risen to 209,286 and cumulative program payments have passed $1.7 billion.

Payment volumes have grown: staff said average weekly payments were about $9.92 million over the last 26 weeks and roughly $10.29 million over the last 13 weeks; staff linked the rising weekly payment totals to higher claim volumes, a higher approval rate and increases in weekly benefit rates tied to minimum wage changes.

Board member Melissa Gibran asked whether staff track people who use the program more than once and requested a deeper dive into the geographic distribution of usage. Staff said they do track repeat claimants to some degree and maintain a town-level heat map of claims; staff offered to provide more detailed analysis and to refine estimates of the total number of contributing workers.

Members did not take formal action on the presentation but asked staff to return with additional analysis requested during the discussion.