Medical Only Claims

Minor employee injuries that result in no more than one lost work shift and two treatments by a doctor are classified as "Section 110" claims. The ABC Trust requires its members to self pay Section 110 medical bills so the claim won’t be counted against the employer’s experience modifier and the Trust reduces its claims administration expenses.

When a minor employee or first aid type injury has been reported you must:

1. Complete an "Employers Report of Work-Related Accident/Occupational Disease," (commonly called a C2 form). Send the C2 form to ABC Compensation Trust c/o Reller Risk Management LLC and mark the C2 information only.

2. When the medical bill arrives, mark it as first aid and send it to ABC Compensation Trust c/o Reller Risk Management LLC. We will review the bill to see if the charges adhere to the NYS medical fee schedule for workers’ compensation injuries.

   Mailing address:

   ABC Compensation Trust
   c/o Reller Risk Management LLC
   6315 Fly Road
   East Syracuse, NY 13057

   FAX: 315-671-2684

   Contacts:

   Stanne Nourse
   Senior Claims Adjuster
   stanne.nourse@rellerrisk.com
   (315) 671-4189

   Mary Jane Mirra
   Claims Adjuster
   maryjane.mirra@rellerrisk.com
   (315) 671-4191

   Liz Santaferra
   Claims Adjuster
   liz.santaferra@rellerrisk.com
   (315) 671-4190

   Robin Marcoccia
   Medical Only Claims Adjuster
   robin.marcoccia@rellerrisk.com
   (315) 671-4192

3. Pay the medical provider according to the corrected billing you receive from ABC Compensation Trust.

Following Procedures

It is important to follow these procedures exactly. If ABC Compensation Trust receives a bill, they will pay it and follow-up with you for the C2 form. You will not be able to reimburse ABC Compensation Trust and erase the claim.

Please call Stanne Nourse (ext 4189), Liz Santaferra (ext 4190), or Mary Jane Mirra (ext 4191) with any questions regarding these procedures.