Don't Fear an Insurance Audit
June 23, 2021
Don’t fear an Insurance Audit

The term audit is often misunderstood and sometimes feared when a business owner receives the notification that their insurance policy is being audited. Never fear, your trusty insurance advisor is here to help you through this sometimes confusing, and often irritating audit process. There are two main types of policies that can be audited. They are the worker’s comp policy and a liability policy.


Worker’s Comp Policy Audit

The worker’s comp audit is a reconciliation of your payroll estimate that was reported to your carrier at the beginning of your worker’s comp policy term and comparing it to the actual amount that was paid to your employee. These amounts are broken down by the employee’s classification code, as determined by the class guide of your worker’s comp board by state. Each class code has a different rate, and each class has a specific scope of work that is entailed in the class code description. There are several codes that are similar and include comparable work functions across industries--so it is imperative to talk to your agent about the duties of each of your employees. Putting an employee’s payroll into the wrong class code will skew the audit; and when reconciled it can either go in your favor with a lower rate or go against you with the payroll being applied to a class with a higher rate.


How an Audit Process Works

A worker’s comp auditor may contact you through various channels including by mail, phone, or electronic submissions, which are the most popular, although paper audits are still done when necessary. An auditor will typically ask you to provide your:


  • Federal 941 tax forms
  • A detailed payroll report of the dates included in the policy period,
  • A general ledger of expenses or profit and loss statement
  • Certificates of insurance from any sub-contractors that were used during the year


It is important that you provide this information in a timely manner and cooperate with the auditor during this process. This is a requirement set out within your policy.


Be aware that in NY State, all sub-contractors who do work for you should have their own worker’s compensation coverage in place. If they do not have worker’s comp insurance, the audit will consider that person on your payroll with regard to worker’s compensation in whatever class they best fit. So anytime your business needs a plumber, electrician, or roofer, make sure they have worker’s comp or call your agent for a rate to include it in your bid for work as an expense. The general ledger is requested to ferret out these independent/sub-contractors in your books; so stay ahead of the game, and request proof of coverage before they start the job, or certainly before they get paid.


A pay-as-you-go payment platform is a great way to mitigate the difference of your estimated versus actual premiums on a worker’s comp policy. This payment platform allows you to report your payroll in real time and the premiums are pulled out of your payroll account shortly after you’ve reported to the worker’s comp carrier. SimcoHR has access to several carriers that have the ability to offer this payment option. As a bonus, when you also have your payroll done by SimcoHR, the payroll reporting and the audit process is smooth and much less stressful because we already have copies of most of what you need! Call SimcoHR today and talk to us about whether this option is right for your business and how we can help you navigate the world of worker’s comp audits.


Liability Policy Audit

The second type of audit business owners may encounter is the liability audit. Liability is rated differently dependent on the type of business. A manufacturer or a retailer are rated based on gross sales. A contractor will be rated on payroll, and some risks are rated based on square footage or the number of units in the case of habitational risks or lessor’s (or commercial landlord’s) risk buildings. Whether the rating is based on  sales or payroll, the amount that you report when the policy is taken out is what your liability premiums will reflect. If you’re a food establishment, the sales may be broken out between food sales and liquor sales. If you’re a contractor, an owner is considered on the payroll at a pre-set amount and all of the employee payroll should be included in that figure as well. You may notice that these figures are further broken out in the liability rate between two main liability coverages. A different rate usually applies to your premises and operations section of your policy (what you do and where you do it) and products and completed operations section (what you make). When the two rates are combined you can calculate the premium amount for your general liability coverage.


If your audit results in an additional premium, that amount will be billed to you by the carrier or the agent to be paid. In addition, you may see an endorsement to your renewal policy amending the rating basis for the renewal term to match the prior term. Fair warning, if your agent chose the incorrect class code for your business operations, an auditor is within their rights to make the change to your class and charge the appropriate rate for that class on the policy term in question along with the renewal.


The insurance professionals here at SimcoHR are here to help you get it done right and assist you through the audit process to make it as painless as possible, so if you have any questions or would like a free assessment whether your commercial insurance is with us or not, give us a call.

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October 24, 2025
When HR Is Overloaded, Your Business Feels It For many small to mid-sized businesses, HR is one of the most critical (and most overextended) functions. From payroll and benefits to onboarding and compliance reporting, administrative tasks can quickly consume your team’s time, leaving little room for strategic work that actually moves the business forward. Sound familiar? You’re not alone. A recent survey from Champions of Change: isolved’s Fourth-Annual HR Leaders’ Research Study found that 51% of HR leaders spend four or more hours a day answering repetitive questions. This time could be better spent on employee engagement, culture, and growth initiatives. When HR teams are pulled in too many directions, the consequences ripple across the entire organization, resulting in missed deadlines, frustrated staff, compliance risks, and ultimately, higher turnover. Why HR Leaders Consider Outsourcing Outsourcing HR isn’t just for businesses without dedicated HR teams. In fact, a survey of 1,000 HR decision-makers found that 76% could benefit from outsourcing certain tasks, even though only 54% currently have plans to do so. HR outsourcing allows organizations to offload both core and strategic tasks, including payroll, benefits administration, recruitment, onboarding, compliance support, performance management, employee relations, and workforce analytics, without adding headcount. This augmentation provides a multiplier effect: a small HR team can function like a much larger one, accomplishing more in less time. By leveraging experienced HR professionals through outsourcing, organizations can free up internal HR teams to focus on initiatives that directly impact business growth, such as talent development, employee engagement, and culture-building. Routine administrative tasks, when handled externally, no longer distract from these high-value priorities. The True Cost of Administrative Overload Overburdened HR teams don’t just affect your internal operations; they impact your employees’ experience. Inconsistent onboarding can create a rocky first impression for new hires. Delayed payroll or benefits questions lead to frustration and decreased trust. Compliance oversights expose your business to fines and legal risk. Even small inefficiencies add up. According to the National Association of Professional Employer Organizations (NAPEO), organizations that leverage an outsourced HR model achieve an average ROI of 27.2% per year, saving around $1,775 per employee while paying $1,395 per employee for outsourced services. That’s not just cost savings, it’s a reinvestment in your team and your business. The Power of Strategic HR Outsourcing Outsourcing doesn’t mean giving up control or handing HR off to a faceless provider. Done strategically, it’s about extending your team. Administrative tasks like payroll, benefits, onboarding, and reporting can be handled efficiently by experts, while HR teams gain confidence that compliance requirements are being met. Most importantly, it frees internal HR to pivot from reactive, day-to-day tasks toward engagement, culture-building, and retention strategies. Outsourced HR support can scale with your business, providing additional expertise during busy periods, leaves of absence, or rapid growth phases. The impact is clear. Teams feel supported, employees feel heard, and the organization operates smarter, not harder. With the right outsourcing partner, a small HR team can act like a team of 10, and a team of five can perform like a team of 25, all while maintaining compliance and efficiency. Retention Starts With the Right Employee Experience When administrative burdens are reduced, HR teams can focus on creating meaningful experiences for employees. Transparent processes around pay, benefits, and policies build trust. Faster, more organized onboarding leaves a strong first impression. Access to modern self-service HCM tools empowers employees to manage their own information, reducing repetitive questions and improving engagement. By leveraging experienced HR professionals to handle gaps in internal processes, organizations can enhance overall employee satisfaction, ensuring every interaction, from onboarding to open enrollment, feels seamless and supportive. A Smarter Approach to HR Means a Stronger Business Across industries, companies are recognizing that HR outsourcing is no longer a luxury. It’s a strategic advantage. Organizations that adopt a blended model of technology and advisory support report measurable reductions in administrative workload, cost savings compared to maintaining fully in-house HR teams, and improved engagement for employees. Strategic HR outsourcing allows internal teams to shift from transactional tasks to big-picture initiatives, creating a more resilient, efficient, and high-performing workforce. At the end of the day, HR isn’t just a function; it’s the backbone of your organization. When it’s overextended, the entire business suffers. But with the right support, HR teams can focus on meaningful initiatives, employees feel more valued, and the business benefits from measurable ROI. Strategic HR outsourcing isn’t about replacing your team, it’s about empowering it. Your people, your culture, and your bottom line all benefit. Curious how Simco's HR Advisory services can help your business? Let's talk today.
October 14, 2025
If you recently received notice that your Medicare plan, or Medicare Advantage plan, is being discontinued, you’re not alone. Across the country (and right here in New York), insurers are scaling back or exiting less profitable markets ( Kiplinger ). While this can feel stressful, there are steps you can take to make sure your coverage doesn’t lapse and to find a better plan for your health and budget. Why Are Plans Being Discontinued? A mix of financial pressure, federal reimbursement changes, and rising health costs is driving insurers to reduce their Medicare Advantage footprints: Some major insurers are cutting back or exiting entire counties. For example, UnitedHealth announced it will discontinue its Medicare Advantage presence in 109 U.S. counties in 2026, according to Reuters . Local carriers in New York are also making changes: MVP is dropping several plans, and CDPHP is eliminating certain drug-coverage options, the Times Union explains . These shifts are happening alongside tighter government funding and increased regulatory strain. Because insurers must absorb the extra cost of covering benefits while meeting regulatory caps (for example, on prescription drug out-of-pocket limits), some plans become financially unsustainable and are discontinued ( the Kaiser Family Foundation ). Steps to Take if Your Plan Is Discontinued Here’s how to act so you don’t lose coverage: 1. Review the notice you received carefully Your insurer is required to send you a non-renewal or discontinuance notice. It often includes deadlines, whether you can enroll through a Special Enrollment Period (SEP), and what options you have. 2. Note the relevant enrollment period The Annual Enrollment Period (AEP) runs October 15 to December 7, 2025 , during which you can switch Medicare Advantage or Part D plans. If your plan was discontinued, some notices allow you to select a new plan until December 31 without penalty. In limited cases, you may qualify for a Special Enrollment Period (SEP) following the discontinuation. 3. Research your options early Don’t wait until the last minute. Compare plans available in your area. Key things to look at: Provider networks: Will your doctors still be covered? Drug formularies: Does the plan cover your medications and at what cost? Premiums, deductibles, and out-of-pocket max: These can vary significantly. Benefit trade-offs: Some plans reduce supplemental benefits (vision, dental, wellness perks) when trying to maintain financial viability. 4. Enroll in the new plan Submit your enrollment by the relevant deadline (typically December 7 for the Annual Enrollment Period (AEP). However, If your plan was discontinued, you may have until December 31 to choose a new one without penalty). Make sure the new plan starts January 1 to avoid coverage gaps. 5. If your plan wasn’t discontinued, still review Even if your current plan remains active, benefits, networks, and costs often change each year. It’s wise to compare alternatives anyway, especially after insurer shake-ups. Why Timing & Support Matter Delays cost you: Failing to enroll by deadlines could mean losing drug coverage or being locked into a less ideal plan. Support can ease the burden: Licensed agents can help you compare side-by-side, explain trade-offs, and guide you through enrollment. You deserve the best match: Everyone’s health and financial needs differ. Don’t settle for the first available option unless it truly fits. How Simco Can Help At Simco, we understand the stress of sudden plan changes. Our licensed insurance advisors are ready to: Help you interpret your discontinuance notice Compare plan options available in your area Assist with enrollment paperwork Explain benefit trade-offs and cost implications You don’t have to navigate this alone. Whether your Medicare Advantage plan was discontinued or you’re simply exploring your options, our team is here to support you. Contact us today to schedule a 1-on-1 consultation, and let us help you find the plan that keeps you covered and confident in 2026 and beyond.
October 3, 2025
At Simco, we’re proud to be a trusted isolved Network Partner , which means the Human Capital Management (HCM) technology we deliver to our clients is powered by isolved People Cloud™. And now there’s even more reason to celebrate: isolved has been recognized as the #1 SMB HCM provider across the entire employee lifecycle in Sapient Insights Group’s 28th Annual HR Systems Survey. This annual survey is one of the most respected benchmarks in the HR technology industry. With feedback from over 4,500 HR professionals, Sapient Insights captures the real voice of the customer by evaluating vendors across two critical areas: User Experience (UX) and Vendor Satisfaction (VS). isolved earned an impressive 38 badges this year, the most awarded SMB vendor for the second year in a row, and ranked #1 in 13 different SMB categories . Breaking Down the Results isolved’s recognition wasn’t limited to a single function. It spanned the entire employee lifecycle, covering everything from payroll and benefits to recruiting and workforce management. Highlights from the survey include: Payroll — Ranked #1 in both User Experience and Vendor Satisfaction for SMBs Core HR — #1 in Vendor Satisfaction Benefits — #1 in User Experience Recruiting — #1 in both User Experience and Vendor Satisfaction Time & Attendance — #1 in both User Experience and Vendor Satisfaction Skills Management — #1 in User Experience Rewards & Recognition — #1 in User Experience In addition, isolved placed in the Top 5 across numerous other categories like onboarding, learning, performance management, workforce scheduling, and contingent management. What does this mean? isolved’s solution isn’t just strong in one area, it’s consistently delivering across all the areas that matter most for small and mid-sized businesses. Why This Matters for SMBs Today’s SMBs face more challenges than ever. Recruiting is competitive, employee expectations are higher, and compliance requirements grow more complex every year. Business owners often find themselves piecing together multiple vendors to handle payroll, HR, benefits, and insurance, adding complexity and risk. isolved’s sweep across the Sapient Insights report shows that SMBs no longer have to choose between great payroll software and effective talent tools, or between benefits management and workforce scheduling. With isolved, the technology already covers the full employee lifecycle, validated by real-world HR pros. From Recognition to Results isolved’s 38 badges and top rankings validate what our clients experience every day: Accuracy and trust in payroll with fewer errors and compliance risks. Simplified benefits administration that keeps employees happy and businesses competitive. Recruiting and onboarding tools that make hiring more effective. Time and scheduling solutions that align workforce needs with operational efficiency. These results aren’t just about technology; they’re about enabling SMBs to compete, thrive, and support their people better. The Simco Advantage: More Than Just Software Here’s the ultimate key: technology is only half of the solution. Technology is powerful, but the real impact comes from how it’s put into practice. At Simco, we go beyond simply providing software. We deliver a fully integrated HCM and advisory solution that ties every part of workforce management together. Here’s what sets us apart: One Point of Contact: A dedicated resource who understands your business and ensures your HCM, HR, benefits, insurance, and retirement services work in sync. All-in-One Partner: From payroll and HR to insurance and 401(k) plans, we eliminate the hassle of juggling multiple vendors. Advisory + Optimization: We don’t just implement technology. We guide you in using it to strengthen compliance, employee engagement, and growth strategies. As your business grows, your needs change. By pairing isolved’s award-winning technology with Simco’s hands-on expertise, we help you stay ahead, operate more efficiently, and build better employee experiences. Key Takeaways isolved’s recognition in the Sapient Insights report shows that SMBs have access to enterprise-grade HR technology tailored for their needs. And with Simco as your partner, you’ll never have to choose between the strength of your platform and the quality of your service; you’ll have both. Want to see how Simco + isolved can streamline your payroll, HR, benefits, and more? Contact us today.

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