DAR File No. 37131
This rule was published in the January 15, 2013, issue (Vol. 2013, No. 2) of the Utah State Bulletin.
Labor Commission, Industrial Accidents
Rule R612-3
Workers' Compensation Rules - Self-Insurance
Notice of Proposed Rule
(Repeal)
DAR File No.: 37131
Filed: 12/28/2012 02:30:10 PM
RULE ANALYSIS
Purpose of the rule or reason for the change:
The Labor Commission proposes to repeal this and other Industrial Accident Division rules in order to consolidate, reorganize, and reenact the substance of those rules in a format that is more logical and user friendly.
Summary of the rule or change:
The existing Rule R612-3 will be repealed in its entirety. The substance of the existing rule will be reenacted in new Rules R612-100 and R612-400. (DAR NOTE: The proposed new Rule R612-100 is under DAR No. 37124, and the proposed new Rule R612-400 is under DAR No. 37127 in this issue, January 15, 2013, of the Bulletin.)
State statutory or constitutional authorization for this rule:
- Section 34A-1-104
- Section 34A-2-201
Anticipated cost or savings to:
the state budget:
Because the substantive provisions of the existing rule will be reenacted as a new rule, repeal of the existing rule will not result in costs of savings to the state budget.
local governments:
Because the substantive provisions of the existing rule will be reenacted as a new rule, repeal of the existing rule will not result in costs or savings to local government.
small businesses:
Because the substantive provisions of the existing rule will be reenacted as a new rule, repeal of the existing rule will not result in costs or savings to small businesses.
persons other than small businesses, businesses, or local governmental entities:
Because the substantive provisions of the existing rule will be reenacted as a new rule, repeal of the existing rule will not result in costs or savings to other affected persons.
Compliance costs for affected persons:
The repeal of existing Rule R612-3 and reenactment of its substantive provisions in Rules R612-100 and R612-400 will not change interested parties' rights or duties and will not impose any compliance costs on affected persons.
Comments by the department head on the fiscal impact the rule may have on businesses:
The repeal of existing Rule R612-3, coupled with reenactment of the rule's substantive provisions in the new Rules R612-100 and R612-400, is intended to make the rule easier to find and use by businesses and all other stakeholders in the workers' compensation system. The Commission does not anticipate that the improved organization of these rules will result in any fiscal impact on businesses.
Sherrie Hayashi, Commissioner
The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:
Labor CommissionIndustrial Accidents
HEBER M WELLS BLDG
160 E 300 S
SALT LAKE CITY, UT 84111-2316
Direct questions regarding this rule to:
- Ron Dressler at the above address, by phone at 801-530-6841, by FAX at 801-530-6804, or by Internet E-mail at rdressler@utah.gov
Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:
02/14/2013
This rule may become effective on:
02/21/2013
Authorized by:
Sherrie Hayashi, Commissioner
RULE TEXT
R612. Labor Commission, Industrial Accidents.
[R612-3. Workers' Compensation Rules -
Self-Insurance.
R612-3-1. Definitions.
A. "Reserve" is defined as the amount necessary
to satisfy all debts, past, present, and future, incurred by
reason of industrial accidents or occupational diseases, the
origins of which commenced prior to the date of reserve
determination.
B. "Aggregate Excess Insurance" is defined as
the amount of insurance required to cover the total accumulated
workers' compensation benefits for all claims payable for a
given period of time with the employer retaining an obligation
for a designated amount as a deductible and the insurance company
paying all amounts due thereafter up to a maximum total
obligation.
C. "Specific Excess Insurance" is defined as
the amount of insurance required to cover the workers'
compensation benefits arising out of a specific occurrence
(accident) or occupational disease under the Workers'
Compensation Law with the employer retaining an obligation for a
designated amount as a deductible and the insurance company
assuming the obligation for all amounts due thereafter up to a
maximum total obligation.
D. In addition to the foregoing definitions, all
definitions in Rule R612-1 apply to this section.
R612-3-2. Authority.
This rule is enacted under the authority of Section
34A-1-104.
R612-3-3. Application.
A. An employer seeking authorization to become
self-insured under the provision of Section 34A-2-201 of the Utah
Workers' Compensation Act must apply to the division through
the use of a form entitled "Application for Self
Insurance."
B. The division will require annual renewals for
continuing self-insurance. Renewal, through the use of a form
entitled "Renewal Application for Self-Insurance", will
require an update of the initial information. Renewal information
must be submitted at least 60 days before the self-insurance
anniversary date. Failure to file a renewal application on time
may result in an interruption or cancellation of self-insurance
privileges.
C. The initial and all renewal applications must be
completed and signed by the employer's duly authorized
representative.
R612-3-4. Qualifying Requirements.
A. To qualify, an employer must be in business for a
period of not less than five years and shall demonstrate
sufficient financial strength and liquidity of the business to
assure that all obligations will be promptly met. An employer in
business less than five years will be considered only if a
pre-existing parent corporation (in business more than five
years) guarantees the liability. In cases of merger or name
identification change, the history of the pre-existing entity
will be considered for the five year requirement. Upon applying
for self-insurance privileges, the applicant must forward a
current, certified financial statement or other proof of
financial ability to pay direct compensation and other expenses
as provided by Section 34A-2-201. Mergers occurring after an
entity is self-insured will require a new application by the
merged entity. However, entities whose financial information can
be obtained from Dunn and Bradstreet will not be required to file
financial statements unless clarification or supplemental
statements are deemed appropriate or necessary.
B. Specific or aggregate excess insurance with policy
limits and retention amounts acceptable are required as a
condition of approval and continuation of self-insurance
privileges.
C. Excess Insurance policies shall include a bankruptcy
and insolvency endorsement (Form 303) for each self-insured
entity. The endorsement adds the Uninsured Employer's Fund to
the excess insurance policy and specifies the conditions of the
Utah bankruptcy and insolvency endorsement for individual
self-insureds.
D. A minimum $100,000 surety bond.
E. No corporate surety shall be eligible to write
self-insurers' surety bonds or excess insurance unless
authorized to transact such business in this state.
F. Surety bonds must be issued on a prescribed form
entitled "Self-Insurance Aggregate Surety Bond" and
shall be exchanged or replaced with another surety bond only if a
60 day notice of termination of liability is given by the bonding
company. The replacement bond must be issued on a form as
prescribed by the Commission. No replacements will be authorized
by the Commission unless the new surety accepts the liability of
the previous surety(ies) or a guarantee is filed by both (all)
sureties acknowledging their respective liabilities and periods
of time covering such liabilities.
G. All subsidiary companies must have the parent company
guarantee liability for payment of benefits (unless such
requirement is waived by the division). The form and substance of
such guarantees are to be approved by the division.
H. The division may utilize services such as Dunn and
Bradstreet credit ratings for the purpose of evaluating a
company's financial ability to pay.
I. Entities that fall within the top two composite credit
appraisal ratings by Dunn and Bradstreet (or information from an
equivalent service) and their top two ratings on estimated
financial strength may qualify for self-insurance in Utah with
the minimum requirements as set forth in Rule R612-3-4C.
Companies with a 5A or 4A estimated financial strength rating and
falling within the fair composite credit appraisal of Dunn and
Bradstreet may qualify for self-insurance with higher security
requirements as determined by the division. The provisions herein
are to be construed as optional, with the division having the
option.
J. Self-insured entities, or their parent company if such
is a guarantor, that fall below either the 5A or 4A estimated
financial strength rating or the top three composite credit
appraisal ratings of Dunn and Bradstreet will not be allowed to
self-insure. A company already self-insured that falls in the
aforementioned disqualifying categories will not be allowed to
continue self-insurance privileges. However, at the discretion of
the division continuation of self-insurance will be considered if
the following steps are taken:
1. An independent actuarial study satisfactory to the
division and the employer is made of the reserve requirements of
the self-insured entity, said study to be at the employer's
expense. Selection of the actuary will be mutually agreed upon by
the division and the employer. However, should the parties fail
to agree, the division will make the final selection.
2. Satisfactory security is obtained for the reserves
plus the aggregate excess retention amount.
3. Any company whose self-insurance privileges are
revoked under the provisions of these rules will be required to
obtain security for their reserve requirements under the
foregoing two step process regardless of whether or not
self-insurance privileges are continued.
4. Companies whose privileges are to be revoked will be
allowed 60 days from notice to comply with steps 1 through 3
above.
5. Quarterly financial reviews will be taken of entities
which retain their self-insurance privileges by following 1, 2,
and 3 above.
K. Security requirements for all entities requiring
security will be determined by a review of past incurred losses
and application of exposure, loss, and contingency factors. The
minimum acceptable bond amount is $100,000.
L. Public and eleemosynary entities are classified as
special categories requiring separate consideration for
self-insurance privileges and security requirements.
R612-3-5. Administration of the Self-Insurance Program.
A. A self-insurer must procure the services of an
insurance carrier or adjusting company to administer the
self-insurance program with regard to claims, setting up of
reserves, and safety programs; or
B. The self-insurer must show proof of sufficient and
competent staff to administer the self-insurance program and
provide safety engineering. The division reserves the right to
train and test adjustors and administrators of self-insurance
programs.
C. Whether a self-insurer hires their own adjustor or
contracts with an insurance carrier or service organization, the
following conditions must be met:
1. A knowledgeable contact concerning claims will be
located in the state of Utah.
2. The self-insurer will maintain a toll free number or
accept during office hours a reasonable number of collect calls
from injured employees if either employees of the company or the
division offices are in a different city than that of the
adjustor.
D. The self-insurer will comply with all rules of the
Commission and with the Workers' Compensation Act.
R612-3-6. Notice of Certification for Self-Insurance or
Denial and Renewal.
Upon meeting the requirements set forth in these rules,
an employer shall receive a formal certificate approving
self-insured status. The privilege may be renewed from year to
year with renewal procedure as required by these rules. An
employer whose original or renewal application for self-insurance
has been denied or revoked, or who takes exception to insurance
or reserve requirements, may request a review or reconsideration
by the Commission. The request must be made within 20 days of the
notice of Commission action issued to the employer. A request for
review will not automatically extend the authorization to
self-insure. However, the Commission may extend the privilege
pending review. Without such an extension, the privilege is
revoked on the anniversary date.
R612-3-7. Revocation of Right to Self-Insure.
The right to self-insure may be revoked by the division
for failure to comply with the rules contained herein.
KEY: self insurance plans, workers' compensation,
benefits
Date of Enactment or Last Substantive Amendment: October 22,
2012
Notice of Continuation: April 28, 2008
Authorizing, and Implemented or Interpreted Law: 34A-1-104;
34A-2-201]
Additional Information
The Portable Document Format (PDF) version of the Bulletin is the official version. The PDF version of this issue is available at https://rules.utah.gov/publicat/bull-pdf/2013/b20130115.pdf. The HTML edition of the Bulletin is a convenience copy. Any discrepancy between the PDF version and HTML version is resolved in favor of the PDF version.
Text to be deleted is struck through and surrounded by brackets (e.g., [example]). Text to be added is underlined (e.g., example). Older browsers may not depict some or any of these attributes on the screen or when the document is printed.
For questions regarding the content or application of this rule, please contact Ron Dressler at the above address, by phone at 801-530-6841, by FAX at 801-530-6804, or by Internet E-mail at rdressler@utah.gov.