CODING: Words stricken are deletions; words underlined are additions.House Bill 1703e1
HB 1703, First Engrossed
1 A bill to be entitled
2 An act relating to the Special Disability Trust
3 Fund; amending s. 440.49, F.S.; revising
4 procedures and requirements for reimbursement
5 from the fund; providing for barring the filing
6 of a claim for reimbursement under certain
7 circumstances; providing a maximum fund
8 assessment rate; requiring certain fees;
9 requiring the Department of Labor and
10 Employment Security to prepare an annual
11 report; providing a schedule for reimbursements
12 from the fund under certain circumstances;
13 amending s. 625.091, F.S.; providing for
14 accounting for anticipated recoveries under the
15 Special Disability Trust Fund; requiring
16 insurers to identify anticipated recoveries
17 from the fund; providing an appropriation;
18 providing an effective date.
19
20 Be It Enacted by the Legislature of the State of Florida:
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22 Section 1. Subsections (7), (9), and (11) of section
23 440.49, Florida Statutes, 1996 Supplement, are amended to
24 read:
25 440.49 Limitation of liability for subsequent injury
26 through Special Disability Trust Fund.--
27 (7) REIMBURSEMENT OF EMPLOYER.--
28 (a) The right to reimbursement as provided in this
29 section is barred unless written notice of claim of the right
30 to such reimbursement is filed by the employer or carrier
31 entitled to such reimbursement with the division at
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HB 1703, First Engrossed
1 Tallahassee within 2 years after the date the employee last
2 reached maximum medical improvement, or within 2 years after
3 the date of the first payment of compensation for permanent
4 total disability, wage loss, or death, whichever is later. The
5 notice of claim must contain such information as the division
6 by rule requires; and the employer or carrier claiming
7 reimbursement shall furnish such evidence in support of the
8 claim as the division reasonably may require.
9 (b) For notice of claims on the Special Disability
10 Trust Fund filed on or after July 1, 1978, the Special
11 Disability Trust Fund shall, within 120 days after receipt of
12 notice that a carrier has paid, been required to pay, or
13 accepted liability for excess compensation, serve notice of
14 the acceptance of the claim for reimbursement.
15 (c) A proof of claim must be filed on each notice of
16 claim on file as of June 30, 1997, within 1 year after July 1,
17 1997, or the right to reimbursement of the claim shall be
18 barred. A notice of claim on file on or before June 30, 1997,
19 may be withdrawn and refiled if, at the time refiled, the
20 notice of claim remains within the limitation period specified
21 in paragraph (a). Such refiling shall not toll, extend, or
22 otherwise alter in any way the limitation period applicable to
23 the withdrawn and subsequently refiled notice of claim. Each
24 proof of claim filed shall be accompanied by a proof-of-claim
25 fee as provided in paragraph (9)(d). The Special Disability
26 Trust Fund shall, within 120 days after receipt of the proof
27 of claim, serve notice of the acceptance of the claim for
28 reimbursement. This paragraph shall apply to all claims
29 notwithstanding the provisions of subsection (12).
30 (d) Each notice of claim filed or refiled on or after
31 July 1, 1997, must be accompanied by a notification fee as
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HB 1703, First Engrossed
1 provided in paragraph (9)(d). A proof of claim must be filed
2 within 1 year after the date the notice of claim is filed or
3 refiled, accompanied by a proof-of-claim fee as provided in
4 paragraph (9)(d), or the claim shall be barred. The
5 notification fee shall be waived if both the notice of claim
6 and proof of claim are submitted together as a single filing.
7 The Special Disability Trust Fund shall, within 180 days after
8 receipt of the proof of claim, serve notice of the acceptance
9 of the claim for reimbursement. This paragraph shall apply to
10 all claims notwithstanding the provisions of subsection (12).
11 (e) For dates of accident on or after before January
12 1, 1994, the Special Disability Trust Fund shall, within 120
13 days of receipt of notice that a carrier has been required to
14 pay, and has paid over $10,000 in benefits, serve notice of
15 the acceptance of the claim for reimbursement. Failure of the
16 Special Disability Trust Fund to serve notice of acceptance
17 shall give rise to the right to request a hearing on the claim
18 for reimbursement. If the Special Disability Trust Fund
19 through its representative denies or controverts the claim,
20 the right to such reimbursement shall be barred unless an
21 application for a hearing thereon is filed with the division
22 at Tallahassee within 60 days after notice to the employer or
23 carrier of such denial or controversion. When such application
24 for a hearing is timely filed, the claim shall be heard and
25 determined in accordance with the procedure prescribed in s.
26 440.25, to the extent that such procedure is applicable, and
27 in accordance with the workers' compensation rules of
28 procedure. In such proceeding on a claim for reimbursement,
29 the Special Disability Trust Fund shall be made the party
30 respondent, and no findings of fact made with respect to the
31 claim of the injured employee or the dependents for
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HB 1703, First Engrossed
1 compensation, including any finding made or order entered
2 pursuant to s. 440.20(12), shall be res judicata. The Special
3 Disability Trust Fund may not be joined or made a party to any
4 controversy or dispute between an employee and the dependents
5 and the employer or between two or more employers or carriers
6 without the written consent of the fund.
7 (f) When it has been determined that an employer or
8 carrier is entitled to reimbursement in any amount, the
9 employer or carrier shall be reimbursed annually from the
10 Special Disability Trust Fund for the compensation and medical
11 benefits paid by the employer or carrier for which the
12 employer or carrier is entitled to reimbursement, upon filing
13 request therefor and submitting evidence of such payment in
14 accordance with rules prescribed by the division, which rules
15 may include parameters for annual audits. The Special
16 Disability Trust Fund shall pay the approved reimbursement
17 requests on a first-in, first-out basis reflecting the order
18 in which the reimbursement requests were received.
19 (9) SPECIAL DISABILITY TRUST FUND.--
20 (a) There is established in the State Treasury a
21 special fund to be known as the "Special Disability Trust
22 Fund," which shall be available only for the purposes stated
23 in this section; and the assets thereof may not at any time be
24 appropriated or diverted to any other use or purpose. The
25 Treasurer shall be the custodian of such fund, and all moneys
26 and securities in such fund shall be held in trust by such
27 Treasurer and shall not be the money or property of the state.
28 The Treasurer is authorized to disburse moneys from such fund
29 only when approved by the division and upon the order of the
30 Comptroller. The Treasurer shall deposit any moneys paid into
31 such fund into such depository banks as the division may
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HB 1703, First Engrossed
1 designate and is authorized to invest any portion of the fund
2 which, in the opinion of the division, is not needed for
3 current requirements, in the same manner and subject to all
4 the provisions of the law with respect to the deposits of
5 state funds by such Treasurer. All interest earned by such
6 portion of the fund as may be invested by the Treasurer shall
7 be collected by him and placed to the credit of such fund.
8 (b)1. The Special Disability Trust Fund shall be
9 maintained by annual assessments upon the insurance companies
10 writing compensation insurance in the state, the commercial
11 self-insurers under ss. 624.462 and 624.4621, the assessable
12 mutuals under s. 628.601, and the self-insurers under this
13 chapter, which assessments shall become due and be paid
14 quarterly at the same time and in addition to the assessments
15 provided in s. 440.51. The division shall estimate annually in
16 advance the amount necessary for the administration of this
17 subsection and the maintenance of this fund and shall make
18 such assessment in the manner hereinafter provided.
19 2. The annual assessment shall be calculated to
20 produce during the ensuing fiscal year an amount which, when
21 combined with that part of the balance in the fund on June 30
22 of the current fiscal year which is in excess of $100,000, is
23 equal to the average of:
24 a. The sum of disbursements from the fund during the
25 immediate past 3 calendar years, and
26 b. Two times the disbursements of the most recent
27 calendar year.
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29 Such amount shall be prorated among the insurance companies
30 writing compensation insurance in the state and the
31 self-insurers.
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HB 1703, First Engrossed
1 3. The net premiums written by the companies for
2 workers' compensation in this state and the net premium
3 written applicable to the self-insurers in this state are the
4 basis for computing the amount to be assessed as a percentage
5 of net premiums. Such payments shall be made by each insurance
6 company and self-insurer to the division for the Special
7 Disability Trust Fund in accordance with such regulations as
8 the division prescribes.
9 4. The Treasurer is authorized to receive and credit
10 to such Special Disability Trust Fund any sum or sums that may
11 at any time be contributed to the state by the United States
12 under any Act of Congress, or otherwise, to which the state
13 may be or become entitled by reason of any payments made out
14 of such fund.
15 (c) Notwithstanding the Special Disability Trust Fund
16 assessment rate calculated pursuant to this section, the rate
17 assessed shall not exceed 4.52 percent provisions of this
18 subsection, in order to implement specific appropriations 1475
19 and 1748 of the 1996-1997 General Appropriations Act, for
20 fiscal year 1996-1997 only, the workers' compensation Special
21 Disability Trust Fund assessment rate in effect on January 1,
22 1995, shall remain in effect until June 30, 1997. This
23 paragraph is repealed on July 1, 1997.
24 (d) The Special Disability Trust Fund shall be
25 supplemented by a $250 notification fee on each notice of
26 claim filed or refiled after July 1, 1997 and a $500 fee on
27 each proof of claim filed in accordance with subsection (7).
28 Revenues from the fee shall be deposited into the Special
29 Disability Trust Fund and are exempt from the deduction
30 required by s. 215.20. The fees provided in this paragraph
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HB 1703, First Engrossed
1 shall not be imposed upon any insurer which is in receivership
2 with the Department of Insurance.
3 (e) The Department of Labor and Employment Security
4 shall report annually on the status of the Special Disability
5 Trust Fund. The report shall update the projected change in
6 fund liability, change in the total number of notices of claim
7 on file with the fund in addition to the number of newly filed
8 notices of claim, change in the number of proofs of claim
9 processed by the fund, and the fee revenues refunded and
10 revenues applied to pay down the liability of the fund. The
11 department shall submit its initial report to the Governor,
12 the President of the Senate, and the Speaker of the House of
13 Representatives by March 1, 1998, for the period ending
14 February 1, 1998, with additional reports submitted by
15 December 1, 1998, and December 1, 1999.
16 (11) EFFECTIVE DATES.--This section does not apply to
17 any case in which the accident causing the subsequent injury
18 or death or the disablement or death from a subsequent
19 occupational disease occurred prior to July 1, 1955, or on or
20 after January 1, 1998. In no event shall the Special
21 Disability Trust Fund be liable for, or reimburse employers or
22 carriers for, any case in which the accident causing the
23 subsequent injury or death or the disablement or death from a
24 subsequent occupational disease occurred on or after January
25 1, 1998. The Special Disability Trust Fund shall continue to
26 reimburse employers or carriers for subsequent injuries
27 occurring prior to January 1, 1998, and the division shall
28 continue to assess for and fund reimbursements as provided in
29 subsection (9) for this purpose.
30 Section 2. Subsection (4) is added to section 625.091,
31 Florida Statutes, to read:
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HB 1703, First Engrossed
1 625.091 Losses and loss adjustment expense reserves;
2 liability insurance and workers' compensation insurance.--The
3 reserve liabilities recorded in the insurer's annual statement
4 and financial statements for unpaid losses and loss adjustment
5 expenses shall be the estimated value of its claims when
6 ultimately settled and shall be computed as follows:
7 (4)(a) Accounting credit for anticipated recoveries
8 from the Special Disability Trust Fund may only be taken in
9 the determination of loss reserves and may not be reflected on
10 the financial statements in any manner other than that allowed
11 pursuant to this subsection.
12 (b)1. For calendar years 1999-2003, an insurer
13 recording anticipated recoveries from the Special Disability
14 Trust Fund shall limit the aggregate amount to the amount
15 management reasonably expects will be reimbursed or the
16 following amount, whichever is lower:
17 a. For financial statements filed in 2000, an insurer
18 may take accounting credit in an amount equalling 80% of the
19 amount utilized in calendar year 1996.
20 b. For financial statements filed in 2001, an insurer
21 may take accounting credit in an amount equalling 60% of the
22 amount utilized in calendar year 1996.
23 c. For financial statements filed in 2002, an insurer
24 may take accounting credit in an amount equalling 40% of the
25 amount utilized in calendar year 1996.
26 d. For financial statements filed in 2003, an insurer
27 may take accounting credit in an amount equalling 20% of the
28 amount utilized in calendar year 1996.
29 2. Subparagraph 1. does not apply to an insurer
30 recording anticipated recoveries from the Special Disability
31 Trust Fund on the basis of:
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HB 1703, First Engrossed
1 a. A proof of claim which the Fund has reviewed,
2 determined to be a valid claim and so notified the carrier,
3 and extended a payment offer; or
4 b. A reimbursement request audited and approved for
5 payment or paid by the Fund;
6 (c) Beginning with financial statements filed in 2004,
7 an insurer may only take accounting credit for anticipated
8 recoveries from the Special Disability Trust Fund for each
9 proof of claim which the Fund has reviewed, determined to be a
10 valid claim and so notified the carrier, and extended a
11 payment offer; or a reimbursement request audited and approved
12 for payment or paid by the Fund.
13 (d)1. Beginning in calendar year 1998, each insurer
14 shall separately identify anticipated recoveries from the
15 Special Disability Trust Fund on the annual statement required
16 to be filed pursuant to s. 624.424.
17 2. For all financial statements filed with the
18 department beginning in calendar year 1998, each insurer shall
19 disclose in the notes to the financial statements of any
20 financial statement required to be filed pursuant to s.
21 624.424 any credit in loss reserves taken for anticipated
22 recoveries from the Special Disability Trust Fund. That
23 disclosure shall include:
24 a. The amount of credit taken by the insurer in the
25 determination of its loss reserves for the prior calendar year
26 and the current reporting period on a year-to-date basis.
27 b. The amount of payments received by the insurer from
28 the Special Disability Trust Fund during the prior calendar
29 year and the year-to-date recoveries for the current year.
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HB 1703, First Engrossed
1 c. The amount the insurer was assessed by the Special
2 Disability Trust Fund during the prior calendar year and
3 during the current calendar year.
4 Section 3. There is hereby appropriated from the
5 Special Disability Trust Fund in the Department of Labor and
6 Employment Security $2,743,000 for Other Personal Services and
7 $300,000 for related expenses.
8 Section 4. This act shall take effect July 1, 1997.
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