1 | A bill to be entitled |
2 | An act relating to a joint underwriting plan of insurers; |
3 | amending s. 627.311, F.S.; revising provisions requiring |
4 | the Office of Insurance Regulation to approve a joint |
5 | underwriting plan for workers' compensation and employer's |
6 | liability insurers; requiring plan rates to be |
7 | noncompetitive with the voluntary market for certain |
8 | purposes; deleting authorization for insureds to select |
9 | certain alternative coverages; requiring the plan of |
10 | operation to establish three tiers for eligible employers; |
11 | specifying criteria and rates for each tier; providing for |
12 | an Assigned Risk Adjustment Program for certain employers; |
13 | deleting provisions requiring establishment of certain |
14 | subplans; providing policyholder choice under certain |
15 | circumstances; providing requirements for premiums under |
16 | such tiers; revising criteria, requirements, and |
17 | limitations for a required depopulation program to reduce |
18 | numbers of insureds under the tiers; providing an |
19 | application fee for administration and fraud prevention; |
20 | revising certain tier notice requirements; providing for |
21 | funding of the plan through deficit funding; providing for |
22 | a one-time capital contribution from the Workers' |
23 | Compensation Administration Trust Fund to defray deficits |
24 | prior to certain assessments; providing a mechanism for |
25 | collecting deficit assessments; providing duties of the |
26 | office; providing requirements, procedures, and |
27 | limitations for collecting and enforcing deficit |
28 | assessments; providing for transfers of funds from the |
29 | Workers' Compensation Administration Trust Fund to the |
30 | plan under certain circumstances; providing an exclusion |
31 | for deficit assessments from certain taxes; specifying |
32 | that deficit assessments are plan funds when collected; |
33 | providing notice requirements for certain policies; |
34 | providing for liability of certain insureds for certain |
35 | additional deficit assessments; specifying venue for |
36 | proceedings to enforce or collect assessments; expanding a |
37 | prohibition against providing certain persons with |
38 | workers' compensation and employers' liability insurance; |
39 | providing an exclusion for the plan from certain taxes and |
40 | assessments; providing an effective date. |
41 |
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42 | Be It Enacted by the Legislature of the State of Florida: |
43 |
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44 | Section 1. Paragraphs (a), (c), (d), (e), (g), and (p) of |
45 | subsection (5) of section 627.311, Florida Statutes, are |
46 | amended, and paragraph (q) is added to said subsection, to read: |
47 | 627.311 Joint underwriters and joint reinsurers; public |
48 | records and public meetings exemptions.-- |
49 | (5)(a) The office shall, after consultation with insurers, |
50 | approve a joint underwriting plan of insurers which shall |
51 | operate as a nonprofit entity. For the purposes of this |
52 | subsection, the term "insurer" includes group self-insurance |
53 | funds authorized by s. 624.4621, commercial self-insurance funds |
54 | authorized by s. 624.462, assessable mutual insurers authorized |
55 | under s. 628.6011, and insurers licensed to write workers' |
56 | compensation and employer's liability insurance in this state. |
57 | The purpose of the plan is to provide workers' compensation and |
58 | employer's liability insurance to applicants who are required by |
59 | law to maintain workers' compensation and employer's liability |
60 | insurance and who are in good faith entitled to but who are |
61 | unable to procure purchase such insurance through the voluntary |
62 | market. The plan must have actuarially sound rates that ensure |
63 | assure that the plan is self-supporting. |
64 | (c) The operation of the plan shall be governed by a plan |
65 | of operation that is prepared at the direction of the board of |
66 | governors. The plan of operation may be changed at any time by |
67 | the board of governors or upon request of the office. The plan |
68 | of operation and all changes thereto are subject to the approval |
69 | of the office. The plan of operation shall: |
70 | 1. Authorize the board to engage in the activities |
71 | necessary to implement this subsection, including, but not |
72 | limited to, borrowing money. |
73 | 2. Develop criteria for eligibility for coverage by the |
74 | plan, including, but not limited to, documented rejection by at |
75 | least two insurers which reasonably assures that insureds |
76 | covered under the plan are unable to acquire coverage in the |
77 | voluntary market. Any insured may voluntarily elect to accept |
78 | coverage from an insurer for a premium equal to or greater than |
79 | the plan premium if the insurer writing the coverage adheres to |
80 | the provisions of s. 627.171. |
81 | 3. Require notice from the agent to the insured at the |
82 | time of the application for coverage that the application is for |
83 | coverage with the plan and that coverage may be available |
84 | through an insurer, group self-insurers' fund, commercial self- |
85 | insurance fund, or assessable mutual insurer through another |
86 | agent at a lower cost. |
87 | 4. Establish programs to encourage insurers to provide |
88 | coverage to applicants of the plan in the voluntary market and |
89 | to insureds of the plan, including, but not limited to: |
90 | a. Establishing procedures for an insurer to use in |
91 | notifying the plan of the insurer's desire to provide coverage |
92 | to applicants to the plan or existing insureds of the plan and |
93 | in describing the types of risks in which the insurer is |
94 | interested. The description of the desired risks must be on a |
95 | form developed by the plan. |
96 | b. Developing forms and procedures that provide an insurer |
97 | with the information necessary to determine whether the insurer |
98 | wants to write particular applicants to the plan or insureds of |
99 | the plan. |
100 | c. Developing procedures for notice to the plan and the |
101 | applicant to the plan or insured of the plan that an insurer |
102 | will insure the applicant or the insured of the plan, and notice |
103 | of the cost of the coverage offered; and developing procedures |
104 | for the selection of an insuring entity by the applicant or |
105 | insured of the plan. |
106 | d. Provide for a market-assistance plan to assist in the |
107 | placement of employers. All applications for coverage in the |
108 | plan received 45 days before the effective date for coverage |
109 | shall be processed through the market-assistance plan. A market- |
110 | assistance plan specifically designed to serve the needs of |
111 | small, good policyholders as defined by the board must be |
112 | finalized by January 1, 1994. |
113 | 5. Provide for policy and claims services to the insureds |
114 | of the plan of the nature and quality provided for insureds in |
115 | the voluntary market. |
116 | 6. Provide for the review of applications for coverage |
117 | with the plan for reasonableness and accuracy, using any |
118 | available historic information regarding the insured. |
119 | 7. Provide for procedures for auditing insureds of the |
120 | plan which are based on reasonable business judgment and are |
121 | designed to maximize the likelihood that the plan will collect |
122 | the appropriate premiums. |
123 | 8. Authorize the plan to terminate the coverage of and |
124 | refuse future coverage for any insured that submits a fraudulent |
125 | application to the plan or provides fraudulent or grossly |
126 | erroneous records to the plan or to any service provider of the |
127 | plan in conjunction with the activities of the plan. |
128 | 9. Establish service standards for agents who submit |
129 | business to the plan. |
130 | 10. Establish criteria and procedures to prohibit any |
131 | agent who does not adhere to the established service standards |
132 | from placing business with the plan or receiving, directly or |
133 | indirectly, any commissions for business placed with the plan. |
134 | 11. Provide for the establishment of reasonable safety |
135 | programs for all insureds in the plan. All insureds of the plan |
136 | must participate in the safety program. |
137 | 12. Authorize the plan to terminate the coverage of and |
138 | refuse future coverage to any insured who fails to pay premiums |
139 | or surcharges when due; who, at the time of application, is |
140 | delinquent in payments of workers' compensation or employer's |
141 | liability insurance premiums or surcharges owed to an insurer, |
142 | group self-insurers' fund, commercial self-insurance fund, or |
143 | assessable mutual insurer licensed to write such coverage in |
144 | this state; or who refuses to substantially comply with any |
145 | safety programs recommended by the plan. |
146 | 13. Authorize the board of governors to provide the |
147 | services required by the plan through staff employed by the |
148 | plan, through reasonably compensated service providers who |
149 | contract with the plan to provide services as specified by the |
150 | board of governors, or through a combination of employees and |
151 | service providers. |
152 | 14. Provide for service standards for service providers, |
153 | methods of determining adherence to those service standards, |
154 | incentives and disincentives for service, and procedures for |
155 | terminating contracts for service providers that fail to adhere |
156 | to service standards. |
157 | 15. Provide procedures for selecting service providers and |
158 | standards for qualification as a service provider that |
159 | reasonably assure that any service provider selected will |
160 | continue to operate as an ongoing concern and is capable of |
161 | providing the specified services in the manner required. |
162 | 16. Provide for reasonable accounting and data-reporting |
163 | practices. |
164 | 17. Provide for annual review of costs associated with the |
165 | administration and servicing of the policies issued by the plan |
166 | to determine alternatives by which costs can be reduced. |
167 | 18. Authorize the acquisition of such excess insurance or |
168 | reinsurance as is consistent with the purposes of the plan. |
169 | 19. Provide for an annual report to the office on a date |
170 | specified by the office and containing such information as the |
171 | office reasonably requires. |
172 | 20. Establish multiple rating plans for various |
173 | classifications of risk which reflect risk of loss, hazard |
174 | grade, actual losses, size of premium, and compliance with loss |
175 | control. At least one of such plans must be a preferred-rating |
176 | plan to accommodate small-premium policyholders with good |
177 | experience as defined in sub-subparagraph 22.a. |
178 | 21. Establish agent commission schedules. |
179 | 22. For employers otherwise eligible for coverage under |
180 | the plan, establish three tiers of employers meeting the |
181 | criteria and subject to the rate limitations specified in this |
182 | subparagraph. Establish four subplans as follows: |
183 | a. Tier One.-- |
184 | (I) Criteria; rated employers.--An employer that has an |
185 | experience modification rating shall be included in Tier One if |
186 | the employer meets all of the following: |
187 | (A) The experience modification is below 1.00. |
188 | (B) The employer had no lost-time claims subsequent to the |
189 | applicable experience modification rating period. |
190 | (C) The total of the employer's medical-only claims |
191 | subsequent to the applicable experience modification rating |
192 | period did not exceed 20 percent of premium. |
193 | (II) Criteria; non-rated employers.--An employer that does |
194 | not have an experience modification rating shall be included in |
195 | Tier One if the employer meets all of the following: |
196 | (A) The employer had no lost-time claims for the 3-year |
197 | period immediately preceding the inception date or renewal date |
198 | of the employer's coverage under the plan. |
199 | (B) The total of the employer's medical-only claims for |
200 | the 3-year period immediately preceding the inception date or |
201 | renewal date of the employer's coverage under the plan did not |
202 | exceed 20 percent of premium. |
203 | (C) The employer has secured workers' compensation |
204 | coverage for the entire 3-year period immediately preceding the |
205 | inception date or renewal date of the employer's coverage under |
206 | the plan. |
207 | (D) The employer is able to provide the plan with a loss |
208 | history generated by the employer's prior workers' compensation |
209 | insurer, except if the employer is not able to produce a loss |
210 | history due to the insolvency of an insurer, the receiver shall |
211 | provide to the plan, upon the request of the employer or the |
212 | employer's agent, a copy of the employer's loss history from the |
213 | records of the insolvent insurer if the loss history is |
214 | contained in records of the insurer which are in the possession |
215 | of the receiver. If the receiver is unable to produce the loss |
216 | history, the employer may, in lieu of the loss history, submit |
217 | an affidavit from the employer and the employer's insurance |
218 | agent setting forth the loss history. |
219 | (E) The employer is not a new business. |
220 | (III) Premiums.--The premiums for Tier One insureds shall |
221 | be set at a premium level 25 percent above the comparable |
222 | voluntary market premiums until the plan has sufficient |
223 | experience as determined by the board to establish an |
224 | actuarially sound rate for Tier One, at which point the board |
225 | shall, subject to paragraph (e), adjust the rates, if necessary, |
226 | to produce actuarially sound rates, provided such rate |
227 | adjustment shall not take effect prior to January 1, 2007. |
228 | Subplan "A" must include those insureds whose annual premium |
229 | does not exceed $2,500 and who have neither incurred any lost- |
230 | time claims nor incurred medical-only claims exceeding 50 |
231 | percent of their premium for the immediate 2 years. |
232 | b. Tier Two.-- |
233 | (I) Criteria; rated employers.--An employer that has an |
234 | experience modification rating shall be included in Tier Two if |
235 | the employer meets all of the following: |
236 | (A) The experience modification is equal to or greater |
237 | than 1.00 but not greater than 1.10. |
238 | (B) The employer had no lost-time claims subsequent to the |
239 | applicable experience modification rating period. |
240 | (C) The total of the employer's medical-only claims |
241 | subsequent to the applicable experience modification rating |
242 | period did not exceed 20 percent of premium. |
243 | (II) Criteria; non-rated employers.--An employer that does |
244 | not have any experience modification rating shall be included in |
245 | Tier Two if the employer is a new business. An employer shall be |
246 | included in Tier Two if the employer has less than 3 years of |
247 | loss experience in the 3-year period immediately preceding the |
248 | inception date or renewal date of the employer's coverage under |
249 | the plan and the employer meets all of the following: |
250 | (A) The employer had no lost-time claims for the 3-year |
251 | period immediately preceding the inception date or renewal date |
252 | of the employer's coverage under the plan. |
253 | (B) The total of the employer's medical-only claims for |
254 | the 3-year period immediately preceding the inception date or |
255 | renewal date of the employer's coverage under the plan did not |
256 | exceed 20 percent of premium. |
257 | (C) The employer is able to provide the plan with a loss |
258 | history generated by the workers' compensation insurer that |
259 | provided coverage for the portion or portions of such period |
260 | during which the employer had secured workers' compensation |
261 | coverage, except if the employer is not able to produce a loss |
262 | history due to the insolvency of an insurer, the receiver shall |
263 | provide to the plan, upon the request of the employer or the |
264 | employer's agent, a copy of the employer's loss history from the |
265 | records of the insolvent insurer if the loss history is |
266 | contained in records of the insurer which are in the possession |
267 | of the receiver. If the receiver is unable to produce the loss |
268 | history, the employer may, in lieu of the loss history, submit |
269 | an affidavit from the employer and the employer's insurance |
270 | agent setting forth the loss history. |
271 | (III) Premiums.--The premiums for Tier Two insureds shall |
272 | be set at a rate level 50 percent above the comparable voluntary |
273 | market premiums until the plan has sufficient experience as |
274 | determined by the board to establish an actuarially sound rate |
275 | for Tier Two, at which point the board shall, subject to |
276 | paragraph (e), adjust the rates, if necessary, to produce |
277 | actuarially sound rates, provided such rate adjustment shall not |
278 | take effect prior to January 1, 2007. |
279 | (IV) Assigned Risk Adjustment Program.--Employers assigned |
280 | to Tier Two shall be subject to the Assigned Risk Adjustment |
281 | Program, as applicable. Subplan "B" must include insureds that |
282 | are employers identified by the board of governors as high-risk |
283 | employers due solely to the nature of the operations being |
284 | performed by those insureds and for whom no market exists in the |
285 | voluntary market, and whose experience modifications are less |
286 | than 1.00. |
287 | c. Tier Three.-- |
288 | (I) Eligibility.--An employer shall be included in Tier |
289 | Three if the employer does not meet the criteria for Tier One or |
290 | Tier Two. |
291 | (II) Rates.--The board shall establish, subject to |
292 | paragraph (e), and the plan shall charge, actuarially sound |
293 | rates for Tier Three insureds. |
294 | (III) Assigned Risk Adjustment Program.--Employers |
295 | assigned to Tier Three shall be subject to the Assigned Risk |
296 | Adjustment Program, as applicable. Subplan "C" must include all |
297 | insureds within the plan that are not eligible for subplan "A," |
298 | subplan "B," or subplan "D." |
299 | d. Subplan "D" must include any employer, regardless of |
300 | the length of time for which it has conducted business |
301 | operations, which has an experience modification factor of 1.10 |
302 | or less and either employs 15 or fewer employees or is an |
303 | organization that is exempt from federal income tax pursuant to |
304 | s. 501(c)(3) of the Internal Revenue Code and receives more than |
305 | 50 percent of its funding from gifts, grants, endowments, or |
306 | federal or state contracts. The rate plan for subplan "D" shall |
307 | be the same rate plan as the plan approved under ss. 627.091- |
308 | 627.151, and each participant in subplan "D" shall pay the |
309 | premium determined under such rate plan, plus a surcharge |
310 | determined by the board to be sufficient to ensure that the plan |
311 | does not compete with the voluntary market rate for any |
312 | participant, but not to exceed 25 percent. However, the |
313 | surcharge shall not exceed 10 percent for an organization that |
314 | is exempt from federal income tax pursuant to s. 501(c)(3) of |
315 | the Internal Revenue Code. |
316 | 23. For Tier One or Tier Two employers in construction |
317 | class codes which employ no nonexempt employees or which report |
318 | payroll that is insufficient to develop premiums in excess of |
319 | $2,500, establish premiums of $2,500, which shall be in addition |
320 | to the fee specified in subparagraph 26. When the board |
321 | establishes actuarially sound rates for Tier One and Tier Two, |
322 | the board shall also establish actuarially sound rates for |
323 | minimum premium policies in those tiers. |
324 | 24.23. Provide for a depopulation program to reduce the |
325 | number of insureds in the plan subplan "D." If an employer |
326 | insured through the plan subplan "D" is offered coverage from a |
327 | voluntary market carrier: |
328 | a. During the first 30 days of coverage under the plan |
329 | subplan; |
330 | b. Before a policy is issued under the plan subplan; |
331 | c. By issuance of a policy upon expiration or cancellation |
332 | of the policy under the plan subplan; or |
333 | d. By assumption of the plan's subplan's obligation with |
334 | respect to an in-force policy, |
335 |
|
336 | that employer is no longer eligible for coverage through the |
337 | plan. The premium for risks assumed by the voluntary market |
338 | carrier must be the same premium plus, for the first 2 years, |
339 | the surcharge as the insured would have paid under the plan, and |
340 | shall be adjusted upon renewal to reflect changes in the plan |
341 | rates and the tier for which the insured would qualify as of the |
342 | time of renewal. Such premium change shall occur upon renewal, |
343 | but in no event more than once annually determined in sub- |
344 | subparagraph 22.d. A premium under this subparagraph, including |
345 | surcharge, is deemed approved and is not an excess premium for |
346 | purposes of s. 627.171. |
347 | 25.24. Require that policies issued under subplan "D" and |
348 | applications for such policies must include a notice that the |
349 | policy issued under subplan "D" could be replaced by a policy |
350 | issued from a voluntary market carrier and that, if an offer of |
351 | coverage is obtained from a voluntary market carrier, the |
352 | policyholder is no longer eligible for coverage through the plan |
353 | subplan "D." The notice must also specify that acceptance of |
354 | coverage under the plan subplan "D" creates a conclusive |
355 | presumption that the applicant or policyholder is aware of this |
356 | potential. |
357 | 26. Require that each application for coverage and each |
358 | renewal premium be accompanied by a nonrefundable fee of $475 to |
359 | cover costs of administration and fraud prevention. The board |
360 | may, with the approval of the office, increase the amount of the |
361 | fee pursuant to a rate filing to reflect increased costs of |
362 | administration and fraud prevention. The fee is not subject to |
363 | commission and is fully earned upon commencement of coverage. |
364 | (d)1. The funding of the plan shall include premiums as |
365 | provided in subparagraph (c)22. and assessments as provided in |
366 | this paragraph. The plan must be funded through actuarially |
367 | sound premiums charged to insureds of the plan. |
368 | 2.a. If the board determines that a deficit exists in Tier |
369 | One or Tier Two or that there is any deficit remaining |
370 | attributable to any of the plan's former subplans and that the |
371 | deficit cannot be funded without the use of deficit assessments, |
372 | the board shall request the office to levy, by order, a deficit |
373 | assessment against premiums charged to insureds for workers' |
374 | compensation insurance by insurers as defined in s. 631.904(5). |
375 | The office shall issue the order after verifying the amount of |
376 | the deficit. The assessment shall be specified as a percentage |
377 | of future premium collections, as recommended by the board and |
378 | approved by the office. The same percentage shall apply to |
379 | premiums on all workers' compensation policies issued or renewed |
380 | during the 12-month period beginning on the effective date of |
381 | the assessment, as specified in the order. |
382 | b. With respect to each insurer collecting premiums that |
383 | are subject to the assessment, the insurer shall collect the |
384 | assessment at the same time as the insurer collects the premium |
385 | payment for each policy and shall remit the assessments |
386 | collected to the plan as provided in the order issued by the |
387 | office. The office shall verify the accurate and timely |
388 | collection and remittance of deficit assessments and shall |
389 | report such information to the board. Each insurer collecting |
390 | assessments shall provide such information with respect to |
391 | premiums and collections as may be required by the office to |
392 | enable the office to monitor and audit compliance with this |
393 | paragraph. |
394 | c. Deficit assessments are not considered part of an |
395 | insurer's rate, are not premium, and are not subject to the |
396 | premium tax, to the assessments under ss. 440.49 and 440.51, to |
397 | the surplus lines tax, to any fees, or to any commissions. The |
398 | deficit assessment imposed shall become plan funds at the moment |
399 | of collection and shall not constitute income to the insurer for |
400 | any purpose, including financial reporting on the insurer's |
401 | income statement. An insurer is liable for all assessments that |
402 | the insurer collects and must treat the failure of an insured to |
403 | pay an assessment as a failure to pay premium. An insurer is not |
404 | liable for uncollectible assessments. |
405 | d. When an insurer is required to return unearned premium, |
406 | the insurer shall also return any collected assessments |
407 | attributable to the unearned premium. The plan may issue |
408 | assessable policies only to those insureds in subplans "C" and |
409 | "D." Subject to verification by the department, the board may |
410 | levy assessments against insureds in subplan "C" or subplan "D," |
411 | on a pro rata earned premium basis, to fund any deficits that |
412 | exist in those subplans. Assessments levied against subplan "C" |
413 | participants shall cover only the deficits attributable to |
414 | subplan "C," and assessments levied against subplan "D" |
415 | participants shall cover only the deficits attributable to |
416 | subplan "D." In no event may the plan levy assessments against |
417 | any person or entity, except as authorized by this paragraph. |
418 | Those assessable policies must be clearly identified as |
419 | assessable by containing, in contrasting color and in not less |
420 | than 10-point type, the following statements: "This is an |
421 | assessable policy. If the plan is unable to pay its obligations, |
422 | policyholders will be required to contribute on a pro rata |
423 | earned premium basis the money necessary to meet any assessment |
424 | levied." |
425 | 3.a. All policies issued to Tier Three insureds shall be |
426 | assessable. All Tier Three assessable policies must be clearly |
427 | identified as assessable by containing, in contrasting color and |
428 | in not less than 10-point type, the following statement: |
429 |
|
430 | "This is an assessable policy. If the plan is unable to |
431 | pay its obligations, policyholders will be required to |
432 | contribute on a pro rata earned premium basis the money |
433 | necessary to meet any assessment levied." |
434 |
|
435 | b. The board may from time to time assess Tier Three |
436 | insureds to whom the plan has issued assessable policies for the |
437 | purpose of funding plan deficits. Any such assessment shall be |
438 | based upon a reasonable actuarial estimate of the amount of the |
439 | deficit, taking into account the amount needed to fund medical |
440 | and indemnity reserves and reserves for incurred but not |
441 | reported claims, and allowing for general administrative |
442 | expenses, the cost of levying and collecting the assessment, a |
443 | reasonable allowance for estimated uncollectible assessments, |
444 | and allocated and unallocated loss adjustment expenses. |
445 | c. Each Tier Three insured's share of a deficit shall be |
446 | computed by applying to the premium earned on the insured's |
447 | policy or policies during the period to be covered by the |
448 | assessment the ratio of the total deficit to the total premiums |
449 | earned during such period upon all policies subject to the |
450 | assessment. If one or more Tier Three insureds fail to pay an |
451 | assessment, the other Tier Three insureds shall be liable on a |
452 | proportionate basis for additional assessments to fund the |
453 | deficit. The plan may compromise and settle individual |
454 | assessment claims without affecting the validity of or amounts |
455 | due on assessments levied against other insureds. The plan may |
456 | offer and accept discounted payments for assessments which are |
457 | promptly paid. The plan may offset the amount of any unpaid |
458 | assessment against unearned premiums which may otherwise be due |
459 | to an insured. The plan shall institute legal action when |
460 | necessary and appropriate to collect the assessment from any |
461 | insured who fails to pay an assessment when due. |
462 | d. The venue of a proceeding to enforce or collect an |
463 | assessment or to contest the validity or amount of an assessment |
464 | shall be in the Circuit Court of Leon County. |
465 | e. If the board finds that a deficit in Tier Three exists |
466 | for any period and that an assessment is necessary, the board |
467 | shall certify to the office the need for an assessment. No |
468 | sooner than 30 days after the date of such certification, the |
469 | board shall notify in writing each insured who is to be assessed |
470 | that an assessment is being levied against the insured, and |
471 | informing the insured of the amount of the assessment, the |
472 | period for which the assessment is being levied, and the date by |
473 | which payment of the assessment is due. The board shall |
474 | establish a date by which payment of the assessment is due, |
475 | which shall be no sooner than 30 days nor later than 120 days |
476 | after the date on which notice of the assessment is mailed to |
477 | the insured. |
478 | f. Whenever the board makes a determination that the plan |
479 | does not have a sufficient cash basis to meet 3 months of |
480 | projected cash needs due to a deficit in Tier Three, the board |
481 | may request the department to transfer funds from the Workers' |
482 | Compensation Administration Trust Fund to the plan in an amount |
483 | sufficient to fund the difference between the amount available |
484 | and the amount needed to meet a 3-month projected cash need as |
485 | determined by the board and verified by the office, subject to |
486 | the approval of the Legislative Budget Commission. If the |
487 | Legislative Budget Commission approves a transfer of funds under |
488 | this sub-subparagraph, the plan shall report to the Legislature |
489 | the transfer of funds and the Legislature shall review the plan |
490 | during the next legislative session or the current legislative |
491 | session, if the transfer occurs during a legislative session. |
492 | This sub-subparagraph shall not apply until the plan determines |
493 | and the office verifies that assessments collected by the plan |
494 | pursuant to sub-subparagraph b. are insufficient to fund the |
495 | deficit in Tier Three and to meet 3 months of projected cash |
496 | needs. The plan may issue assessable policies with differing |
497 | terms and conditions to different groups within subplans "C" and |
498 | "D" when a reasonable basis exists for the differentiation. |
499 | 4. The plan may offer rating, dividend plans, and other |
500 | plans to encourage loss prevention programs. |
501 | (e) The plan shall establish and use its rates and rating |
502 | plans, and the plan may establish and use changes in rating |
503 | plans at any time, but no more frequently than two times per any |
504 | rating class for any calendar year. By December 1, 1993, and |
505 | December 1 of each year thereafter, except as provided in |
506 | subparagraph (c)22., the board shall establish and use |
507 | actuarially sound rates for use by the plan to assure that the |
508 | plan is self-funding while those rates are in effect. Such rates |
509 | and rating plans must be filed with the office within 30 |
510 | calendar days after their effective dates, and shall be |
511 | considered a "use and file" filing. Any disapproval by the |
512 | office must have an effective date that is at least 60 days from |
513 | the date of disapproval of the rates and rating plan and must |
514 | have prospective effect only. The plan may not be subject to any |
515 | order by the office to return to policyholders any portion of |
516 | the rates disapproved by the office. The office may not |
517 | disapprove any rates or rating plans unless it demonstrates that |
518 | such rates and rating plans are excessive, inadequate, or |
519 | unfairly discriminatory. |
520 | (g) Whenever a deficit exists, the plan shall, within 90 |
521 | days, provide the office with a program to eliminate the deficit |
522 | within a reasonable time. The deficit may be funded through |
523 | increased premiums charged to insureds of the plan for |
524 | subsequent years, through the use of policyholder surplus |
525 | attributable to any year, through the use of assessments as |
526 | provided in subparagraph (d)2., and through assessments on |
527 | insureds in the plan if the plan uses assessable policies as |
528 | provided in subparagraph (d)3. |
529 | (p) No insurer shall provide workers' compensation and |
530 | employer's liability insurance to any person who is delinquent |
531 | in the payment of premiums, assessments, penalties, or |
532 | surcharges owed to the plan or to any person who is an |
533 | affiliated person of a person who is delinquent in the payment |
534 | of premiums, assessments, penalties, or surcharges owed to the |
535 | plan. For purposes of this paragraph, the term "affiliated |
536 | person" of another person means: |
537 | 1. The spouse of such other natural person; |
538 | 2. Any person who directly or indirectly owns or controls, |
539 | or holds with the power to vote, 5 percent or more of the |
540 | outstanding voting securities of such other person; |
541 | 3. Any person who directly or indirectly owns 5 percent or |
542 | more of the outstanding voting securities that are directly or |
543 | indirectly owned or controlled, or held with the power to vote, |
544 | by such other person; |
545 | 4. Any person or group of persons who directly or |
546 | indirectly control, are controlled by, or are under common |
547 | control with such other person; |
548 | 5. Any officer, director, trustee, partner, owner, |
549 | manager, joint venturer, or employee, or other person performing |
550 | duties similar to persons in those positions, of such other |
551 | persons; or |
552 | 6. Any person who has an officer, director, trustee, |
553 | partner, or joint venturer in common with such other person. |
554 | (q) Effective July 1, 2004, the plan is exempt from the |
555 | premium tax under s. 624.509 and any assessments under ss. |
556 | 440.49 and 440.51. |
557 | Section 2. Notwithstanding the provisions of ss. 440.50 |
558 | and 440.51, Florida Statutes, for the 2004-2005 fiscal year the |
559 | sum of $25 million is appropriated from the Workers' |
560 | Compensation Administration Trust Fund in the Department of |
561 | Financial Services for transfer to the workers' compensation |
562 | joint underwriting plan provided in s. 627.311(5), Florida |
563 | Statutes, as a capital contribution to fund any deficit in the |
564 | plan. The Chief Financial Officer shall transfer such funds to |
565 | the plan no later than July 31, 2004. An additional amount not |
566 | to exceed $10 million is appropriated from the Workers' |
567 | Compensation Administration Trust Fund for transfer to the |
568 | workers' compensation joint underwriting plan provided in s. |
569 | 627.311(5), Florida Statutes, subject to the approval of the |
570 | Legislative Budget Commission, if the Board of Governors and the |
571 | Office of Insurance Regulation determine that a deficit exists |
572 | in Tier One or Tier Two or that there is any deficit remaining |
573 | attributable to the former Subplan "D" under former s. |
574 | 627.311(5)(c)22., Florida Statutes, and that the deficit cannot |
575 | be funded without the use of deficit assessments as authorized |
576 | by s. 627.351(5)(d), Florida Statutes. |
577 | Section 3. Except as otherwise provided herein, this act |
578 | shall take effect July 1, 2004. |