| 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. |