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 the |
4 | Office of Insurance Regulation to approve a joint underwriting |
5 | plan for workers' compensation and employer's liability |
6 | insurers; requiring plan rates to be noncompetitive with the |
7 | voluntary market for certain purposes; deleting authorization |
8 | for insureds to select certain alternative coverages; requiring |
9 | the plan of operation to establish three tiers for eligible |
10 | employers; specifying criteria and rates for each tier; deleting |
11 | provisions requiring establishment of certain subplans; |
12 | providing criteria for minimum premium policies; providing |
13 | requirements for premiums under such tiers; revising criteria, |
14 | requirements, and limitations for a required depopulation |
15 | program to reduce numbers of insureds under the tiers; providing |
16 | an application fee for administration and fraud prevention; |
17 | revising certain tier notice requirements; providing for funding |
18 | of the plan through deficit funding; providing for transferring |
19 | an appropriation in an amount not to exceed $10 million from the |
20 | Workers' Compensation Administration Trust Fund to the workers' |
21 | compensation joint underwriting plan for certain purposes; |
22 | providing procedures and requirements; providing for |
23 | establishing a contingency reserve for certain purposes; |
24 | providing for transfers of funds from the contingency reserve in |
25 | an amount not to exceed $15 million to the plan for purposes of |
26 | funding certain deficits; providing limitations; providing for |
27 | review of the reasonableness of the plan's administration; |
28 | providing a sunset date for deficit funding; providing a |
29 | mechanism for collecting deficit assessments; providing duties |
30 | of the office; providing requirements, procedures, and |
31 | limitations for collecting and enforcing deficit assessments; |
32 | providing for transfers of funds from the Workers' Compensation |
33 | Administration Trust Fund to the plan under certain |
34 | circumstances; providing an exclusion for deficit assessments |
35 | from certain taxes; specifying that deficit assessments are plan |
36 | funds when collected; providing notice requirements for certain |
37 | policies; providing for liability of certain insureds for |
38 | certain additional deficit assessments; specifying venue for |
39 | proceedings to enforce or collect assessments; expanding a |
40 | prohibition against providing certain persons with workers' |
41 | compensation and employers' liability insurance; providing an |
42 | exclusion for the plan from certain taxes and assessments; |
43 | requiring the Auditor General to conduct an operational audit of |
44 | the association; providing audit requirements; requiring the |
45 | association to comply with the Florida Single Audit Act, if |
46 | certain conditions are met; requiring a report; providing |
47 | appropriations; providing an exception from certain deficit |
48 | funding assessment provisions; providing a procedure for a |
49 | transition period; providing application; providing an effective |
50 | date. |
51 |
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52 | Be It Enacted by the Legislature of the State of Florida: |
53 |
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54 | Section 1. Paragraphs (a), (c), (d), (e), (g), and (p) of |
55 | subsection (5) of section 627.311, Florida Statutes, are |
56 | amended, and paragraph (q) is added to said subsection, to read: |
57 | 627.311 Joint underwriters and joint reinsurers; public |
58 | records and public meetings exemptions.-- |
59 | (5)(a) The office shall, after consultation with insurers, |
60 | approve a joint underwriting plan of insurers which shall |
61 | operate as a nonprofit entity. For the purposes of this |
62 | subsection, the term "insurer" includes group self-insurance |
63 | funds authorized by s. 624.4621, commercial self-insurance funds |
64 | authorized by s. 624.462, assessable mutual insurers authorized |
65 | under s. 628.6011, and insurers licensed to write workers' |
66 | compensation and employer's liability insurance in this state. |
67 | The purpose of the plan is to provide workers' compensation and |
68 | employer's liability insurance to applicants who are required by |
69 | law to maintain workers' compensation and employer's liability |
70 | insurance and who are in good faith entitled to but who are |
71 | unable to procure purchase such insurance through the voluntary |
72 | market. Except as provided herein, the plan must have |
73 | actuarially sound rates that ensure assure that the plan is |
74 | self-supporting. |
75 | (c) The operation of the plan shall be governed by a plan |
76 | of operation that is prepared at the direction of the board of |
77 | governors. The plan of operation may be changed at any time by |
78 | the board of governors or upon request of the office. The plan |
79 | of operation and all changes thereto are subject to the approval |
80 | of the office. The plan of operation shall: |
81 | 1. Authorize the board to engage in the activities |
82 | necessary to implement this subsection, including, but not |
83 | limited to, borrowing money. |
84 | 2. Develop criteria for eligibility for coverage by the |
85 | plan, including, but not limited to, documented rejection by at |
86 | least two insurers which reasonably assures that insureds |
87 | covered under the plan are unable to acquire coverage in the |
88 | voluntary market. Any insured may voluntarily elect to accept |
89 | coverage from an insurer for a premium equal to or greater than |
90 | the plan premium if the insurer writing the coverage adheres to |
91 | the provisions of s. 627.171. |
92 | 3. Require notice from the agent to the insured at the |
93 | time of the application for coverage that the application is for |
94 | coverage with the plan and that coverage may be available |
95 | through an insurer, group self-insurers' fund, commercial self- |
96 | insurance fund, or assessable mutual insurer through another |
97 | agent at a lower cost. |
98 | 4. Establish programs to encourage insurers to provide |
99 | coverage to applicants of the plan in the voluntary market and |
100 | to insureds of the plan, including, but not limited to: |
101 | a. Establishing procedures for an insurer to use in |
102 | notifying the plan of the insurer's desire to provide coverage |
103 | to applicants to the plan or existing insureds of the plan and |
104 | in describing the types of risks in which the insurer is |
105 | interested. The description of the desired risks must be on a |
106 | form developed by the plan. |
107 | b. Developing forms and procedures that provide an insurer |
108 | with the information necessary to determine whether the insurer |
109 | wants to write particular applicants to the plan or insureds of |
110 | the plan. |
111 | c. Developing procedures for notice to the plan and the |
112 | applicant to the plan or insured of the plan that an insurer |
113 | will insure the applicant or the insured of the plan, and notice |
114 | of the cost of the coverage offered; and developing procedures |
115 | for the selection of an insuring entity by the applicant or |
116 | insured of the plan. |
117 | d. Provide for a market-assistance plan to assist in the |
118 | placement of employers. All applications for coverage in the |
119 | plan received 45 days before the effective date for coverage |
120 | shall be processed through the market-assistance plan. A market- |
121 | assistance plan specifically designed to serve the needs of |
122 | small, good policyholders as defined by the board must be |
123 | finalized by January 1, 1994. |
124 | 5. Provide for policy and claims services to the insureds |
125 | of the plan of the nature and quality provided for insureds in |
126 | the voluntary market. |
127 | 6. Provide for the review of applications for coverage |
128 | with the plan for reasonableness and accuracy, using any |
129 | available historic information regarding the insured. |
130 | 7. Provide for procedures for auditing insureds of the |
131 | plan which are based on reasonable business judgment and are |
132 | designed to maximize the likelihood that the plan will collect |
133 | the appropriate premiums. |
134 | 8. Authorize the plan to terminate the coverage of and |
135 | refuse future coverage for any insured that submits a fraudulent |
136 | application to the plan or provides fraudulent or grossly |
137 | erroneous records to the plan or to any service provider of the |
138 | plan in conjunction with the activities of the plan. |
139 | 9. Establish service standards for agents who submit |
140 | business to the plan. |
141 | 10. Establish criteria and procedures to prohibit any |
142 | agent who does not adhere to the established service standards |
143 | from placing business with the plan or receiving, directly or |
144 | indirectly, any commissions for business placed with the plan. |
145 | 11. Provide for the establishment of reasonable safety |
146 | programs for all insureds in the plan. All insureds of the plan |
147 | must participate in the safety program. |
148 | 12. Authorize the plan to terminate the coverage of and |
149 | refuse future coverage to any insured who fails to pay premiums |
150 | or surcharges when due; who, at the time of application, is |
151 | delinquent in payments of workers' compensation or employer's |
152 | liability insurance premiums or surcharges owed to an insurer, |
153 | group self-insurers' fund, commercial self-insurance fund, or |
154 | assessable mutual insurer licensed to write such coverage in |
155 | this state; or who refuses to substantially comply with any |
156 | safety programs recommended by the plan. |
157 | 13. Authorize the board of governors to provide the |
158 | services required by the plan through staff employed by the |
159 | plan, through reasonably compensated service providers who |
160 | contract with the plan to provide services as specified by the |
161 | board of governors, or through a combination of employees and |
162 | service providers. |
163 | 14. Provide for service standards for service providers, |
164 | methods of determining adherence to those service standards, |
165 | incentives and disincentives for service, and procedures for |
166 | terminating contracts for service providers that fail to adhere |
167 | to service standards. |
168 | 15. Provide procedures for selecting service providers and |
169 | standards for qualification as a service provider that |
170 | reasonably assure that any service provider selected will |
171 | continue to operate as an ongoing concern and is capable of |
172 | providing the specified services in the manner required. |
173 | 16. Provide for reasonable accounting and data-reporting |
174 | practices. |
175 | 17. Provide for annual review of costs associated with the |
176 | administration and servicing of the policies issued by the plan |
177 | to determine alternatives by which costs can be reduced. |
178 | 18. Authorize the acquisition of such excess insurance or |
179 | reinsurance as is consistent with the purposes of the plan. |
180 | 19. Provide for an annual report to the office on a date |
181 | specified by the office and containing such information as the |
182 | office reasonably requires. |
183 | 20. Establish multiple rating plans for various |
184 | classifications of risk which reflect risk of loss, hazard |
185 | grade, actual losses, size of premium, and compliance with loss |
186 | control. At least one of such plans must be a preferred-rating |
187 | plan to accommodate small-premium policyholders with good |
188 | experience as defined in sub-subparagraph 22.a. |
189 | 21. Establish agent commission schedules. |
190 | 22. For employers otherwise eligible for coverage under |
191 | the plan, establish three tiers of employers meeting the |
192 | criteria and subject to the rate limitations specified in this |
193 | subparagraph. Establish four subplans as follows: |
194 | a. Tier One.-- |
195 | (I) Criteria; rated employers.--An employer that has an |
196 | experience modification rating shall be included in Tier One if |
197 | the employer meets all of the following: |
198 | (A) The experience modification is below 1.00. |
199 | (B) The employer had no lost-time claims subsequent to the |
200 | applicable experience modification rating period. |
201 | (C) The total of the employer's medical-only claims |
202 | subsequent to the applicable experience modification rating |
203 | period did not exceed 20 percent of premium. |
204 | (II) Criteria; non-rated employers.--An employer that does |
205 | not have an experience modification rating shall be included in |
206 | Tier One if the employer meets all of the following: |
207 | (A) The employer had no lost-time claims for the 3-year |
208 | period immediately preceding the inception date or renewal date |
209 | of the employer's coverage under the plan. |
210 | (B) The total of the employer's medical-only claims for |
211 | the 3-year period immediately preceding the inception date or |
212 | renewal date of the employer's coverage under the plan did not |
213 | exceed 20 percent of premium. |
214 | (C) The employer has secured workers' compensation |
215 | coverage for the entire 3-year period immediately preceding the |
216 | inception date or renewal date of the employer's coverage under |
217 | the plan. |
218 | (D) The employer is able to provide the plan with a loss |
219 | history generated by the employer's prior workers' compensation |
220 | insurer, except if the employer is not able to produce a loss |
221 | history due to the insolvency of an insurer, the receiver shall |
222 | provide to the plan, upon the request of the employer or the |
223 | employer's agent, a copy of the employer's loss history from the |
224 | records of the insolvent insurer if the loss history is |
225 | contained in records of the insurer which are in the possession |
226 | of the receiver. If the receiver is unable to produce the loss |
227 | history, the employer may, in lieu of the loss history, submit |
228 | an affidavit from the employer and the employer's insurance |
229 | agent setting forth the loss history. |
230 | (E) The employer is not a new business. |
231 | (III) Premiums.--The premiums for Tier One insureds shall |
232 | be set at a premium level 25 percent above the comparable |
233 | voluntary market premiums until the plan has sufficient |
234 | experience as determined by the board to establish an |
235 | actuarially sound rate for Tier One, at which point the board |
236 | shall, subject to paragraph (e), adjust the rates, if necessary, |
237 | to produce actuarially sound rates, provided such rate |
238 | adjustment shall not take effect prior to January 1, 2007. |
239 | Subplan "A" must include those insureds whose annual premium |
240 | does not exceed $2,500 and who have neither incurred any lost- |
241 | time claims nor incurred medical-only claims exceeding 50 |
242 | percent of their premium for the immediate 2 years. |
243 | b. Tier Two.-- |
244 | (I) Criteria; rated employers.--An employer that has an |
245 | experience modification rating shall be included in Tier Two if |
246 | the employer meets all of the following: |
247 | (A) The experience modification is equal to or greater |
248 | than 1.00 but not greater than 1.10. |
249 | (B) The employer had no lost-time claims subsequent to the |
250 | applicable experience modification rating period. |
251 | (C) The total of the employer's medical-only claims |
252 | subsequent to the applicable experience modification rating |
253 | period did not exceed 20 percent of premium. |
254 | (II) Criteria; non-rated employers.--An employer that does |
255 | not have any experience modification rating shall be included in |
256 | Tier Two if the employer is a new business. An employer shall be |
257 | included in Tier Two if the employer has less than 3 years of |
258 | loss experience in the 3-year period immediately preceding the |
259 | inception date or renewal date of the employer's coverage under |
260 | the plan and the employer meets all of the following: |
261 | (A) The employer had no lost-time claims for the 3-year |
262 | period immediately preceding the inception date or renewal date |
263 | of the employer's coverage under the plan. |
264 | (B) The total of the employer's medical-only claims for |
265 | the 3-year period immediately preceding the inception date or |
266 | renewal date of the employer's coverage under the plan did not |
267 | exceed 20 percent of premium. |
268 | (C) The employer is able to provide the plan with a loss |
269 | history generated by the workers' compensation insurer that |
270 | provided coverage for the portion or portions of such period |
271 | during which the employer had secured workers' compensation |
272 | coverage, except if the employer is not able to produce a loss |
273 | history due to the insolvency of an insurer, the receiver shall |
274 | provide to the plan, upon the request of the employer or the |
275 | employer's agent, a copy of the employer's loss history from the |
276 | records of the insolvent insurer if the loss history is |
277 | contained in records of the insurer which are in the possession |
278 | of the receiver. If the receiver is unable to produce the loss |
279 | history, the employer may, in lieu of the loss history, submit |
280 | an affidavit from the employer and the employer's insurance |
281 | agent setting forth the loss history. |
282 | (III) Premiums.--The premiums for Tier Two insureds shall |
283 | be set at a rate level 50 percent above the comparable voluntary |
284 | market premiums until the plan has sufficient experience as |
285 | determined by the board to establish an actuarially sound rate |
286 | for Tier Two, at which point the board shall, subject to |
287 | paragraph (e), adjust the rates, if necessary, to produce |
288 | actuarially sound rates, provided such rate adjustment shall not |
289 | take effect prior to January 1, 2007. Subplan "B" must include |
290 | insureds that are employers identified by the board of governors |
291 | as high-risk employers due solely to the nature of the |
292 | operations being performed by those insureds and for whom no |
293 | market exists in the voluntary market, and whose experience |
294 | modifications are less than 1.00. |
295 | c. Tier Three.-- |
296 | (I) Eligibility.--An employer shall be included in Tier |
297 | Three if the employer does not meet the criteria for Tier One or |
298 | Tier Two. |
299 | (II) Rates.--The board shall establish, subject to |
300 | paragraph (e), and the plan shall charge, actuarially sound |
301 | rates for Tier Three insureds. Subplan "C" must include all |
302 | insureds within the plan that are not eligible for subplan "A," |
303 | subplan "B," or subplan "D." |
304 | d. Subplan "D" must include any employer, regardless of |
305 | the length of time for which it has conducted business |
306 | operations, which has an experience modification factor of 1.10 |
307 | or less and either employs 15 or fewer employees or is an |
308 | organization that is exempt from federal income tax pursuant to |
309 | s. 501(c)(3) of the Internal Revenue Code and receives more than |
310 | 50 percent of its funding from gifts, grants, endowments, or |
311 | federal or state contracts. The rate plan for subplan "D" shall |
312 | be the same rate plan as the plan approved under ss. 627.091- |
313 | 627.151, and each participant in subplan "D" shall pay the |
314 | premium determined under such rate plan, plus a surcharge |
315 | determined by the board to be sufficient to ensure that the plan |
316 | does not compete with the voluntary market rate for any |
317 | participant, but not to exceed 25 percent. However, the |
318 | surcharge shall not exceed 10 percent for an organization that |
319 | is exempt from federal income tax pursuant to s. 501(c)(3) of |
320 | the Internal Revenue Code. |
321 | 23. For Tier One or Tier Two employers which employ no |
322 | nonexempt employees or which report payroll which is less than |
323 | the minimum wage hourly rate for one full-time employee for 1 |
324 | year at 40 hours per week, the plan shall establish actuarially |
325 | sound premiums, provided, however, that the premiums may not |
326 | exceed $2,500. These premiums shall be in addition to the fee |
327 | specified in subparagraph 26. When the plan establishes |
328 | actuarially sound rates for all employers in Tier One and Tier |
329 | Two, the premiums for employers referred to in this paragraph |
330 | are no longer subject to the $2,500 cap. |
331 | 24.23. Provide for a depopulation program to reduce the |
332 | number of insureds in the plan subplan "D." If an employer |
333 | insured through the plan subplan "D" is offered coverage from a |
334 | voluntary market carrier: |
335 | a. During the first 30 days of coverage under the plan |
336 | subplan; |
337 | b. Before a policy is issued under the plan subplan; |
338 | c. By issuance of a policy upon expiration or cancellation |
339 | of the policy under the plan subplan; or |
340 | d. By assumption of the plan's subplan's obligation with |
341 | respect to an in-force policy, |
342 |
|
343 | that employer is no longer eligible for coverage through the |
344 | plan. The premium for risks assumed by the voluntary market |
345 | carrier must be no greater than the same premium plus, for the |
346 | first 2 years, the surcharge as the insured would have paid |
347 | under the plan, and shall be adjusted upon renewal to reflect |
348 | changes in the plan rates and the tier for which the insured |
349 | would qualify as of the time of renewal. The insured may be |
350 | charged such premiums only for the first 3 years of coverage in |
351 | the voluntary market. determined in sub-subparagraph 22.d. A |
352 | premium under this subparagraph, including surcharge, is deemed |
353 | approved and is not an excess premium for purposes of s. |
354 | 627.171. |
355 | 25.24. Require that policies issued under subplan "D" and |
356 | applications for such policies must include a notice that the |
357 | policy issued under subplan "D" could be replaced by a policy |
358 | issued from a voluntary market carrier and that, if an offer of |
359 | coverage is obtained from a voluntary market carrier, the |
360 | policyholder is no longer eligible for coverage through the plan |
361 | subplan "D." The notice must also specify that acceptance of |
362 | coverage under the plan subplan "D" creates a conclusive |
363 | presumption that the applicant or policyholder is aware of this |
364 | potential. |
365 | 26. Require that each application for coverage and each |
366 | renewal premium be accompanied by a nonrefundable fee of $475 to |
367 | cover costs of administration and fraud prevention. The board |
368 | may, with the approval of the office, increase the amount of the |
369 | fee pursuant to a rate filing to reflect increased costs of |
370 | administration and fraud prevention. The fee is not subject to |
371 | commission and is fully earned upon commencement of coverage. |
372 | (d)1. The funding of the plan shall include premiums as |
373 | provided in subparagraph (c)22. and assessments as provided in |
374 | this paragraph. The plan must be funded through actuarially |
375 | sound premiums charged to insureds of the plan. |
376 | 2.a. If the board determines that a deficit exists in Tier |
377 | One or Tier Two or that there is any deficit remaining |
378 | attributable to any of the plan's former subplans and that the |
379 | deficit cannot be funded without the use of deficit assessments, |
380 | the board shall request the office to levy, by order, a deficit |
381 | assessment against premiums charged to insureds for workers' |
382 | compensation insurance by insurers as defined in s. 631.904(5). |
383 | The office shall issue the order after verifying the amount of |
384 | the deficit. The assessment shall be specified as a percentage |
385 | of future premium collections, as recommended by the board and |
386 | approved by the office. The same percentage shall apply to |
387 | premiums on all workers' compensation policies issued or renewed |
388 | during the 12-month period beginning on the effective date of |
389 | the assessment, as specified in the order. |
390 | b. With respect to each insurer collecting premiums that |
391 | are subject to the assessment, the insurer shall collect the |
392 | assessment at the same time as the insurer collects the premium |
393 | payment for each policy and shall remit the assessments |
394 | collected to the plan as provided in the order issued by the |
395 | office. The office shall verify the accurate and timely |
396 | collection and remittance of deficit assessments and shall |
397 | report such information to the board. Each insurer collecting |
398 | assessments shall provide such information with respect to |
399 | premiums and collections as may be required by the office to |
400 | enable the office to monitor and audit compliance with this |
401 | paragraph. |
402 | c. Deficit assessments are not considered part of an |
403 | insurer's rate, are not premium, and are not subject to the |
404 | premium tax, to the assessments under ss. 440.49 and 440.51, to |
405 | the surplus lines tax, to any fees, or to any commissions. The |
406 | deficit assessment imposed shall become plan funds at the moment |
407 | of collection and shall not constitute income to the insurer for |
408 | any purpose, including financial reporting on the insurer's |
409 | income statement. An insurer is liable for all assessments that |
410 | the insurer collects and must treat the failure of an insured to |
411 | pay an assessment as a failure to pay premium. An insurer is not |
412 | liable for uncollectible assessments. |
413 | d. When an insurer is required to return unearned premium, |
414 | the insurer shall also return any collected assessments |
415 | attributable to the unearned premium. |
416 | e. Deficit assessments as described in this subparagraph |
417 | shall not be levied after July 1, 2007. The plan may issue |
418 | assessable policies only to those insureds in subplans "C" and |
419 | "D." Subject to verification by the department, the board may |
420 | levy assessments against insureds in subplan "C" or subplan "D," |
421 | on a pro rata earned premium basis, to fund any deficits that |
422 | exist in those subplans. Assessments levied against subplan "C" |
423 | participants shall cover only the deficits attributable to |
424 | subplan "C," and assessments levied against subplan "D" |
425 | participants shall cover only the deficits attributable to |
426 | subplan "D." In no event may the plan levy assessments against |
427 | any person or entity, except as authorized by this paragraph. |
428 | Those assessable policies must be clearly identified as |
429 | assessable by containing, in contrasting color and in not less |
430 | than 10-point type, the following statements: "This is an |
431 | assessable policy. If the plan is unable to pay its obligations, |
432 | policyholders will be required to contribute on a pro rata |
433 | earned premium basis the money necessary to meet any assessment |
434 | levied." |
435 | 3.a. All policies issued to Tier Three insureds shall be |
436 | assessable. All Tier Three assessable policies must be clearly |
437 | identified as assessable by containing, in contrasting color and |
438 | in not less than 10-point type, the following statement: |
439 |
|
440 | "This is an assessable policy. If the plan is unable to |
441 | pay its obligations, policyholders will be required to |
442 | contribute on a pro rata earned premium basis the money |
443 | necessary to meet any assessment levied." |
444 |
|
445 | b. The board may from time to time assess Tier Three |
446 | insureds to whom the plan has issued assessable policies for the |
447 | purpose of funding plan deficits. Any such assessment shall be |
448 | based upon a reasonable actuarial estimate of the amount of the |
449 | deficit, taking into account the amount needed to fund medical |
450 | and indemnity reserves and reserves for incurred but not |
451 | reported claims, and allowing for general administrative |
452 | expenses, the cost of levying and collecting the assessment, a |
453 | reasonable allowance for estimated uncollectible assessments, |
454 | and allocated and unallocated loss adjustment expenses. |
455 | c. Each Tier Three insured's share of a deficit shall be |
456 | computed by applying to the premium earned on the insured's |
457 | policy or policies during the period to be covered by the |
458 | assessment the ratio of the total deficit to the total premiums |
459 | earned during such period upon all policies subject to the |
460 | assessment. If one or more Tier Three insureds fail to pay an |
461 | assessment, the other Tier Three insureds shall be liable on a |
462 | proportionate basis for additional assessments to fund the |
463 | deficit. The plan may compromise and settle individual |
464 | assessment claims without affecting the validity of or amounts |
465 | due on assessments levied against other insureds. The plan may |
466 | offer and accept discounted payments for assessments which are |
467 | promptly paid. The plan may offset the amount of any unpaid |
468 | assessment against unearned premiums which may otherwise be due |
469 | to an insured. The plan shall institute legal action when |
470 | necessary and appropriate to collect the assessment from any |
471 | insured who fails to pay an assessment when due. |
472 | d. The venue of a proceeding to enforce or collect an |
473 | assessment or to contest the validity or amount of an assessment |
474 | shall be in the Circuit Court of Leon County. |
475 | e. If the board finds that a deficit in Tier Three exists |
476 | for any period and that an assessment is necessary, the board |
477 | shall certify to the office the need for an assessment. No |
478 | sooner than 30 days after the date of such certification, the |
479 | board shall notify in writing each insured who is to be assessed |
480 | that an assessment is being levied against the insured, and |
481 | informing the insured of the amount of the assessment, the |
482 | period for which the assessment is being levied, and the date by |
483 | which payment of the assessment is due. The board shall |
484 | establish a date by which payment of the assessment is due, |
485 | which shall be no sooner than 30 days nor later than 120 days |
486 | after the date on which notice of the assessment is mailed to |
487 | the insured. |
488 | f. Whenever the board makes a determination that the plan |
489 | does not have a sufficient cash basis to meet 3 months of |
490 | projected cash needs due to a deficit in Tier Three, the board |
491 | may request the department to transfer funds from the Workers' |
492 | Compensation Administration Trust Fund to the plan in an amount |
493 | sufficient to fund the difference between the amount available |
494 | and the amount needed to meet a 3-month projected cash need as |
495 | determined by the board and verified by the office, subject to |
496 | the approval of the Legislative Budget Commission. If the |
497 | Legislative Budget Commission approves a transfer of funds under |
498 | this sub-subparagraph, the plan shall report to the Legislature |
499 | the transfer of funds and the Legislature shall review the plan |
500 | during the next legislative session or the current legislative |
501 | session, if the transfer occurs during a legislative session. |
502 | This sub-subparagraph shall not apply until the plan determines |
503 | and the office verifies that assessments collected by the plan |
504 | pursuant to sub-subparagraph b. are insufficient to fund the |
505 | deficit in Tier Three and to meet 3 months of projected cash |
506 | needs. The plan may issue assessable policies with differing |
507 | terms and conditions to different groups within subplans "C" and |
508 | "D" when a reasonable basis exists for the differentiation. |
509 | 4. The plan may offer rating, dividend plans, and other |
510 | plans to encourage loss prevention programs. |
511 | (e) The plan shall establish and use its rates and rating |
512 | plans, and the plan may establish and use changes in rating |
513 | plans at any time, but no more frequently than two times per any |
514 | rating class for any calendar year. By December 1, 1993, and |
515 | December 1 of each year thereafter, except as provided in |
516 | subparagraph (c)22., the board shall establish and use |
517 | actuarially sound rates for use by the plan to assure that the |
518 | plan is self-funding while those rates are in effect. Such rates |
519 | and rating plans must be filed with the office within 30 |
520 | calendar days after their effective dates, and shall be |
521 | considered a "use and file" filing. Any disapproval by the |
522 | office must have an effective date that is at least 60 days from |
523 | the date of disapproval of the rates and rating plan and must |
524 | have prospective effect only. The plan may not be subject to any |
525 | order by the office to return to policyholders any portion of |
526 | the rates disapproved by the office. The office may not |
527 | disapprove any rates or rating plans unless it demonstrates that |
528 | such rates and rating plans are excessive, inadequate, or |
529 | unfairly discriminatory. |
530 | (g) Whenever a deficit exists, the plan shall, within 90 |
531 | days, provide the office with a program to eliminate the deficit |
532 | within a reasonable time. The deficit may be funded through |
533 | increased premiums charged to insureds of the plan for |
534 | subsequent years, through the use of policyholder surplus |
535 | attributable to any year, through the use of assessments as |
536 | provided in subparagraph (d)2., and through assessments on |
537 | insureds in the plan if the plan uses assessable policies as |
538 | provided in subparagraph (d)3. |
539 | (p) No insurer shall provide workers' compensation and |
540 | employer's liability insurance to any person who is delinquent |
541 | in the payment of premiums, assessments, penalties, or |
542 | surcharges owed to the plan or to any person who is an |
543 | affiliated person of a person who is delinquent in the payment |
544 | of premiums, assessments, penalties, or surcharges owed to the |
545 | plan. For purposes of this paragraph, the term "affiliated |
546 | person" of another person means: |
547 | 1. The spouse of such other natural person; |
548 | 2. Any person who directly or indirectly owns or controls, |
549 | or holds with the power to vote, 5 percent or more of the |
550 | outstanding voting securities of such other person; |
551 | 3. Any person who directly or indirectly owns 5 percent or |
552 | more of the outstanding voting securities that are directly or |
553 | indirectly owned or controlled, or held with the power to vote, |
554 | by such other person; |
555 | 4. Any person or group of persons who directly or |
556 | indirectly control, are controlled by, or are under common |
557 | control with such other person; |
558 | 5. Any officer, director, trustee, partner, owner, |
559 | manager, joint venturer, or employee, or other person performing |
560 | duties similar to persons in those positions, of such other |
561 | persons; or |
562 | 6. Any person who has an officer, director, trustee, |
563 | partner, or joint venturer in common with such other person. |
564 | (q) Effective July 1, 2004, the plan is exempt from the |
565 | premium tax under s. 624.509 and any assessments under ss. |
566 | 440.49 and 440.51. |
567 | Section 2. Notwithstanding the provisions of sections |
568 | 440.50 and 440.51, Florida Statutes, for the 2004-2005 fiscal |
569 | year the sum of $10 million is appropriated from the Workers' |
570 | Workers' Compensation Administration Trust Fund in the |
571 | Department of Financial Services for transfer to the workers' |
572 | workers' compensation joint underwriting plan provided in |
573 | section 627.311(5), Florida Statutes, as a capital contribution |
574 | to fund any deficit in the plan. The Chief Financial Officer |
575 | shall transfer such funds to the plan no later than July 31, |
576 | 2004. |
577 | Notwithstanding the provisions of ss. 440.50 and 440.51, |
578 | Florida Statutes, subject to the following procedures and |
579 | approval, the Department of Financial Services may request |
580 | transfer funds from the Workers' Compensation Administration |
581 | Trust Fund within the Department of Financial Services to the |
582 | workers' compensation joint underwriting plan provided in s. |
583 | 627.311(5), Florida Statutes. |
584 | (1) The department shall establish a contingency reserve |
585 | within the Workers' Compensation Administration Trust Fund, from |
586 | which the department is authorized to expend funds as provided |
587 | in the subsection, in an amount not to exceed $15 million to be |
588 | released only upon the approval of a budget amendment presented |
589 | to the Legislative Budget Commission. For actuarial deficits |
590 | projected for policyholders, based on actuarial best estimates, |
591 | covered in subplan "D" prior to July 1, 2004, and upon |
592 | verification by the Office of Insurance Regulation, the plan is |
593 | authorized to request and the department is authorized to submit |
594 | a budget amendment in an amount not to exceed $15 million for |
595 | the purpose of funding deficits in subplan "D". |
596 | (2) After the contingency reserve is established, whenever |
597 | the board determines subplan "D" does not have a sufficient cash |
598 | basis to meet 3 months of projected cash needs due to any |
599 | deficit in subplan "D," the board is authorized to request the |
600 | department to transfer funds from the contingency reserve fund |
601 | within the Workers' Compensation Administration Trust Fund to |
602 | the plan in an amount sufficient to fund the difference between |
603 | the amount available and the amount needed to meet subplan "D"'s |
604 | & |
605 | projected cash need for the subsequent 3-month period. The board |
606 | and the office must first certify to the Department of Financial |
607 | Services that there is not sufficient cash within subplan |
608 | "D" to meet the projected cash needs in subplan "D" within |
609 | subsequent 3 months. The amount requested for transfer to |
610 | subplan "D" may not exceed the difference between the |