Senate Bill sb1590c1

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    Florida Senate - 2005                           CS for SB 1590

    By the Committee on General Government Appropriations; and
    Senator Garcia




    601-2056-05

  1                      A bill to be entitled

  2         An act relating to joint underwriters and

  3         reinsurers; amending s. 627.311, F.S.;

  4         providing requirements for the joint

  5         underwriting plan of insurers that operates as

  6         a nonprofit entity; requiring that the plan

  7         maintain its headquarters in Tallahassee;

  8         increasing the membership of the board of

  9         governors that oversees operation of the joint

10         underwriting plan; authorizing the Financial

11         Services Commission to remove a board member

12         for cause; authorizing the board to select

13         service providers competitively; requiring that

14         the board provide notice of intent to solicit

15         bids; requiring that the board provide for an

16         annual review of the administrative costs of

17         the plan and determine alternatives for

18         procuring goods and services efficiently;

19         requiring that the Office of Insurance

20         Regulation review filings of the joint

21         underwriting plan of workers' compensation

22         insurers; requiring that the office annually

23         approve rates; deleting certain provisions

24         limiting the disapproval of rates by the

25         office; requiring that excess funds received by

26         the plan be returned to the state; providing an

27         effective date.

28  

29  Be It Enacted by the Legislature of the State of Florida:

30  

31  

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    Florida Senate - 2005                           CS for SB 1590
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 1         Section 1.  Subsections (5), (6), and (7) of section

 2  627.311, Florida Statutes, are amended to read:

 3         627.311  Joint underwriters and joint reinsurers;

 4  public records and public meetings exemptions.--

 5         (5)(a)  The office shall, after consultation with

 6  insurers, approve a joint underwriting plan of insurers that

 7  which shall operate as a nonprofit entity. For the purposes of

 8  this subsection, the term "insurer" includes group

 9  self-insurance funds authorized by s. 624.4621, commercial

10  self-insurance funds authorized by s. 624.462, assessable

11  mutual insurers authorized under s. 628.6011, and insurers

12  licensed to write workers' compensation and employer's

13  liability insurance in this state. The purpose of the plan is

14  to provide workers' compensation and employer's liability

15  insurance to applicants who are required by law to maintain

16  workers' compensation and employer's liability insurance and

17  who are in good faith entitled to but who are unable to

18  procure such insurance through the voluntary market. Except as

19  provided herein, the plan must have actuarially sound rates

20  that ensure that the plan is self-supporting. The plan shall

21  establish and maintain its headquarters in Tallahassee.

22         (b)  The operation of the plan is subject to the

23  supervision of an 11-member a 9-member board of governors. The

24  board of governors shall be comprised of:

25         1.  Five Three members appointed by the Financial

26  Services Commission. Each member appointed by the commission

27  shall serve at the pleasure of the commission;

28         2.  Two of the 20 domestic insurers, as defined in s.

29  624.06(1), having the largest voluntary direct premiums

30  written in this state for workers' compensation and employer's

31  

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    Florida Senate - 2005                           CS for SB 1590
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 1  liability insurance, which shall be elected by those 20

 2  domestic insurers;

 3         3.  Two of the 20 foreign insurers as defined in s.

 4  624.06(2) having the largest voluntary direct premiums written

 5  in this state for workers' compensation and employer's

 6  liability insurance, which shall be elected by those 20

 7  foreign insurers;

 8         4.  One person appointed by the largest property and

 9  casualty insurance agents' association in this state; and

10         5.  The consumer advocate appointed under s. 627.0613

11  or the consumer advocate's designee.

12  

13  Each board member shall serve a 4-year term and may serve

14  consecutive terms. A vacancy on the board shall be filled in

15  the same manner as the original appointment for the unexpired

16  portion of the term. The Financial Services Commission shall

17  designate a member of the board to serve as chair. The

18  Financial Services Commission may remove any member for cause.

19  No board member shall be an insurer which provides services to

20  the plan or which has an affiliate which provides services to

21  the plan or which is serviced by a service company or

22  third-party administrator which provides services to the plan

23  or which has an affiliate which provides services to the plan.

24  The meeting minutes, audits, and procedures of the board of

25  governors are subject to chapters chapter 119 and 286, unless

26  otherwise provided.

27         (c)  The operation of the plan shall be governed by a

28  plan of operation that is prepared at the direction of the

29  board of governors. The plan of operation may be changed at

30  any time by the board of governors or upon request of the

31  office. The plan of operation and all changes thereto are

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    Florida Senate - 2005                           CS for SB 1590
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 1  subject to the approval of the office. The plan of operation

 2  shall:

 3         1.  Authorize the board to engage in the activities

 4  necessary to implement this subsection, including, but not

 5  limited to, borrowing money.

 6         2.  Develop criteria for eligibility for coverage by

 7  the plan, including, but not limited to, documented rejection

 8  by at least two insurers which reasonably assures that

 9  insureds covered under the plan are unable to acquire coverage

10  in the voluntary market.

11         3.  Require notice from the agent to the insured at the

12  time of the application for coverage that the application is

13  for coverage with the plan and that coverage may be available

14  through an insurer, group self-insurers' fund, commercial

15  self-insurance fund, or assessable mutual insurer through

16  another agent at a lower cost.

17         4.  Establish programs to encourage insurers to provide

18  coverage to applicants of the plan in the voluntary market and

19  to insureds of the plan, including, but not limited to:

20         a.  Establishing procedures for an insurer to use in

21  notifying the plan of the insurer's desire to provide coverage

22  to applicants to the plan or existing insureds of the plan and

23  in describing the types of risks in which the insurer is

24  interested. The description of the desired risks must be on a

25  form developed by the plan.

26         b.  Developing forms and procedures that provide an

27  insurer with the information necessary to determine whether

28  the insurer wants to write particular applicants to the plan

29  or insureds of the plan.

30         c.  Developing procedures for notice to the plan and

31  the applicant to the plan or insured of the plan that an

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    Florida Senate - 2005                           CS for SB 1590
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 1  insurer will insure the applicant or the insured of the plan,

 2  and notice of the cost of the coverage offered; and developing

 3  procedures for the selection of an insuring entity by the

 4  applicant or insured of the plan.

 5         d.  Provide for a market-assistance plan to assist in

 6  the placement of employers. All applications for coverage in

 7  the plan received 45 days before the effective date for

 8  coverage shall be processed through the market-assistance

 9  plan. A market-assistance plan specifically designed to serve

10  the needs of small, good policyholders as defined by the board

11  must be finalized by January 1, 1994.

12         5.  Provide for policy and claims services to the

13  insureds of the plan of the nature and quality provided for

14  insureds in the voluntary market.

15         6.  Provide for the review of applications for coverage

16  with the plan for reasonableness and accuracy, using any

17  available historic information regarding the insured.

18         7.  Provide for procedures for auditing insureds of the

19  plan which are based on reasonable business judgment and are

20  designed to maximize the likelihood that the plan will collect

21  the appropriate premiums.

22         8.  Authorize the plan to terminate the coverage of and

23  refuse future coverage for any insured that submits a

24  fraudulent application to the plan or provides fraudulent or

25  grossly erroneous records to the plan or to any service

26  provider of the plan in conjunction with the activities of the

27  plan.

28         9.  Establish service standards for agents who submit

29  business to the plan.

30         10.  Establish criteria and procedures to prohibit any

31  agent who does not adhere to the established service standards

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    Florida Senate - 2005                           CS for SB 1590
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 1  from placing business with the plan or receiving, directly or

 2  indirectly, any commissions for business placed with the plan.

 3         11.  Provide for the establishment of reasonable safety

 4  programs for all insureds in the plan. All insureds of the

 5  plan must participate in the safety program.

 6         12.  Authorize the plan to terminate the coverage of

 7  and refuse future coverage to any insured who fails to pay

 8  premiums or surcharges when due; who, at the time of

 9  application, is delinquent in payments of workers'

10  compensation or employer's liability insurance premiums or

11  surcharges owed to an insurer, group self-insurers' fund,

12  commercial self-insurance fund, or assessable mutual insurer

13  licensed to write such coverage in this state; or who refuses

14  to substantially comply with any safety programs recommended

15  by the plan.

16         13.  Authorize the board of governors to provide the

17  services required by the plan in the most cost-effective and

18  efficient manner through staff employed by the plan, through

19  reasonably compensated service providers who contract with the

20  plan to provide services as specified by the board of

21  governors, or through a combination of employees and service

22  providers.

23         14.  Provide for service standards for service

24  providers, methods of determining adherence to those service

25  standards, incentives and disincentives for service, and

26  procedures for terminating contracts for service providers

27  that fail to adhere to service standards.

28         15.  Provide procedures for the competitive selection

29  of selecting service providers and standards for qualification

30  as a service provider that reasonably assure that any service

31  provider selected will continue to operate as an ongoing

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    Florida Senate - 2005                           CS for SB 1590
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 1  concern and is capable of providing the specified services in

 2  the manner required. If the board of governors undertakes to

 3  procure services from a servicing carrier required by the

 4  plan, the board of governors shall provide reasonable notice

 5  to potential service providers of its intent to solicit bids

 6  for the procurement of such services by publishing a notice in

 7  the Florida Administrative Weekly and at least one newspaper

 8  of general circulation in this state, or in at least two

 9  business trade journals.

10         16.  Provide for reasonable accounting and

11  data-reporting practices.

12         17.  Provide for annual review of costs associated with

13  the general administration of the plan and the administration

14  and servicing of the policies issued by the plan to determine

15  alternatives by which costs can be reduced and goods and

16  services can be procured and provided in the most

17  cost-effective and efficient manner.

18         18.  Authorize the acquisition of such excess insurance

19  or reinsurance as is consistent with the purposes of the plan.

20         19.  Provide for an annual report to the office on a

21  date specified by the office and containing such information

22  as the office reasonably requires.

23         20.  Establish multiple rating plans for various

24  classifications of risk which reflect risk of loss, hazard

25  grade, actual losses, size of premium, and compliance with

26  loss control. At least one of such plans must be a

27  preferred-rating plan to accommodate small-premium

28  policyholders with good experience as defined in

29  sub-subparagraph 22.a.

30         21.  Establish agent commission schedules.

31  

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 1         22.  For employers otherwise eligible for coverage

 2  under the plan, establish three tiers of employers meeting the

 3  criteria and subject to the rate limitations specified in this

 4  subparagraph.

 5         a.  Tier One.--

 6         (I)  Criteria; rated employers.--An employer that has

 7  an experience modification rating shall be included in Tier

 8  One if the employer meets all of the following:

 9         (A)  The experience modification is below 1.00.

10         (B)  The employer had no lost-time claims subsequent to

11  the applicable experience modification rating period.

12         (C)  The total of the employer's medical-only claims

13  subsequent to the applicable experience modification rating

14  period did not exceed 20 percent of premium.

15         (II)  Criteria; non-rated employers.--An employer that

16  does not have an experience modification rating shall be

17  included in Tier One if the employer meets all of the

18  following:

19         (A)  The employer had no lost-time claims for the

20  3-year period immediately preceding the inception date or

21  renewal date of the employer's coverage under the plan.

22         (B)  The total of the employer's medical-only claims

23  for the 3-year period immediately preceding the inception date

24  or renewal date of the employer's coverage under the plan did

25  not exceed 20 percent of premium.

26         (C)  The employer has secured workers' compensation

27  coverage for the entire 3-year period immediately preceding

28  the inception date or renewal date of the employer's coverage

29  under the plan.

30         (D)  The employer is able to provide the plan with a

31  loss history generated by the employer's prior workers'

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    Florida Senate - 2005                           CS for SB 1590
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 1  compensation insurer, except if the employer is not able to

 2  produce a loss history due to the insolvency of an insurer,

 3  the receiver shall provide to the plan, upon the request of

 4  the employer or the employer's agent, a copy of the employer's

 5  loss history from the records of the insolvent insurer if the

 6  loss history is contained in records of the insurer which are

 7  in the possession of the receiver. If the receiver is unable

 8  to produce the loss history, the employer may, in lieu of the

 9  loss history, submit an affidavit from the employer and the

10  employer's insurance agent setting forth the loss history.

11         (E)  The employer is not a new business.

12         (III)  Premiums.--The premiums for Tier One insureds

13  shall be set at a premium level 25 percent above the

14  comparable voluntary market premiums until the plan has

15  sufficient experience as determined by the board to establish

16  an actuarially sound rate for Tier One, at which point the

17  board shall, subject to paragraph (e), adjust the rates, if

18  necessary, to produce actuarially sound rates, provided such

19  rate adjustment shall not take effect prior to January 1,

20  2007.

21         b.  Tier Two.--

22         (I)  Criteria; rated employers.--An employer that has

23  an experience modification rating shall be included in Tier

24  Two if the employer meets all of the following:

25         (A)  The experience modification is equal to or greater

26  than 1.00 but not greater than 1.10.

27         (B)  The employer had no lost-time claims subsequent to

28  the applicable experience modification rating period.

29         (C)  The total of the employer's medical-only claims

30  subsequent to the applicable experience modification rating

31  period did not exceed 20 percent of premium.

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    Florida Senate - 2005                           CS for SB 1590
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 1         (II)  Criteria; non-rated employers.--An employer that

 2  does not have any experience modification rating shall be

 3  included in Tier Two if the employer is a new business. An

 4  employer shall be included in Tier Two if the employer has

 5  less than 3 years of loss experience in the 3-year period

 6  immediately preceding the inception date or renewal date of

 7  the employer's coverage under the plan and the employer meets

 8  all of the following:

 9         (A)  The employer had no lost-time claims for the

10  3-year period immediately preceding the inception date or

11  renewal date of the employer's coverage under the plan.

12         (B)  The total of the employer's medical-only claims

13  for the 3-year period immediately preceding the inception date

14  or renewal date of the employer's coverage under the plan did

15  not exceed 20 percent of premium.

16         (C)  The employer is able to provide the plan with a

17  loss history generated by the workers' compensation insurer

18  that provided coverage for the portion or portions of such

19  period during which the employer had secured workers'

20  compensation coverage, except if the employer is not able to

21  produce a loss history due to the insolvency of an insurer,

22  the receiver shall provide to the plan, upon the request of

23  the employer or the employer's agent, a copy of the employer's

24  loss history from the records of the insolvent insurer if the

25  loss history is contained in records of the insurer which are

26  in the possession of the receiver. If the receiver is unable

27  to produce the loss history, the employer may, in lieu of the

28  loss history, submit an affidavit from the employer and the

29  employer's insurance agent setting forth the loss history.

30         (III)  Premiums.--The premiums for Tier Two insureds

31  shall be set at a rate level 50 percent above the comparable

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 1  voluntary market premiums until the plan has sufficient

 2  experience as determined by the board to establish an

 3  actuarially sound rate for Tier Two, at which point the board

 4  shall, subject to paragraph (e), adjust the rates, if

 5  necessary, to produce actuarially sound rates, provided such

 6  rate adjustment shall not take effect prior to January 1,

 7  2007.

 8         c.  Tier Three.--

 9         (I)  Eligibility.--An employer shall be included in

10  Tier Three if the employer does not meet the criteria for Tier

11  One or Tier Two.

12         (II)  Rates.--The board shall establish, subject to

13  paragraph (e), and the plan shall charge, actuarially sound

14  rates for Tier Three insureds.

15         23.  For Tier One or Tier Two employers which employ no

16  nonexempt employees or which report payroll which is less than

17  the minimum wage hourly rate for one full-time employee for 1

18  year at 40 hours per week, the plan shall establish

19  actuarially sound premiums, provided, however, that the

20  premiums may not exceed $2,500. These premiums shall be in

21  addition to the fee specified in subparagraph 26. When the

22  plan establishes actuarially sound rates for all employers in

23  Tier One and Tier Two, the premiums for employers referred to

24  in this paragraph are no longer subject to the $2,500 cap.

25         24.  Provide for a depopulation program to reduce the

26  number of insureds in the plan. If an employer insured through

27  the plan is offered coverage from a voluntary market carrier:

28         a.  During the first 30 days of coverage under the

29  plan;

30         b.  Before a policy is issued under the plan;

31  

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    Florida Senate - 2005                           CS for SB 1590
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 1         c.  By issuance of a policy upon expiration or

 2  cancellation of the policy under the plan; or

 3         d.  By assumption of the plan's obligation with respect

 4  to an in-force policy,

 5  

 6  that employer is no longer eligible for coverage through the

 7  plan. The premium for risks assumed by the voluntary market

 8  carrier must be no greater than the premium the insured would

 9  have paid under the plan, and shall be adjusted upon renewal

10  to reflect changes in the plan rates and the tier for which

11  the insured would qualify as of the time of renewal. The

12  insured may be charged such premiums only for the first 3

13  years of coverage in the voluntary market. A premium under

14  this subparagraph is deemed approved and is not an excess

15  premium for purposes of s. 627.171.

16         25.  Require that policies issued and applications must

17  include a notice that the policy could be replaced by a policy

18  issued from a voluntary market carrier and that, if an offer

19  of coverage is obtained from a voluntary market carrier, the

20  policyholder is no longer eligible for coverage through the

21  plan. The notice must also specify that acceptance of coverage

22  under the plan creates a conclusive presumption that the

23  applicant or policyholder is aware of this potential.

24         26.  Require that each application for coverage and

25  each renewal premium be accompanied by a nonrefundable fee of

26  $475 to cover costs of administration and fraud prevention.

27  The board may, with the approval of the office, increase the

28  amount of the fee pursuant to a rate filing to reflect

29  increased costs of administration and fraud prevention. The

30  fee is not subject to commission and is fully earned upon

31  commencement of coverage.

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    Florida Senate - 2005                           CS for SB 1590
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 1         (d)1.  The funding of the plan shall include premiums

 2  as provided in subparagraph (c)22. and assessments as provided

 3  in this paragraph.

 4         2.a.  If the board determines that a deficit exists in

 5  Tier One or Tier Two or that there is any deficit remaining

 6  attributable to any of the plan's former subplans and that the

 7  deficit cannot be funded without the use of deficit

 8  assessments, the board shall request the office to levy, by

 9  order, a deficit assessment against premiums charged to

10  insureds for workers' compensation insurance by insurers as

11  defined in s. 631.904(5). The office shall issue the order

12  after verifying the amount of the deficit. The assessment

13  shall be specified as a percentage of future premium

14  collections, as recommended by the board and approved by the

15  office. The same percentage shall apply to premiums on all

16  workers' compensation policies issued or renewed during the

17  12-month period beginning on the effective date of the

18  assessment, as specified in the order.

19         b.  With respect to each insurer collecting premiums

20  that are subject to the assessment, the insurer shall collect

21  the assessment at the same time as the insurer collects the

22  premium payment for each policy and shall remit the

23  assessments collected to the plan as provided in the order

24  issued by the office. The office shall verify the accurate and

25  timely collection and remittance of deficit assessments and

26  shall report such information to the board. Each insurer

27  collecting assessments shall provide such information with

28  respect to premiums and collections as may be required by the

29  office to enable the office to monitor and audit compliance

30  with this paragraph.

31  

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 1         c.  Deficit assessments are not considered part of an

 2  insurer's rate, are not premium, and are not subject to the

 3  premium tax, to the assessments under ss. 440.49 and 440.51,

 4  to the surplus lines tax, to any fees, or to any commissions.

 5  The deficit assessment imposed shall become plan funds at the

 6  moment of collection and shall not constitute income to the

 7  insurer for any purpose, including financial reporting on the

 8  insurer's income statement. An insurer is liable for all

 9  assessments that the insurer collects and must treat the

10  failure of an insured to pay an assessment as a failure to pay

11  premium. An insurer is not liable for uncollectible

12  assessments.

13         d.  When an insurer is required to return unearned

14  premium, the insurer shall also return any collected

15  assessments attributable to the unearned premium.

16         e.  Deficit assessments as described in this

17  subparagraph shall not be levied after July 1, 2007.

18         3.a.  All policies issued to Tier Three insureds shall

19  be assessable. All Tier Three assessable policies must be

20  clearly identified as assessable by containing, in contrasting

21  color and in not less than 10-point type, the following

22  statement:

23  

24         "This is an assessable policy. If the plan is

25         unable to pay its obligations, policyholders

26         will be required to contribute on a pro rata

27         earned premium basis the money necessary to

28         meet any assessment levied."

29  

30         b.  The board may from time to time assess Tier Three

31  insureds to whom the plan has issued assessable policies for

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 1  the purpose of funding plan deficits. Any such assessment

 2  shall be based upon a reasonable actuarial estimate of the

 3  amount of the deficit, taking into account the amount needed

 4  to fund medical and indemnity reserves and reserves for

 5  incurred but not reported claims, and allowing for general

 6  administrative expenses, the cost of levying and collecting

 7  the assessment, a reasonable allowance for estimated

 8  uncollectible assessments, and allocated and unallocated loss

 9  adjustment expenses.

10         c.  Each Tier Three insured's share of a deficit shall

11  be computed by applying to the premium earned on the insured's

12  policy or policies during the period to be covered by the

13  assessment the ratio of the total deficit to the total

14  premiums earned during such period upon all policies subject

15  to the assessment. If one or more Tier Three insureds fail to

16  pay an assessment, the other Tier Three insureds shall be

17  liable on a proportionate basis for additional assessments to

18  fund the deficit. The plan may compromise and settle

19  individual assessment claims without affecting the validity of

20  or amounts due on assessments levied against other insureds.

21  The plan may offer and accept discounted payments for

22  assessments which are promptly paid. The plan may offset the

23  amount of any unpaid assessment against unearned premiums

24  which may otherwise be due to an insured. The plan shall

25  institute legal action when necessary and appropriate to

26  collect the assessment from any insured who fails to pay an

27  assessment when due.

28         d.  The venue of a proceeding to enforce or collect an

29  assessment or to contest the validity or amount of an

30  assessment shall be in the Circuit Court of Leon County.

31  

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 1         e.  If the board finds that a deficit in Tier Three

 2  exists for any period and that an assessment is necessary, the

 3  board shall certify to the office the need for an assessment.

 4  No sooner than 30 days after the date of such certification,

 5  the board shall notify in writing each insured who is to be

 6  assessed that an assessment is being levied against the

 7  insured, and informing the insured of the amount of the

 8  assessment, the period for which the assessment is being

 9  levied, and the date by which payment of the assessment is

10  due. The board shall establish a date by which payment of the

11  assessment is due, which shall be no sooner than 30 days nor

12  later than 120 days after the date on which notice of the

13  assessment is mailed to the insured.

14         f.  Whenever the board makes a determination that the

15  plan does not have a sufficient cash basis to meet 3 months of

16  projected cash needs due to a deficit in Tier Three, the board

17  may request the department to transfer funds from the Workers'

18  Compensation Administration Trust Fund to the plan in an

19  amount sufficient to fund the difference between the amount

20  available and the amount needed to meet a 3-month projected

21  cash need as determined by the board and verified by the

22  office, subject to the approval of the Legislative Budget

23  Commission. If the Legislative Budget Commission approves a

24  transfer of funds under this sub-subparagraph, the plan shall

25  report to the Legislature the transfer of funds and the

26  Legislature shall review the plan during the next legislative

27  session or the current legislative session, if the transfer

28  occurs during a legislative session. This sub-subparagraph

29  shall not apply until the plan determines and the office

30  verifies that assessments collected by the plan pursuant to

31  

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 1  sub-subparagraph b. are insufficient to fund the deficit in

 2  Tier Three and to meet 3 months of projected cash needs.

 3         4.  The plan may offer rating, dividend plans, and

 4  other plans to encourage loss prevention programs.

 5         (e)  The plan shall file with the office each manual of

 6  classifications, rules, and rates; each rating plan; and each

 7  modification pursuant to the requirements of this part which

 8  applies to workers' compensation insurers. The office shall

 9  review and approve or disapprove the filing pursuant to such

10  requirements and the requirements of this section establish

11  and use its rates and rating plans, and the plan may establish

12  and use changes in rating plans at any time, but no more

13  frequently than two times per any rating class for any

14  calendar year. By January 1 December 1, 1993, and December 1

15  of each year thereafter, except as provided in subparagraph

16  (c)22., the board shall establish and use actuarially sound

17  rates approved by the office for use by the plan to assure

18  that the plan is self-funding while those rates are in effect.

19  Such rates and rating plans must be filed with the office

20  within 30 calendar days after their effective dates, and shall

21  be considered a "use and file" filing. Any disapproval by the

22  office must have an effective date that is at least 60 days

23  from the date of disapproval of the rates and rating plan and

24  must have prospective effect only. The plan may not be subject

25  to any order by the office to return to policyholders any

26  portion of the rates disapproved by the office. The office may

27  not disapprove any rates or rating plans unless it

28  demonstrates that such rates and rating plans are excessive,

29  inadequate, or unfairly discriminatory.

30         (f)  No later than June 1 of each year, the plan shall

31  obtain an independent actuarial certification of the results

                                  17

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 1  of the operations of the plan for prior years, and shall

 2  furnish a copy of the certification to the office. If, after

 3  the effective date of the plan, the projected ultimate

 4  incurred losses and expenses and dividends for prior years

 5  exceed collected premiums, accrued net investment income, and

 6  prior assessments for prior years, the certification is

 7  subject to review and approval by the office before it becomes

 8  final.

 9         (g)  Whenever a deficit exists, the plan shall, within

10  90 days, provide the office with a program to eliminate the

11  deficit within a reasonable time. The deficit may be funded

12  through increased premiums charged to insureds of the plan for

13  subsequent years, through the use of policyholder surplus

14  attributable to any year, through the use of assessments as

15  provided in subparagraph (d)2., and through assessments on

16  assessable policies as provided in subparagraph (d)3.

17         (h)  Any premium or assessments collected by the plan

18  in excess of the amount necessary to fund projected ultimate

19  incurred losses and expenses of the plan and not paid to

20  insureds of the plan in conjunction with loss prevention or

21  dividend programs shall be retained by the plan for future

22  use. Any state funds received by the plan in excess of the

23  amount necessary to fund deficits in subplan "D" or any tier

24  shall be returned to the state.

25         (i)  The decisions of the board of governors do not

26  constitute final agency action and are not subject to chapter

27  120.

28         (j)  Policies for insureds shall be issued by the plan.

29         (k)  The plan created under this subsection is liable

30  only for payment for losses arising under policies issued by

31  

                                  18

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 1  the plan with dates of accidents occurring on or after January

 2  1, 1994.

 3         (l)  Plan losses are the sole and exclusive

 4  responsibility of the plan, and payment for such losses must

 5  be funded in accordance with this subsection and must not

 6  come, directly or indirectly, from insurers or any guaranty

 7  association for such insurers.

 8         (m)  Each joint underwriting plan or association

 9  created under this section is not a state agency, board, or

10  commission. However, for the purposes of s. 199.183(1) only,

11  the joint underwriting plan is a political subdivision of the

12  state and is exempt from the corporate income tax.

13         (n)  Each joint underwriting plan or association may

14  elect to pay premium taxes on the premiums received on its

15  behalf or may elect to have the member insurers to whom the

16  premiums are allocated pay the premium taxes if the member

17  insurer had written the policy. The joint underwriting plan or

18  association shall notify the member insurers and the

19  Department of Revenue by January 15 of each year of its

20  election for the same year. As used in this paragraph, the

21  term "premiums received" means the consideration for

22  insurance, by whatever name called, but does not include any

23  policy assessment or surcharge received by the joint

24  underwriting association as a result of apportioning losses or

25  deficits of the association pursuant to this section.

26         (m)(o)  Neither the plan nor any member of the board of

27  governors is liable for monetary damages to any person for any

28  statement, vote, decision, or failure to act, regarding the

29  management or policies of the plan, unless:

30         1.  The member breached or failed to perform her or his

31  duties as a member; and

                                  19

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 1         2.  The member's breach of, or failure to perform,

 2  duties constitutes:

 3         a.  A violation of the criminal law, unless the member

 4  had reasonable cause to believe her or his conduct was not

 5  unlawful. A judgment or other final adjudication against a

 6  member in any criminal proceeding for violation of the

 7  criminal law estops that member from contesting the fact that

 8  her or his breach, or failure to perform, constitutes a

 9  violation of the criminal law; but does not estop the member

10  from establishing that she or he had reasonable cause to

11  believe that her or his conduct was lawful or had no

12  reasonable cause to believe that her or his conduct was

13  unlawful;

14         b.  A transaction from which the member derived an

15  improper personal benefit, either directly or indirectly; or

16         c.  Recklessness or any act or omission that was

17  committed in bad faith or with malicious purpose or in a

18  manner exhibiting wanton and willful disregard of human

19  rights, safety, or property. For purposes of this

20  sub-subparagraph, the term "recklessness" means the acting, or

21  omission to act, in conscious disregard of a risk:

22         (I)  Known, or so obvious that it should have been

23  known, to the member; and

24         (II)  Known to the member, or so obvious that it should

25  have been known, to be so great as to make it highly probable

26  that harm would follow from such act or omission.

27         (n)(p)  No insurer shall provide workers' compensation

28  and employer's liability insurance to any person who is

29  delinquent in the payment of premiums, assessments, penalties,

30  or surcharges owed to the plan or to any person who is an

31  affiliated person of a person who is delinquent in the payment

                                  20

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 1  of premiums, assessments, penalties, or surcharges owed to the

 2  plan. For purposes of this paragraph, the term "affiliated

 3  person" of another person means:

 4         1.  The spouse of such other natural person;

 5         2.  Any person who directly or indirectly owns or

 6  controls, or holds with the power to vote, 5 percent or more

 7  of the outstanding voting securities of such other person;

 8         3.  Any person who directly or indirectly owns 5

 9  percent or more of the outstanding voting securities that are

10  directly or indirectly owned or controlled, or held with the

11  power to vote, by such other person;

12         4.  Any person or group of persons who directly or

13  indirectly control, are controlled by, or are under common

14  control with such other person;

15         5.  Any officer, director, trustee, partner, owner,

16  manager, joint venturer, or employee, or other person

17  performing duties similar to persons in those positions, of

18  such other persons; or

19         6.  Any person who has an officer, director, trustee,

20  partner, or joint venturer in common with such other person.

21         (o)(q)  Effective July 1, 2004, the plan is exempt from

22  the premium tax under s. 624.509 and any assessments under ss.

23  440.49 and 440.51.

24         (6)  Each joint underwriting plan or association

25  created under this section is not a state agency, board, or

26  commission. However, for the purposes of s. 199.183(1) only,

27  the joint underwriting plan created under subsection (5) is a

28  political subdivision of the state and is exempt from the

29  corporate income tax.

30         (7)  Each joint underwriting plan or association may

31  elect to pay premium taxes on the premiums received on its

                                  21

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    Florida Senate - 2005                           CS for SB 1590
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 1  behalf or may elect to have the member insurers to whom the

 2  premiums are allocated pay the premium taxes if the member

 3  insurer had written the policy. The joint underwriting plan or

 4  association shall notify the member insurers and the

 5  Department of Revenue by January 15 of each year of its

 6  election for the same year. As used in this paragraph, the

 7  term "premiums received" means the consideration for

 8  insurance, by whatever name called, but does not include any

 9  policy assessment or surcharge received by the joint

10  underwriting association as a result of apportioning losses or

11  deficits of the association pursuant to this section.

12         (8)(6)  As used in this section and ss. 215.555 and

13  627.351, the term "collateral protection insurance" means

14  commercial property insurance of which a creditor is the

15  primary beneficiary and policyholder and which protects or

16  covers an interest of the creditor arising out of a credit

17  transaction secured by real or personal property. Initiation

18  of such coverage is triggered by the mortgagor's failure to

19  maintain insurance coverage as required by the mortgage or

20  other lending document. Collateral protection insurance is not

21  residential coverage.

22         (9)(7)(a)  The Florida Automobile Joint Underwriting

23  Association created under this section shall be deemed to have

24  appointed its general manager as its agent to receive service

25  of all legal process issued against the association in any

26  civil action or proceeding in this state. Process so served

27  shall be valid and binding upon the insurer.

28         (b)  Service of process upon the association's general

29  manager as the association's agent pursuant to such an

30  appointment shall be the sole method of service of process

31  upon the association.

                                  22

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 1         Section 2.  This act shall take effect October 1, 2005.

 2  

 3          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
 4                         Senate Bill 1590

 5                                 

 6  Corrects two cross references and clarifies a reference to the
    Workers' Compensation Joint Underwriting Association.
 7  

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