Current through Register Vol. 49, No. 9, September, 2024
PART
I
GENERAL - ALL SELF-INSURERS
A.
Definitions. When used in
these rules, the following words or terms shall have the meaning as described
in this section.
(1) Certified Audit - an
audit upon, which the auditor expresses his professional opinion that the
accompanying statements present fairly the financial position of the
Self-Insurer or fund in conformity with generally accepted accounting
principles consistently applied, and accordingly including such tests of the
accounting records and other auditing procedures as considered necessary in the
circumstances.
(2) Common
Self-Insurer - employers who are members of the same trade or professional
association entering into agreement to pool their liabilities.
(3) Conditional Reserves - acceptable assets
equal to the security deposit requirement plus any additional contingent
reserves established by the trustees or required by the Commission.
(4) Contingent Liability - the amount that a
Self-Insurer's fund may be obliged to pay in excess of a given fund year's
standard premium collected or on hand. This liability is considered funded if a
security deposit equal to the total amount of the contingent liability has been
posted. This liability is considered unfunded if a surety bond has been posted
equal to all or a portion of the total amount of the contingent
liability.
(5) Current Ratio - the
ratio of current assets to current liabilities as shown in the most recent
financial statement.
(6) Group -
Common Self-Insurer or Homogeneous Self-Insurer.
(7) Homogeneous Self-Insurer - employers who
are engaged in the same type of business activity or pursuit entering into
agreement to pool their liabilities.
(8) Manual Premium - premium determined by
multiplying the payroll (segregated into the proper workers' compensation job
classifications) times the appropriate manual premium rates, or limited
payrolls as promulgated by the National Council on Compensation
Insurance.
(9) Loss Development -
the change in incurred loss from one point .in time to another.
(10) Loss Fund - the retention of liability
for a Self-Insurer, either Individual Self-Insurer or Group Self-Insurer, under
the terms of an aggregate excess contract. In the absence of an aggregate
excess policy, it is the amount of money allocated to pay claims.
(11) Net Safety Factor - any amount needed in
a given fund year in addition to current loss reserves to fund future loss
development.
(12) Service Company -
a business which has met all the requirements of Part
I, E and which has obtained
Commission approval to contract with Self-I
nsurers for the purpose of providing all services necessary to plan and
maintain an approved Self-I nsurer program.
The term 'Service Agent" is synonymous with the term 'Service Company" as used
in these rules.
(13) Surplus - all
other assets a fund may have on hand in excess of all loss reserves, actual and
contingent liabilities and net safety factors in all fund years.
(14) Trustees - a group of members elected by
a Group Self-I nsurer for stated terms of
office, to direct the administration of a Group Self-I
nsurer, and whose duties shall include responsibility for approving
applications for new members in such group. The majority of such trustees must
be members of the group, but a trustee shall not be an owner, officer or
employee of the service agent. They may delegate ministerial authority for
membership approval to such person as they select, provided that person is not
an owner, officer or employee of the service agent.
(15) Trustee's Fund - any fund under the
control of the board of trustees of a Group Self-I
nsurer which is not part of the loss fund or which is not required to pay
claims.
(16) Common Claim Fund - a
fund maintained by a Group Self-I nsurer for the
sole purpose of paying claims imposed by the provisions of the Arkansas
Workers' Compensation Act.
(17)
Working Capital or Net Current Assets - current assets less current
liabilities.
B.
Acceptable Securities
(1) The securities
acceptable to the Commission as a security-deposit shall be Certificates of
Deposit issued by a State Chartered Bank or a National Chartered Bank in the
State of Arkansas. The securities acceptable to the Commission as a security
deposit shall include surety bonds in a form prescribed by the Commission which
are issued by any corporate surety which meets the qualifications prescribed in
Part I, B, (2) of this rule. The securities acceptable to the Commission as a
security deposit shall also include Letters of Credit in a form prescribed and
approved by the Commission. These three approved methods of posting security
must follow strict compliance with this rule.
(2) Any corporate surety, to be eligible for
writing Self-Insurers ' bonds in the State of Arkansas, shall be an admitted or
approved carrier by the Insurance Commissioner of the State of Arkansas to
transact such a business in the State, and its latest financial statement on
file with the Insurance Commissioner shall at all times show assets, including
surplus to policyholders, at least equal to the latest Insurance Commissioner
requirement for admission of a new company to do business in the State. Any
securities held by the Commission may be exchanged or replaced by the depositor
with other securities of like nature and amount. Any surety bond may be
exchanged or replaced with another surety bond provided the required thirty
(30) day notice of termination of liability is given to the Commission.
Whenever an employer discontinues business in the State or desires to terminate
his status as a Self-Insurer, or desires to replace securities with a Surety
Bond, he shall so notify the Commission and may recover the securities
deposited with the Commission upon posting in lieu thereof a special release
bond issued by a corporate surety in an amount equal to the total value of such
securities. The special release bond shall cover all existing liabilities under
the Act and shall remain in force for a period in accordance with the Statute
of Limitations as specified in the Act, and until such time, to be determined
by the Commission, as all obligation under the Act have been fully discharged.
The Commission shall be authorized to bring suit upon any surety bond so
posted, to procure prompt payment of compensation liabilities. other reports
and statements at such time and in such manner as the Commission shall require.
This rule places this responsibility on the employers, groups and service
companies to perform their prescribed duties and responsibilities without
prompting from the Commission. Failure or refusal of any Self-Insurer or Group
to file the prescribed reports with the Commission within the prescribed time
period shall subject the mentioned Self-Insurer to a civil penalty in such
amount as the Commission may prescribe, not to exceed $100 per infraction per
day, and shall be sufficient cause for the revocation of the Self-Insurer
privilege. Failure to pay such penalty within thirty (30) days of notification
shall be considered good cause for revocation of the Self-Insurer
privilege.
(2) The Commission shall
require annual or otherwise periodic payroll audits from each employer, or
group of employers, self-insured under the Act to determine the proper
assessment for tax purposes. The amount of tax shall be based upon the rates
promulgated from time to time by the National Council on Compensation
Insurance. The tax is limited by law at 3 percent of the tabulated manual
premium for each Self-Insurer. Each Individual Self-Insurer or Group shall
maintain a true and accurate payroll record, which shall be made available
during reasonable business hours, upon demand, to the Commission and its
authorized representatives. Unless payroll records are maintained in such
manner that a true and accurate division by departments or occupational
classifications can readily be determined for proper rating, the entire payroll
shall be presumed to be within the classification to which the highest
insurance rate is applicable. If such audits reveal a deficiency in the amounts
reported to the Commission or amounts paid to the Commission, the Commission
may assess the cost of such audit against such Self-Insurer. This audit report
and payment of the proper tax is due on or before April 1 of each
year.
(3) Each Individual
Self-Insurer and Group shall file annual statements of financial condition with
the Commission in a form acceptable to the Commission. Individual Self-Insurers
must maintain a level of financial strength, financial position, and financial
ratios that would be required of any new applicant. These statements must be
prepared by a Certified Public Accountant and must be certified audits, except
that an Individual Self-Insurer may be allowed to submit another type of
statement acceptable to the Commission. Public employers entering the
Individual Self-Insurer Program may satisfy these requirements by furnishing
independent certified audits or by furnishing the most current audit report as
prepared by the Legislative Joint Auditing Committee. Any less requirements of
these annual statements will be at the discretion of the Commission. An
additional security deposit or surety bond may be required in the absence of a
certified audit. Interim financial reports may be required in addition to these
annual financial statements at the discretion of the Commission. This report is
due on or before April 1 of each year.
(4) Summary Loss Data will be filed with the
Commission by each Individual Self-Insurer or Group Self-Insurer under the Act.
This report shall be filed with the Commission on an annual basis, or on a
quarterly basis, or on any interim basis as prescribed by the Commission. This
report will be due within thirty (30) days after each prescribed evaluation
period, and unless otherwise directed, this report will be due not later than
February 1 of each year. This Self-Insurers' statement on this report will be
on a form prescribed by the Commission, and any substitute form must contain
all the requested data. This report will include but not be limited to the name
of the employer, name of the injured employee, claim number, date of accident,
nature of injury, amounts paid on the claim for indemnity, or medical and
outstanding reserves, if any. This report will cover all incurred losses of the
evaluation period as well as any pending claims where any type payment is made
or reserve is pending. This report will require reasonable reserves on all open
pending claims.
D.
Contracts for Excess Insurance
(1) Aggregate and specific excess insurance
with liability limits and retention amounts acceptable to the Commission may be
required as a condition of approval of any Individual Self-Insurer or Group
Self-Insurer as hereinafter provided, except qualifying public employer
self-insurer groups are entitled to statutory options and
limitations.
(2) Any casualty
insurance company to be eligible to write excess liability coverage for
Individual Self-Insurers or Group Self-Insurers in the State of Arkansas, shall
at all times meet the same standard as required of any corporate surety as
outlined in Part I, B (2).
(3) No
contract or policy of excess insurance shall be recognized by the Commission in
considering the ability of an applicant to fulfill its financial obligation
under the Workers' Compensation Act unless such contract or policy:
(a) Is issued by a recognized, admitted or
approved casualty insurance company with the minimum qualifications established
by these rules.
(b) Is not
cancellable except upon thirty (30) days written notice by registered or
certified mail to the other party to the policy and the Arkansas Workers'
Compensation Commission.
(c) Is
renewable at the expiration of the policy period unless written notice by
registered or certified mail is given to the other party to the policy and the
Arkansas Workers' Compensation Commission, thirty (30) days prior to such
expiration, by the party desiring to cancel or not to renew the
policy.
(d) If it contains any type
of commutation clause, provided (1) that any commutation effected thereunder
shall not relieve the underwriter (s) of further liability as respects claims
and expenses unknown at the- time of such commutation or in regard to claims
apparently closed but which may be subsequently revived by or through a
competent authority, and (2) that in the event the underwriter proposes to
redeem any future payments payable as compensation for accidents occurring
during the term of the policy by the payment of a lump sum to be fixed as
provided in the commutation clause of the policy, provided not less than thirty
(30) days prior notice of such commutation shall be given to the Arkansas
Workers' Compensation Commission by registered or certified mail by the
underwriter(s) or their agent.
(e)
In the event any commutation is permitted and effected, the Commission shall
have the right to direct that such sum either (1) be placed in trust for the
benefit of the injured employee(s) entitled to such future payments of
compensation, or (2) be invested in approved securities and deposited with the
Commission to assure such future payments of compensation to the employee(s)
entitled thereto.
(f) Contains the
provision that obligations due under the terms of the policy shall be made to a
party other than the employer, such party to be designated by the Commission if
it is deemed to be in the best interest of the employees covered by this
Act.
E.
Servicing for Self-Insurers; Qualifications for Service Companies
(1) Each Individual Self-Insurer or Group, as
a condition of approval to Self-Insure, shall be required to provide proof of
compliance with the provisions of this section regarding servicing
requirements.
(a) It shall be the sole
responsibility of each Individual Self-Insurer or Group to provide for
qualified persons to service its program in the areas of claims adjusting,
underwriting, safety engineering and loss control. Should the Individual
Self-Insurer or Group be unable or unwilling to provide any or all of these
services through the use of its own employees, then it shall contract with
outside agencies with established qualifications to provide these
services.
(b) In the case where an
Individual Self-Insurer or Group elects to contract with an approved service
company, the Commission may, at its discretion, choose to use the service
company as an intermediary in its dealings with the employer. In the case where
no service company is used, the Commission will deal with the employer
only.
(2) Any firm
desiring to become qualified as a service company for Individual Self-Insurers
or Groups shall make application to the Commission on such forms as may be
prescribed and the application must be approved before any contract for
servicing shall be recognized as fulfilling Part I, E, 1(a).
(3) Any firm making application to qualify as
a service company shall provide proof that it meets the following conditions
before approval may be granted:
(a) The owners
of the firm, including members of a co-partnership and the officers of the
corporation, shall be persons of good moral character with reputations for
honesty and fair dealings.
(b) The
firm must have a sufficient number of experienced and qualified claims
personnel. To represent a Group Self-Insurer client, the service company must
have at least one resident adjuster with check authority.
(c) That the firm has a sufficient number of
experienced and qualified personnel in the areas of loss control and safety
engineering to meet the needs of all Self-Insurers with which it intends to
contract.
(d) That the firm has a
sufficient number of experienced and qualified personnel in the area of
underwriting to meet the needs of all Self-Insurers with which it intends to
contract. In this context, underwriting includes, but is not limited to the
overall planning and- coordinating of a Self-Insurer program, the ability to
advise or assist in the procurement of bonds and excess insurance, the ability
to provide summary data regarding the Self-Insurer's costs of accidents
including the frequency and distribution by type and cause, and the skill to
make recommendations to the Self-Insurer regarding the correction of any
deficiencies that arise in the Self-Insurer program.
(e) The application for the privilege of
being a Service Company as defined herein shall be accompanied by a remittance
in the amount of $5 0, payable to the Arkansas Workers' Compensation
Commission. This fee will not be refunded, regardless of the disposition of the
application.
(4) In
support of its application the firm shall submit summary information concerning
its organization and resumes on all employees with administrative or
professional capacity sufficient to establish compliance with Part I, E
(3).
(5) Upon compliance to the
satisfaction of the Commission with the above provisions, a certificate of
approval as a recognized and authorized service organization shall be issued to
the applicant. Failure to comply with any of the foregoing rules or any order
of the Commission within the time prescribed shall be considered good cause for
withdrawal of the certificate of approval. The Commission shall give prior
written notice of such withdrawal. The service company shall have fifteen (15)
days from the date of mailing to request a hearing. Failure to request a
hearing within the time prescribed shall result in the withdrawal becoming
effective thirty (30) days from the date of mailing of the original notice. In
no event shall the withdrawal of the certificate of approval be effective prior
to the date that the hearing on the question is scheduled. Such notice shall be
served personally or by certified or registered mail upon all interested
parties.
(6) Each service company
shall file immediately upon entering into a contract or agreement for
servicing, notice of this contract or agreement with the Commission. It shall
be the responsibility of the Individual Self-Insurer or Group to obtain the
written permission of the Commission before changing its method of fulfilling
its servicing requirements from those which were previously approved by the
Commission.
(7) All firms which
desire to qualify as service companies shall make application and receive
approval from the Commission under the provisions of these rules before any new
or renewal contracts for servicing shall be recognized.
F.
Revocation or Termination of the
Self-Insurer Privilege(1) Failure to
comply with any of the rules or with any order of the Commission within the
time prescribed shall be considered good cause for revocation or termination of
Self-Insurer privilege, within the meaning of A.C.A.
11-9-404.
Noncompliance with any of the provisions of the Workers Compensation Act,
particularly those relating to time and method of compensation payments, the
furnishing of medical treatment and filing of accident and compensation reports
and failure to pay any assessment, shall likewise be deemed good cause. The
Commission shall give written notice of such revocation or termination to the
employer and/or his agent(s). The employer shall have fifteen (15) days from
the date of mailing of the notice to request a hearing on the revocation or
termination. Failure to request a hearing within the time prescribed shall
result in the revocation or termination becoming effective thirty (3 0) days
from the date of mailing of the original notice. In no event shall any
revocation or termination become effective prior to the date that a hearing on
the question is scheduled. Such notice shall be served personally or by
certified or registered mail upon all interested parties.
(2) It will be necessary for a Self-Insurer
to notify the Commission if the status of the Self-Insurer is materially
changed {Individual ownership to partnership or to corporation, merger, etc.)
at which time the new entity shall be required to qualify. In the event there
is a change in majority ownership of a Self-Insurer, the Self-Insurer privilege
granted to an individual Self-Insurer shall be at the discretion of the
Commission.
G.
Enforcement by Commission of Order of Compliance; Order of Denial; or
Order of Termination of Self-Insured Status
If the Commission has probable cause to believe that an order
denying or terminating Self-Insurer status is being violated or that an
employer who is approved or has been previously approved as a Self-Insurer is
liquidating or may be about to liquidate and distribute its assets to its
stockholders or to its members without providing for its obligation as a
Self-Insurer to pay or arrange for the payment of compensation and benefits as
prescribed for in the Act, the Commission may cause an action to be filed in
the Circuit Court of Pulaski County or in the county in which such person does
business to enjoin and restrain such person from engaging in such method, act,
or practice.
H. Tenure of
Authority
Certificates of Authority granting the privilege of being a
Self-Insurer for Workers' Compensation purposes shall expire on May 1 of each
year. To effect the renewal of the Certificate, the Self-Insurer must furnish
or have on file with the Commission, an acceptable financial statement for its
current fiscal year and must fully comply with the Law and the Rules of this
Commission. Certificates of Approval for Service Companies must be renewed on
an annual basis. Any information submitted by an employer in its application to
become a Self-Insurer or in its request for renewal of that authority will be
treated with strict confidence by the Commission. Any information submitted by
a service company in its application for approval or in its request for renewal
of that approval will be treated with strict confidence by the
Commission.
PART
II
INDIVIDUAL SELF-INSURER - APPLICATION
A. Each employer desiring to become a
Self-Insurer individually, as contemplated by A.C.A.
11-9-404,
shall make application to the Commission for such privilege on a form
prescribed by the Commission, and this application shall be filed with the
Commission sixty (60) days prior to the desired effective date. The application
shall contain answers to all questions propounded and shall be under
oath.
B. Before considering the
application, the Commission will require:
(1)
Financial statement of a current date showing a net worth of not less than
$250,000 and a current ratio of more than 1 to 1 and a working capital of an
amount establishing financial strength and liquidity of the business to pay
normal compensation claims promptly. The requirement for a more than 1 to 1
current ratio may be waived in the case of a public utility or in those
instances where generally recognized accounting principles peculiar to a
particular industry make this requirement unreasonable. In no event shall the
net worth be less than three (3) times the annual loss fund, or in the event
that aggregate excess insurance is not maintained, then the net worth shall be
at least three (3) times the Self-Insurer's annual standard premium. Financial
statements dated six (6) months or more prior to the date of application may be
required to be accompanied by an affidavit stating that there has been no
material lessening of net worth nor significant deterioration of current ratio
since the date of the statement.
(2) In considering the financial strength and
liquidity of the business to pay normal compensation claims, the Commission
will take into consideration contracts or policies of excess insurance in
accordance with Part I, D.
(3) Each
employer shall execute and file with the Commission an agreement, which shall
be part of their application, whereby he agrees (1) to fully discharge by cash
payment all amounts required to be paid by the provisions of the Act and (2) to
deposit with the Commission acceptable securities or corporate surety bond to
secure guarantee of payment of compensation liabilities unless waived by the
Commission.
(4) Each Individual
Self-Insurer shall satisfy the Commission that it has complied with the
provisions of Part I, E (1) and Rule
29 where applicable before
approval for Self-Insurer status may be granted by the Commission. In addition,
the Commission may require periodic proof that the Self-Insurer is complying
with these standards on a continuing basis.
(5) The application for the privilege of
being a Self-Insurer shall be accompanied by a remittance in the amount of
$100, payable to the Arkansas Workers' Compensation Commission. This fee will
not be refunded, regardless of the disposition of the application.
(6) Each Individual Self-Insurer shall
satisfy the Commission that it has complied with the requirements of the
Arkansas Self-Insurer Guaranty Fund.
(7) An investigation and study of the
financial and other capabilities of the Individual applicant to meet its
obligation under the Act, will be conducted by the Self-Insurer Department of
the Commission. The Self-Insurer Department of the Commission will submit an
evaluation report to the Commission, after which formal approval for
Self-Insurer status may be granted by the Commission.
C. Pursuant to A.C.A.
11-9-404,
each individually Self-Insured employer shall deposit with the Commission
acceptable securities or post a surety bond issued by a corporate surety
authorized to do business in the State of Arkansas except that the Commission
may waive the posting of any securities or surety bond by public employers all
in accordance with the following rules:
(1) In
every case where an application is favorably considered, the Commission will
then decide the amount of acceptable securities or surety bond which will be
required; provided, however, that in no case will the amount of securities or
surety bond be less than $100,000 except that the Commission may waive the
posting of any securities or surety bond by public employers. A majority owned
subsidiary of a Parent Company, duly admitted as a Self-Insurer, may not be
required to post securities or surety bond, provided the Parent Company, by
resolution, guarantees payment of the liabilities of the subsidiary.
(2) The minimum excess insurance requirements
that an Individually Self-Insured employer shall maintain shall be determined
by the Commission.
PART
III
GROUP SELF-I NSURER -
APPLICATION
A. In the case of group
coverage as contemplated by A.C.A.
11-9-404,
for the express purpose of establishing a Group Self-Insurer, to be
administered under the direction of an elected Board of Trustees, and to
provide Workers' Compensation coverage for a group of employers classified as
a' Common Self-Insurer Group or a Homogeneous Self-Insurer Group and who are
eligible for membership in accordance with the terms of the Indemnity
Agreement, application shall be made to the Workers' Compensation Commission at
least sixty (60) days prior to the desired effective date of Self-Insurer
status. Any application submitted with less than thirty (30) days remaining
before the desired effective date may be rejected without further
consideration. The application shall be made on forms prescribed by the
Commission and shall contain answers to all questions propounded and shall be
under oath.
(1) The application as submitted
by the Trustees of the Self-Insurer Group shall be accompanied by:
(a) An Indemnity Agreement jointly and
severally binding the Group and each member thereof to comply with the
provisions of the Arkansas Workers' Compensation Act and Rules and Regulations
of the Commission. The Indemnity Agreement requirement mentioned here and
elsewhere in this rule is not applicable to Public Employer Groups.
(b) Individual application of each member of
the Group applying for membership in the Self-Insurer Group on the inception
date of the Group.
(c) Current
financial statements supported by a certified audit of at least two members
showing the combined net worth of these members applying for Self-Insurer
status on the inception date of the Group Self-Insurer to be not less than
$1,000,000, a combined current ratio of more than 1 to 1 and a working capital
of an amount establishing financial strength and liquidity of the business to
pay normal compensation claims promptly and showing evidence of the financial
ability of the Group to meet its obligation under the Act. For members joining
the Group Self-Insurer after inception date or any time after initial
qualification of the group, a certified audited financial statement shall not
be required of any member of a group either for initial membership or as a
condition for continued membership, however, such certified audited financial
statement will be accepted. For members joining an established Private Employer
Self-Insurer Group they may provide in lieu of a certified audited financial
statement, a statement, certified by the president and treasurer of the member
in the case of a corporation, and by the owner and general partners,
respectively, in the case of an individual proprietorship or partnership, to
the effect that such financial statement is true and correct to the best of the
knowledge and belief of the signing authorities. For members joining an
established Public Employer Self-Insurer Group, they may provide in lieu of a
certified audited financial statement, a statement prepared by the Legislative
Joint Auditing Committee or a financial statement certified by the member
entity executive head and the member entity treasurer in the same manner as
required of private employer members.
(d) A set of by-laws governing the operation
of the Group Self-Insurer shall conform to the conditions specified in Part
III, D (1).
(e) The application for the privilege of
being a Group Self-Insurer shall be accompanied by a remittance in the amount
of $100, payable to the Arkansas Workers' Compensation Commission. This fee
will not be refunded, regardless of the disposition of the
application.
(f) Each Group
Self-Insurer shall satisfy the Commission that it has complied with the
requirements of the appropriate Guaranty Fund.
(2) Each Group Self-Insurer shall satisfy the
Commission that it has complied with the provisions of Part I, E (1) before
approval for Self-Insurer status may be granted by the Commission. In addition,
the Commission may require periodic proof that the Self-Insurer is complying
with these standards on a continuing basis.
(3) An investigation and study of the
financial and other capabilities of the Group applicant to meet their
obligation under the Act, will be conducted by the Self-Insurer Department of
the Commission. The Self-Insurer Department of the Commission will submit an
evaluation report to the Commission, after which formal approval for
Self-Insurer status may be granted by the Commission.
(4) Subsequent to the inception date of the
Group Self-Insurer, prospective new members of the Group Self-Insurer shall
submit an application on a form prescribed by the Commission for membership to
the Board of Trustees. The Trustees must approve the application for membership
in accordance with these rules and the terms of the Indemnity Agreement for the
application to be binding upon the Group Self-Insurer and prospective members.
The application for membership shall then be filed with the Commission thirty
(30) days prior to the desired effective date of Self-Insurer status. The
Trustees may "bind" coverage for an individual member for a period of 30 days.
If such a binder has been extended the Trustees must submit a completed
application with supporting documents to the Workers' Compensation Commission,
Group Self-Insurer Division within 15 days of the effective date of coverage.
This binder may be extended for a second 3 0 day period upon expiration of the
first 30 day period provided the Trustees have submitted the completed
application as required above. The Commission retains the right to
reject the admission of any new member. An acceptable financial statement as
heretofore set forth for all members joining the Group Self-Insurer after the
inception date shall be submitted to the Commission with the application for
membership.
B.
Minimum Security Deposit For Group Self-Insurer
Each Group Self-Insurer, pursuant to A.C.A.
11-9-404,
shall deposit and maintain with the Commission acceptable securities or post a
surety bond issued by a corporate surety duly authorized to do business in the
State of Arkansas, in an amount determined by the Commission, but not less than
Two Hundred Thousand Dollars ($200,000.00). The amount of the security deposit
or bond shall be determined at least annually based on net safety factors,
contingent liabilities, growth of the Group, and other data as submitted by the
Group Self-Insurers to the Commission. The amount of the security deposit or
bond requirement mentioned here and elsewhere in this rule is not applicable to
Public Employer Groups.
C.
Group Self-Insurers' Funds and Surplus
(1) Each Group Self-Insurer shall consist of
two separate funds, that is, the Trustee Fund and a Common Claim Fund. All
premiums and assessments charged to the member are paid into the Trustee Fund.
The Trustee Fund shall be used to pay the operational expenses of the Group
Self-Insurer.
(2) From the Trustee
Fund there shall be created a separate Common Claim Fund. The Common Claim Fund
shall be placed in a designated depository, and this fund will be maintained at
all times by the authorized service organization or the designated adjuster or
individual(s) charged with the handling and payment of claims. This fund shall
be adequate to cover any current incurred and contingent liabilities as imposed
by the Act.
(3) Employers
participating in a Group Self-Insurer shall pay the standard premium or percent
thereof as designated by the Group and approved by the Commission with
exceptions being when at the discretion of the Group Manager or Fiscal Agent of
the Group it becomes necessary to surcharge or assess all members because of
the loss experience of the Group. Members of a Group Self-Insurer may elect to
participate in the Experience Rating Plan established by the National Council
on Compensation Insurance or any other acceptable rating plan as approved by
the Commission. In this event an experience modification shall be determined
for each member by the Service Agent.
(4) Surplus funds for a fund year in excess
of the amount necessary to fulfill all obligations under the Law for that fund
year may be declared refundable by the Trustees, provided that such amount
shall not be paid to the members until approved by the Commission.
D.
Solvency of Group
Self-Insurer and Trustee Responsibility
(1) The Trustees of each authorized Group
Self-Insurer shall cause to be adopted a set of by-laws which shall govern the
operation of the fund. These by-laws shall contain, but not be limited to, the
following subjects:
(a) Qualifications for
Group Self-Insurer membership, including underwriting considerations.
(b) The method for selecting the Trustees,
including the term of office.
(c)
The method for amending the by-laws.
(2) In addition to the above by-laws, the
Trustees shall adopt regulations on the following subjects which shall be
binding on the Group Manager and Service Company:
(a) Investment of surplus funds and claim
reserves.
(b) Frequency and extent
of loss control and safety engineering services to members.
(c) The size of the Common Claim
Fund.
(d) A schedule for payment
and collection of premium including a definition of delinquent
premium.
(e) Membership admission
and expulsion procedures.
(f)
Delineation of authority granted to the Trustees.
(g) Delineation of authority granted to the
Group Manager.
(h) Delineation of
authority granted to the Service Company.
(i) Procedures for handling disputes
regarding premium paid by members.
(3) In order to insure the financial
stability of the operations of each and every Group Self-Insurer, the Board of
Trustees of each Group shall be responsible for all operations of the Group.
The Board of Trustees of each Group shall take all necessary precautions to
safeguard the assets of the Group, including:
(a) The designation of a Fiscal Agent and/or
Group Manager to administer the financial affairs of the Group, who shall
furnish a fidelity bond with the Trustees as obligee, in an amount sufficient
to protect the Group against the misappropriation or misuse of any funds or
securities. The amount of the bond shall be determined by the Trustees, and
evidence of such bond shall be filed with the Commission, said bond being one
of the conditions required for approval of the establishment and continued
operation of the Group Self-Insurer. Such Fiscal Agent or Group Manager shall
not .be an owner, officer, or employee of the service organization.
(b) All loss funds or funds of any type shall
remain in the custody of the Trustees or the authorized Group Manager,
provided, however, that a Common Claim Fund for payment of compensation
benefits due and other related expenses may be established for the use of the
authorized service organization. The service organization or the designated
adjuster or individual(s) charged with the handling and payment of claims shall
furnish a fidelity bond covering its employees, with the Trustees as obligee,
in an amount sufficient to protect all funds placed in such Common Claim
Fund.
(c) Requiring of the accounts
and records of the Group to be audited annually or at any time as may be
required by the Commission, such audits to be made by Certified Public
Accountants or by authorized representatives of the Commission, with the
Commission reserving the right to prescribe a uniform accounting system to be
used by Group Self-Insurers and/or service organizations, and the type of
audits to be made, in order that it may determine the solvency of the Group
Self-Insurer. Copies of audits prepared by those other than Commission
personnel shall be filed with the Self-Insurer Department of the Commission
within three (3) months after the close of the fiscal year.
(d) The Trustees or Fiscal Agent or Group
Manager shall cause an actuarial study and report to be performed on an annual
basis. Copies of the actuarial report shall be filed with the Self-Insurer
Department of the Commission within three (3) months after the close of the
fiscal year.
(e) The Trustee or
Fiscal Agent or Group Manager shall not utilize any of the funds collected as
premium for any purpose unrelated to Workers' Compensation. Further, they shall
be prohibited from borrowing any money from the Group Self-Insurer or in the
name of the Group Self-Insurer without advising the Commission of the nature
and purpose of the loan and obtaining Commission approval.
(f) The Trustees shall be authorized to
invest trustees' funds, claims reserves and surplus in the following types of
investments only:
(1) Savings accounts,
certificates of deposit, or similar accounts in a duly chartered commercial
bank whose deposits are federally insured.
(2) Savings accounts, savings certificates,
or similar accounts in a duly chartered savings and loan association whose
deposits are federally insured.
(3)
Direct obligations of the State of Arkansas.
(4) Direct and indirect obligations of the
United States, such as notes, bonds, mortgages or bills which are backed by the
full faith and credit of the United States Government.
(g) The Trustees shall report annually, as
part of the statement of financial condition of the Group Self-Insurer, a
schedule showing all investment income earned during the fund year just
ended.
(4) The Trustees
shall review at least annually the following items for the purpose of
determining whether these areas of concern are being adequately provided for:
(a) Service Company performance
(b) Loss control and safety
engineering
(c) Investment
policies
(d) Collection of bad
debt
(e) Admission and expulsion
procedures
(f) Group Manager
performance
(5) Any
changes in the by-laws or written regulations shall be filed with the
Commission no later than ten (10) days after their taking effect. The
Commission reserves the right to declare any by-law or regulation null and void
if it is in violation of these rules or the law.
(6) The Indemnity Agreement required pursuant
to Part III, A (1) (a) shall conform to the form of the Indemnity Agreement as
prescribed by the Commission, and shall contain all its provisions, but may
also contain other provisions not inconsistent with these rules or with the
required provisions, and wherever the term 'Service Agent" appears therein the
term "Group Manager" or "Fiscal Agent" may be substituted as may be necessary
to reflect the respective authority, responsibility, and duties of these
agents, consistent with these rules.
(7) The minimum excess insurance requirements
that a Group Self-Insurer shall maintain shall be determined by the Commission,
except qualifying public employer self-insurer groups are entitled to statutory
options and limitations. (Effective date April 1, 1989)