Current through Register Vol. 43, No. 39, September 26, 2024
(a) For the purpose of this regulation and
K.S.A.
40-955 and amendments thereto, each of the
following terms shall have the meaning specified in this subsection:
(1) "Advisory organization" means an entity
licensed by the commissioner for the reporting of claims and experience data
for the administration of the workers compensation experience rating
system.
(2) "Client" has the
meaning specified in
L.
2012, ch. 142,
§
2, and amendments thereto.
(3) "Covered employee" has the meaning
specified in
L.
2012, ch. 142,
§
2, and amendments thereto.
(4) "Master policy" means a single policy
issued to a professional employer organization or professional employer group
for the covered employees and any direct-hire employees of the professional
employer organization or the professional employer group.
(5) "Multiple coordinate policy" means an
agreement under which a separate policy is issued to or on behalf of each
client or group of affiliated clients of a professional employer organization
or a professional employer group, but payment of obligations and certain policy
communications are coordinated through the professional employer organization
or the professional employer group. This term is also known as a "multiple
coordinated policy."
(6)
"Professional employer group" has the meaning specified in
L.
2012, ch. 142,
§
2, and amendments thereto.
(7) "Professional employer organization" has
the meaning specified in
L.
2012, ch. 142,
§
2, and amendments thereto.
(8) "Shared employment relationship" means
"co-employment relationship" as defined in
L.
2012, ch. 142,
§
2, and amendments thereto.
(b) When submitting a master
policy to the commissioner for examination, the insurer's filing shall include
a detailed rule stating the manner in which the insurer will track and report
payroll and claims data for each client to the advisory organization in a
manner that identifies both the client and the professional employer
organization and that is acceptable to the advisory organization. The
adjustment of annual premiums based on previous loss experience, which is also
known as experience rating modification, shall be calculated for each client as
if the client were the sole employer of the client's covered employees. Failure
of the insurer to provide this detailed rule with the insurer's filing to the
commissioner shall result in the disapproval of the master policy.
(c) Each master policy shall cover only one
professional employer organization or professional employer group.
(d) Each master policy shall be issued in the
name of the professional employer organization or professional employer group
and shall require that each covered client hold a certificate of coverage
identifying that client as an alternate employer.
(e) Each insurer or its authorized
representative shall issue a certificate of coverage to each client covered
under a master policy. Each certificate of coverage shall meet the following
requirements:
(1) The certificate of coverage
shall specify the effective date of the client's coverage and the expiration
date of the underlying master policy. A renewal certificate of coverage shall
be issued to each client each time the master policy is renewed. If the insurer
cancels the master policy for nonpayment of premium, the insurer shall give the
professional employer organization or professional employer group and each
client at least 10 days' written notice before the effective date of
cancellation.
(2) The certificate
of coverage shall provide that the client is entitled to 30 days' notice before
coverage can be cancelled or nonrenewed with the client's consent, unless
either of the following conditions is met:
(A)
Replacement coverage is provided by the professional employer organization or
professional employer group with no break in coverage.
(B) The insurer has notified the client when
the certificate of coverage is first issued that the master policy will be
cancelled or nonrenewed in less than 30 days.
(f) Cancellation or nonrenewal of a client's
coverage at the initiative of the professional employer organization or
professional employer group without the written consent of the client shall not
be effective, unless at least one of the following conditions is met:
(1) The insurer has given at least 30 days'
advance notice to the client.
(2)
The professional employer organization or professional employer group has given
at least 30 days' advance notice to the insurer and the client.
(3) Coverage for all covered clients has been
replaced with no break in coverage, and the professional employer organization
has given advance notice to the insurer and the clients.
(g) Each professional employer organization
or professional employer group shall be responsible for payment to the insurer
of any premiums, policyholder assessments, and deductible reimbursement charges
under a master policy or a multiple coordinated policy, whether or not the
professional employer organization or professional employer group has received
timely payment from the client. A client's failure to pay any fees to the
professional employer organization or professional employer group when the fees
are due shall not constitute nonpayment of premium pursuant to
K.S.A.
40-2,120, and amendments thereto, or K.A.R.
40-3-15.
