Code of Massachusetts Regulations
211 CMR - DIVISION OF INSURANCE
Title 211 CMR 67.00 - Workers' Compensation Self-insurance Groups
Section 67.02 - Definitions

Actuarially Fully Funded Group. A group for which the funding amount is established at a level sufficient to discharge all obligations incurred pursuant to M.G.L. c. 152 by the members of the group as they become due and payable from time to time, and for which the value of fund assets is at least equal to the present value of ultimate expected incurred claims and claims settlement costs, after giving due consideration to valid and collectible excess insurance or reinsurance. The determination of the sufficiency of the level of funding, including loss reserves, shall be made according to sound actuarial practice, and shall be certified by a qualified actuary.

Administrative Fund Account. The remaining premium, after any payments for reinsurance or excess insurance and after sufficient funds are placed in the Claims Fund Account, placed in a designated depository in the Commonwealth for the payment of taxes, general regulatory fees, assessments and administrative costs.

Administrator. An individual, partnership, corporation or unincorporated association engaged by a workers' compensation self-insurance group's board of trustees to carry out the policies established by the group's board of trustees and to provide daily management of the group.

Affiliate. Any person that directly or indirectly, through one or more intermediaries, controls, is controlled by, or is under common control with, a specified person.

ARAP. Any premium produced by the All Risk Adjustment Program or any similar worker's compensation rating program approved by the Commissioner.

Certified Financial Statement. A current financial statement of a member, which is either audited or reviewed by an independent Certified Public Accountant, including, at a minimum, a balance sheet, a profit and loss statement, a statement of change in fund position and a statement of the member's net worth and including all notes of the Certified Public Accountant which are an integral part of the financial statement. A reviewed financial statement shall be considered a certified financial statement only if accompanied by the member's federal income tax return for the most recent calendar or fiscal year.

Claims Fund Account. Member contributions which are placed in a designated depository in the Commonwealth in an amount equal to the estimated aggregate retained workers' compensation claims liability of the group.

Commissioner. The Commissioner of Insurance appointed pursuant to M.G.L. c. 6, § 26, or his or her designee.

Division. The Division of Insurance established pursuant to M.G.L. c. 26, § 1.

Excess Insurance. Excess insurance or reinsurance.

Financial Reinsurance. A transaction of reinsurance under which there is a limit on the total liability of the reinsurer and future investment income is a recognized component of the underwriting process.

Fund Year. The fiscal year of a group, which shall consist of 12 calendar months, except for the first year, which may consist of fewer than 12 months.

In-force Premium. The annualized standard premium of all policies in effect on a given date.

Insolvent or Insolvency. The inability of a workers' compensation self-insurance group to pay its outstanding lawful obligations as they mature in the regular course of business, as may be shown either by an excess of its required reserves and other liabilities over its assets or by its not having sufficient assets to reinsure all of its outstanding liabilities after paying all accrued claims owed by it.

Member. An employer, as defined in M.G.L. c. 152, § 1, who is a member of a workers' compensation self-insurance group.

Net Premium. Standard premium less any advance premium discounts.

Net Worth for Non-profit Organizations. In the case of a non-profit organization, net worth shall be the aggregate unrestricted fund balance of the non-profit organization as reported in its certified financial statement. Aggregate Unrestricted Fund Balance shall mean the amount equal to the unrestricted total assets less the unrestricted total liabilities. Net worth shall be determined in accordance with either generally accepted accounting principles or generally accepted government auditing standards, whichever is appropriate.

Person. An individual, corporation, partnership, association, joint stock company, trust, unincorporated organization, or any similar entity or any combination of the foregoing acting in concert.

Provable Net Worth. The net worth of a member, supported by certified financial statement(s) of the member.

Public Employer Workers' Compensation Self-insurance Group or Public Employer Group. A not-for-profit association consisting of five or more employers, all of whom are public entities, who enter into agreements to pool their liabilities for workers' compensation benefits and employer's liability in the Commonwealth.

Qualified Actuary. A member in good standing of the Casualty Actuarial Society or, a member in good standing of the American Academy of Actuaries who has been approved as qualified for signing casualty loss reserve opinions by the Casualty Practice Council of the American Academy of Actuaries.

Recalculated Distribution Amount. The amount originally available for distribution to members pursuant to 211 CMR 67.08(4) for a fund year, adjusted for any favorable or adverse loss development, less any distributions previously paid for that fund year.

Standard Premium. The premium derived from the manual rates adjusted by any applicable experience modification factors, including the All Risk Adjustment Program (ARAP), and such other experience rating plans the Commissioner may approve, but before advance premium discounts or any large or small deductible credits.

Subsidiary. An affiliate controlled by a person directly or indirectly, through one or more intermediaries.

Total Reimbursement Reinsurance. A form of reinsurance which transfers all underwriting, timing and financial risk to the reinsurer.

Workers' Compensation. When used as a modifier of benefits, liabilities or obligations, shall mean both workers' compensation and employers' liability.

Workers' Compensation Self-insurance Group or Group. A public employers group or a not-for-profit unincorporated association or a corporation formed under the provisions of M.G.L. c. 180, consisting of five or more employers who are engaged in the same or similar type of business, who are members of the same bona fide industry, trade or professional association which has been in existence for not less than two years, or who are parties to the same or related collective bargaining agreements, and who enter into agreements to pool their liabilities for workers' compensation benefits and employers' liability in the Commonwealth.