Current through Register Vol. 46, No. 12, March 20, 2024
RULES AND REGULATIONS
FOR
SAFETY TRADE ASSOCIATION GROUP NO. ________
ESTABLISHED
______
(date) UNDER THE BASIC RULES FOR SUCH GROUPS
ADOPTED BY THE COMMISSIONERS OF THE STATE INSURANCE FUND
1. NAME - The name of this group shall be
____________
____________
____________
Group No. ________ hereinafter referred to as the
"Group."
2. OBJECTIVES
This Safety Group is formed for the following purposes:
A. The prevention of occupational accidents
and diseases, and the formulation of a sound safety program.
B. The encouragement of improved medical care
of the employees.
C. The reduction
of the cost of compensation insurance to members of this Safety Group.
Incidental to these objectives is the encouragement of members
to assist in the proper handling of claims and payroll information.
3. MEMBERSHIP
A. Eligibility of Members
All Employers who are and continue to be regular dues-paying
members of
________
(enter name of Association for whose members the Group is
established
engaged in the following type or types of employment and whose
compensation insurance experience records meet with the approval of the State
Insurance Fund and the Executive Committee of the Group shall be eligible for
membership in the Group.
B.
Application for Membership
i. All applications
for membership in the Group shall be made to the Group Manager for approval and
acceptance by the Executive Committee. Each such application shall be
accompanied by an application to the State Insurance Fund for insurance to take
effect upon the expiration or termination of any other compensation insurance
then being carried by the applicant. The Group Manager shall forward the
application for insurance to the State Insurance Fund, together with an
authorization that the applicant is a bona fide dues-paying member of the
Association and has been accepted as a member of the Group, subject to the
approval of the application of the State Insurance Fund.
ii. Each member shall, at the time of its
application for membership in the Group, certify that it is a bona fide
dues-paying member of the Association and shall designate and appoint the Group
Manager as its agent and representative to deal with the State Insurance Fund
in all matters pertaining to its insurance. Each member shall, at the time of
its application for membership in the Group, agree to abide by all the Rules
and Regulations of the Group.
C. Industry Classifications
Only those manual classifications, which apply in whole or in
part to the industry are to be included and one of such authorized manual
classifications must be the governing classification for a risk to become
eligible to group membership:
Code Number: Description:
D. Discontinuance of Members
i. Membership in the Group shall be
continuous from year to year except that the Executive Committee of the Group
may, subject to the approval of the State Insurance Fund, exclude any member
from continued membership thereunder at any anniversary date of the Group for
failure to comply with these Rules and Regulations. Notice of intention to
discontinue membership and the reason therefor shall be given to such member
and to the State Insurance Fund at least thirty (30) days prior to the
anniversary date of the Group.
ii.
Any Member of the Group may be removed, terminated or discontinued from the
Group as of any anniversary date, if in the opinion of the State Insurance Fund
management, after consultation with the Group Manager and/or the Executive
Committee, continued membership in the Group would not serve the basic
objectives for which the Group was formed.
E. Withdrawal from Group
i. A member may withdraw from the Group only
upon the anniversary date of the Group and upon giving written notice to the
Group Manager and to the State Insurance Fund at least thirty (30) days prior
to the anniversary date of the Group.
ii. The Executive Committee shall certify to
the Group Manager and the State Insurance Fund at least sixty (60) days before
each Group renewal, the members of the Group who have for any reason terminated
their membership in the Association, for the purpose of withdrawing such
policyholders from the Group membership, as of the end of the Group Year
following the giving of notice.
F. Cancellation of Insurance
i. Cancellation of the insurance of any
member of the Group shall operate to terminate any and all benefits that would
otherwise accrue to such member from its membership in the Group except that
such member shall be entitled to participate in any dividends that may be
declared for the last period of its membership or such other period, if any,
falling within the final three group periods in the event of group termination,
in proportion to the earned premium of the member of such period or periods.
Cancellation of the insurance of a member of the Group during the Group period
shall render such member ineligible for membership in the State Insurance Fund
General Group until the regular policy renewal date following the date of
cancellation.
ii. Cancellation of
insurance of a member of the General Group during the policy period shall
render such member ineligible for membership in a Safety Group until the
regular renewal date following the date of cancellation. The reinstatement of
the insurance of a member by the State Insurance Fund during the same period in
which cancellation becomes effective shall also operate to reinstate such
employer in the Group.
G. Transfer from One Group to Another
i. A qualified risk may transfer from the
General Group to the Group upon giving notice to the Group Manager and to the
State Insurance Fund at least thirty (30) days prior to the anniversary date of
the risk, provided new business in a similar amount of annual premium precedes
or accompanies such notice of transfer.
ii. No policy may be transferred directly
from one State Insurance Fund Safety Group to another State Insurance Fund
Safety Group unless such policy is covered in the State Insurance Fund General
Group for at least two (2) years.
4. GROUP MEETINGS
A. The first meeting of the Group shall be
held within ninety (90) days after the date of establishment of the Group for
ratification of these Rules and Regulations and for the election of an
Executive Committee, Chairman, Vice-Chairman (who shall act in the absence of
the Chairman) of such committee and the Group Secretary, who need not be a
member of the Group but may be the Group Manager.
B. Thereafter, meetings of the Group shall be
held annually within thirty (30) days or at the next annual meeting of the
Group for the election of an Executive Committee, Chairman and Vice-Chairman
(who shall act in the absence of the Chairman) of such committee and the Group
Secretary, who need not be a member of the Group but may be the Group Manager
and for the transaction of such other business as may properly come before the
Group. At each annual meeting the Group Manager shall present a report of the
Group and its relation with the State Insurance Fund, together with any
recommendation that may be proper or desirable in the interest of the Group. A
report shall also be submitted of the transactions of the Executive Committee.
A copy of the minutes of each annual meeting of the Group shall be submitted to
the State Insurance Fund within ten (10) days after the meeting.
C. The State Insurance Fund shall have the
right to be represented at all meetings of the Group and the Group Manager
shall notify the State Insurance Fund Underwriting Director in writing of the
location, date and time of such meeting at least twenty (20) days in advance of
the meeting.
5. VOTING
Voting shall be limited to members of the Group. Each member
shall be entitled to one vote at all meetings of the Group. A majority vote of
those present or proxy shall decide any question which may be acted upon. One
half of the membership, present in person or by proxy, shall constitute a
quorum for the transaction of business and election of officers.
6. EXECUTIVE COMMITTEE
A. There shall be an Executive Committee,
consisting of not less than five (5) Group members, which shall have general
supervision over the affairs of the Group.
B. OPTION 1
The Executive Committee shall hold office until after the next
annual Group meeting when their successors shall be elected. Thereafter, the
Executive Committee shall be elected at each annual meeting. Should vacancies
occur, the Executive Committee shall have the power to fill such vacancies in
its membership until the next annual meeting of the Group. The Executive
Committee may authorize and approve such sub-committees as may be desirable or
necessary and shall define their powers and duties.
OPTION 2
At the next annual meeting of the Group, the Executive
Committee, for the purposes of election, shall be divided into three groups,
and shall be elected in groups, for varying terms of one, two and three years.
Thereafter, members of the Executive Committee shall be elected at the annual
meeting as their respective terms expire, for the term of three years. Should
vacancies occur, the remaining members of the Executive Committee shall have
the power to fill such vacancies in its membership until the next annual
meeting, at which time the members of the Group shall elect a replacement to
fill any unexpired portion of a term. The Executive Committee may authorize and
approve such sub-committees as may be desirable or necessary and shall define
their powers and duties.
C.
The Executive Committee shall elect a Chairman and Vice-Chairman (who shall act
in the absence of the Chairman) from its membership and shall also elect a
Secretary who need not be a member of the Group but may be the Group
Manager.
D. The Chairman shall
preside at all meetings of the Executive Committee and of the Group and shall
submit to the Group all reports of the Executive Committee and shall generally
conduct the affairs of the Group subject to the approval of the Executive
Committee. He shall, except as otherwise provided, appoint all committees and
shall define their powers and duties.
E. The Secretary shall keep the minutes of
the meetings of the Group and of the Executive Committee and, at the direction
of the Chairman, shall give at least fifteen (15) days notice of all meetings
and otherwise conduct the correspondence of the Group. The secretary shall file
the minutes of the meetings of the Group with the State Insurance Fund within
10 days following the meetings.
F.
The Executive Committee shall meet at least annually upon the call of the
Chairman. A majority of the members of the Committee, whether present in person
or by proxy, shall constitute a quorum for the transaction of business and a
majority vote of all members of the Executive Committee, whether present in
person or by proxy, shall be required to decide any question.
G. If a proxy is sought for an Executive
Committee meeting at which a Group Manager is to be designated, written notice
that such a designation is to be considered must accompany the proxy which is
sent to the member. Each proxy must be signed by the member and shall be valid
only for the particular meeting for which the proxy was sought. In the event
more than one proxy is submitted for the same member, the prior proxy will be
the valid one unless the later proxy expressly revokes the prior
proxy.
H. The State Insurance Fund
shall have the right to be represented at all Executive Committee meetings and
the Group Manager shall notify the State Insurance Fund Underwriting Director
in writing of the location, date and time of such meeting at least twenty (20)
days in advance of the meeting.
I.
The Executive Committee shall arrange for and employ the services of a Group
Manager.
7. GROUP
MANAGER
A. Purpose
The Group Manager shall be employed for the purpose of
efficiently securing the benefits for which the Group is established and
carrying out the spirit and intent of the Law.
B. Term
The Group Manager shall be designated at the beginning of each
Group Year by the Executive Committee and shall act in that capacity until the
end of the Group Year unless sooner terminated at the discretion of the
Executive Committee or the State Insurance Fund.
C. Qualification and Approval
The proposed Group Manager shall submit in writing to the State
Insurance Fund his qualifications for Group Management. No Group Manager shall
act in such capacity until the State Insurance Fund has given its approval in
writing, which shall be effective only until the end of the Group Year.
D. Duties
i. The Group Manager shall promulgate rules
and regulations (subject to the approval of the State Insurance Fund) for
establishing an accident prevention program. He shall diligently carry out such
approved program and shall cooperate fully with the State Insurance Fund in the
investigation of claims, the presentation of all material and facts for the
consideration and determination thereof, and shall keep record of the accidents
of the Group.
ii. The Group Manager
shall be responsible for instruction of all members in the maintenance of
proper payroll and other records which may reflect in any way upon wage
expenditures, shall assist the State Insurance Fund in securing true and
accurate payroll records and reports wherever possible, and shall also assist
the State Insurance Fund in the prompt collection of premiums, and shall keep a
record of the estimated and earned premiums of the Group.
iii. The Group Manager shall be the
responsible for insuring that all applications for insurance submitted on
behalf of prospective members shall be correctly and fully completed,
containing all information required by the State Insurance Fund.
iv. The Group Manager shall be the
representative of the Group in dealing with the State Insurance Fund and with
individual members of the Group. The Group Manager shall see that the
provisions of these Group Rules and Regulations are carried out.
E. Service Charges
The Group Manager may be remunerated by the Group members as
may be agreed upon by the Executive Committee of the Group, but in no instance
shall such remuneration be in excess of eight (8) percent of standard (i.e.,
Rating Board level) premium, or alternatively, ten (10) percent of the State
Insurance Fund's premium. All ordinary expenses of the Group shall be borne by
the Group Manager and shall be paid out of such remuneration.
8. ACCIDENT PREVENTION AND SAFETY
SERVICE
A. Safety Advisory Committee
i. The Executive Committee at its first
meeting after the annual meeting of the Group, but not later than thirty (30)
days after such annual meeting, shall appoint a committee of Group members
which together with the Group Manager shall be known as the Safety Advisory
Committee. This Committee shall, as often as practicable, confer with the
appropriate Loss Control Staff of the State Insurance Fund for the purpose of
revising existing rules or formulating new rules and regulations for the
prevention of accidents and the minimizing of occupational disease
hazards.
ii. The Safety Advisory
Committee shall meet as often as practicable to discuss and act on the
following:
a. Review past and current
experience of the Group.
b. Review
accidents currently reported and make suggestions to prevent
recurrence.
c. Review, revise or
formulate new Safety Rules and Regulations to be carried out by Group
members.
d. Devise methods to
obtain cooperation in accident prevention from all Group members and decide
action to be taken with regard to members who are uncooperative or whose risks
indicate a consistently poor loss ratio.
B. Each Group member shall fully cooperate
with the State Insurance Fund, Group Manager and the Group Safety Advisory
Committee in carrying out the following program:
i. Establish a comprehensive and effective
program for the education of supervisory and other employees in safe practices.
Particular attention should be given to new employees.
ii. Cooperate in investigating any accident
immediately after occurrence to determine the cause and the prevention of
recurrence.
iii. Appoint a Safety
Committee from the management (superintendents, foremen and responsible
employees) to hold safety meetings and formulate rules and regulations peculiar
to the individual operation for the prevention of accidents and the minimizing
of occupational disease hazards.
iv. Give access to representatives of the
State Insurance Fund, at any time during work hours, to the premises for the
purpose of making inspections, investigations and making recommendations for
the elimination of accidents and the minimizing of occupational disease
hazards.
v. Make the fullest use of
the facilities of the State Insurance Fund in accident prevention and safety
work and take prompt action on all recommendations for correcting unsafe
conditions.
9. CLAIMS AND MEDICAL SERVICE
Each member shall:
A.
Report promptly all accidents and occupational diseases within ten (10) days in
accordance with the requirements of Section 110 of the Workers' Compensation
Law. (See reverse side form C-2 Employer's Report of Injury.) Irrespective of
whether or not Form C-2 Employer's Report of Injury, are required to be filed,
keep a permanent record of all injuries sustained in the course of employment
and such record shall include the name of the injured, occupation, time, date,
place of injury, description of occurrence, treatment given, name and address
of physician, and shall show any lost time.
B. Consult with the appropriate Claim staff
of the State Insurance Fund (at its nearest office) on matters relating to
accidents, occupational diseases, medical care and treatment in the handling
and investigation of claims. Promptly notify the appropriate Claim staff of the
State Insurance Fund in writing of all lost time of an employee, whether due to
injury or to occupational disease. Promptly file in duplicate Form C-11, upon
return to work of such employee. When requested, file in duplicate payroll
reports of injured employees or similar workers as may be required.
C. Provide adequate and efficient medical
treatment and care to injured employees within the scope and provisions of the
Workers' Compensation Law, and comply with Section 13 of said Law. Send to the
appropriate Claim staff of the State Insurance Fund all medical bills promptly.
Transmit immediately any information or communications, whether oral or
written, received from any physician, attorney, claimant or any other person
relating to any claims.
10. PAYROLL RECORDS
Each member shall keep a complete record of his payroll
expenditures properly segregated by classification. Authorized representatives
of the State Insurance Fund shall be permitted at all times to examine the
members' books, vouchers, contracts, documents and records of any and every
kind, which show or tend to show or verify the remuneration earned by the
employees of the member, or which show or tend to show the premium
payable.
11. DIVIDENDS
Dividend payments will be made pro rata on the basis of the
earned premiums. Before making payment of any dividend to any policyholder, the
amount of its indebtedness, if any, for unpaid premiums will first be deducted.
All dividends and premium returns will be paid or credited by the State
Insurance Fund directly to the individual members of the Group. The declaration
of a Group dividend is within the sole discretion of the State Insurance
Fund.
12. FRAUD
The State Insurance Fund reserves the right to assess a penalty
up to and including the amount of any annual dividend which would have been
otherwise payable to a policyholder, to any policyholder who is adjudged guilty
of insurance fraud related to a policy issued hereunder, for the year(s) during
which such insurance fraud was committed. The State Insurance Fund may
additionally or alternatively exclude any such policyholder from continued
membership in the Group as of the next anniversary date of the Group commencing
in the year following commencement of the fraud. Such penalty(s) shall be
imposed after a hearing before an authorized representative of the State
Insurance Fund. Any dividends withheld or recovered shall be added to the Group
Contingent Balance as provided for in the Group endorsement.
13. DISCONTINUANCE OF GROUP
A. The Group may be discontinued or
terminated upon the adoption of a resolution to such effect by the majority
vote of the active members of the Group. The discontinuance or termination
shall be effective as of the Group anniversary date immediately following the
adoption of the resolution, provided the State Insurance Fund is notified in
writing and a copy of the resolution is given to the State Insurance Fund prior
to such Group anniversary date and not later than thirty (30) days after the
resolution is adopted.
B. The Group
may be discontinued or terminated by the State Insurance Fund as of any
anniversary date if, in the opinion of the State Insurance Fund management,
continued operation would not serve the basic objectives for which the Group
was formed. Written notice shall be given to each member and the Group Manager
not later than thirty (30) days prior to the date of discontinuance or
termination.
14.
AMENDMENTS
A written copy of any new rule, or any amendment of an existing
rule, promulgated by the State Insurance Fund, shall be sent to the Group
Manager at least thirty (30) days before the Group renewal period, and shall
become part of these Group Rules and Regulations. Any rule or amendment,
approved by the State Insurance Fund, may be revoked by the State Insurance
Fund at any time, upon giving the Group Manager thirty (30) days' notice before
the Group renewal period.
15. NOTICE TO MEMBERS
The Group Manager shall send a copy of these Rules and
Regulations or any amendment thereto to each member within ten (10) days after
adoption.
APPROVED AS TO ADOPTED BY:
CONTENT AND FORM:
________ ________
GENERAL ATTORNEY NAME OF GROUP
________ ________
DATE CHAIRMAN
APPROVED: ________
SECRETARY
________ ________
EXECUTIVE DIRECTOR DATE
THE STATE INSURANCE FUND
________
DATE