Oklahoma Administrative Code
Title 810 - Oklahoma Workers' Compensation Commission
Chapter 25 - Workers' Compensation Insurance and Self Insurance
Subchapter 1 - General Provisions
Section 810:25-1-2 - Definitions
In addition to the terms defined in 85A O.S., § 2, the following words and terms, when used in this Chapter, shall have the following meaning, unless the context clearly indicates otherwise:
"Administrator" means the person designated by the supervisory board of members of a group self-insurance association to oversee the financial affairs of the association, accept service of process on behalf of the association, act for and bind the association and members in all transactions either relating to or arising out of the operation of the association.
"Advisory loss costs" means the National Council on Compensation Insurance's projections of future claims costs and loss adjustment expenses by classification code.
"Affidavit of exempt status" means an affidavit authorized by 85A O.S., §36 which any individual or business entity that is not required to secure compensation pursuant to the AWCA may execute and file with the Oklahoma Workers' Compensation Commission.
"Aggregate excess insurance" means an insurance product that limits a group self-insurance association's annual aggregate liability to an agreed upon amount.
"Association" or "Group Self-Insurance Association" means a duly qualified group self-insurance association authorized by the Commission to self fund its workers' compensation obligations.
"AWCA" means the Administrative Workers' Compensation Act, 85A O.S., §§ 1, et seq.
"Board" or "Members' Supervisory Board" means the supervisory board of members of an association.
"Cancellation short rate penalty" means a penalty imposed on the member for cancelling its policy before the expiration date of the policy.
"Certified audit" means a financial audit performed by a certified public accountant, accompanied by the auditor's opinion regarding the audit.
"Claims reserves" means workers' compensation claim losses expected to be paid in the future, but does not include IBNR.
"Commission" means the Oklahoma Workers' Compensation Commission, a designee, or an administrative law judge to whom the Commission has delegated responsibility as authorized by 85A O.S., § 21(D).
"Common interest" means employers engaged in the same industry or members of an Oklahoma trade association that has been in business for at least five (5) years.
"Expense constant" means a flat charge included in a workers' compensation policy to cover the costs of issuing and servicing the policy.
"Experience modifier" means a modification to premium based on the claims history of the policyholder.
"IBNR" means incurred but not reported reserves. It includes a reserve for claims that have been incurred, but not yet reported to the individual own risk employer or group self-insurance association, as applicable, and reserves for adverse loss development on known claims.
"Incurred loss" means the total of the paid indemnity and medical losses plus claims reserves, reported by accident year.
"Insurance Department" means the Insurance Department of the State of Oklahoma.
"Joint and several liability" means mutual and individual responsibility of members for the liabilities of the association.
"Loss portfolio transfer" means the transfer of the liabilities of the association to an insurance carrier for an agreed upon premium.
"Member" means an individual member of an association.
"NCCI" means the National Council on Compensation Insurance, a national source for information on workers' compensation insurance, tools and services, and the provider of advisory ratemaking and statistical services in Oklahoma.
"Partnership" means a type of unincorporated business organization in which two or more individuals own the business and are equally liable for its debts.
"Pro forma financial statement" means a hypothetical financial statement showing revenues and expenses that may be recognized in the upcoming fiscal year.
"Proof of coverage" means the statutory filings of workers' compensation policy information to the NCCI.
"Scopes Manual" is a catalog of four-digit workers' compensation codes based on the nature of business and estimated risk to its workers.
"Self insured retention" means the individual own risk employer's or group self-insurance association's retained amount of risk under a specific excess insurance policy, before the liability is transferred to an insurance carrier.
"Sole proprietor" means an individual (or married couple) who is sole owner of a business that is neither a partnership nor an incorporated or limited liability company.
"Solvency" means a member whose assets are greater than its liabilities and who is capable of meeting its financial obligations to the association.
"Specific excess insurance" means an insurance product that limits the liability of an individual own risk employer or group self-insurance association specific occurrence liability to an agreed upon amount.
"Standard premium" means experience modified workers' compensation premium that has not been discounted.
"Statutory limits" means an insurance carrier's amount of liability under a specific excess insurance policy, capped at the maximum amount allowed by statute.
"TPA" or "Third-Party Administrator" means any person defined in 36 O.S., § 1442 of the Third-Party Administrator Act as an "administrator".
"Unearned premium" means the share of the members' premiums applicable to the unexpired portion of the policy terms.
