Pennsylvania Code
Title 34 - LABOR AND INDUSTRY
Part VIII - Bureau of Workers' Compensation
Chapter 125 - WORKERS' COMPENSATION SELF-INSURANCE
Subchapter B - GROUP SELF-INSURANCE
Section 125.141 - Annual report

Universal Citation: 34 PA Code ยง 125.141

Current through Register Vol. 54, No. 38, September 21, 2024

(a) No more than 5 months following the end of each fund year, a fund shall file a report with the Bureau as required by section 815 of the act (77 P. S. § 1036.15). Failure to file an annual report in the time prescribed may result in the revocation of the fund's permit.

(b) The fund shall submit with its annual report:

(1) The evaluation fee in the amount of $1,000 required by section 815(c) of the act.

(2) The fund's audited financial statements for its prior fund year as prepared by a certified public accountant in accordance with generally accepted accounting principles.

(3) A report prepared by an independent actuary projecting the value of the fund's incurred and outstanding liability by fund year.

(4) The prior fiscal year's audited or reviewed financial statements of each member whose annual contribution to the fund makes up more than 10% of the total annual contributions to the fund.

(5) A schedule of the projected administrative expenses in dollar amounts and as a percentage of the total member contributions for the current fund year.

(6) A schedule of the annual contributions which will be paid by each member and in total during the current fund year and worksheets showing the calculation of each member's annual contributions.

(7) A certificate providing evidence of excess insurance as required by the Bureau.

(8) A schedule of member dividends paid during the prior fund year and the fund year from which the dividends were paid.

(9) A schedule of the dividends the fund plans to return to its members during the current year. The schedule shall include a recommendation from an independent actuary that the dividends proposed will not impair the fund's ability to meet its obligations and that the dividends will comply with the other requirements of section 809 of the act (77 P. S. § 1036.9).

(10) Confirmation of the existence of the fidelity bonds required under § 125.134(d)(6) (relating to decision on application).

(c) A fund shall provide to the Bureau other information required by the Bureau to determine whether the fund has the ability to continue to satisfy its obligations and expenses.

(d) The Bureau may require a fund to file interim reports during its fund year of its financial condition, claims experience and other items the Bureau may require.

(e) Extensions of the filing date under subsection (a) may be granted by the Bureau for 30-day periods upon good cause shown by the fund in stating its reasons for requesting the extension. The request for extension shall be submitted in writing no less than 10 days prior to the due date in sufficient detail to permit the Bureau to make an informed decision with respect to the requested extension.

This section cited in 34 Pa. Code § 125.143 (relating to restriction on the use of assets); and 34 Pa. Code § 125.146 (relating to payment of dividends).

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