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2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 11 - Hearings; Evidence; Continuances

Section 11. At the hearing the member shall make such inquiries and investigations as he deems necessary, and may require and receive any documentary or oral matter not previously obtained as shall enable him to issue a decision with respect to the issues before him. Such decision shall issue within twenty-eight days of the conclusion of the hearing. Failure of a party to appear at a hearing shall not delay the issuance of a decision.
The member conducting the hearing may grant a continuance only for reasons beyond the control of a party or his attorney. Any continuance shall be set forth in writing by the member and shall be compiled quarterly by the department and shall be submitted to the advisory council.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 11b - Procedure for Hearings; Depositions; Record of Proceedings

Section 11B. Procedures within the division of dispute resolution shall be as simple and summary as reasonable. The commissioner shall promulgate rules providing for the use of depositions and interrogatories. In any proceeding under this chapter, the division shall give notice of the date, time, and place of the proceeding to all parties in interest. Any member of the board may subpoena witnesses, administer oaths, and examine such parts of the books and records of the parties to a proceeding as relate to questions before such member. The fee for attending as witness before the department or a member of the board shall be that provided for witnesses before the superior court department of the trial court. The superior court shall have jurisdiction to enforce the provisions of this section relating to the attendance and testimony of witnesses and the examination of books and records.
A member may upon the filing of a written request of any party appearing before him, together with interrogatories and cross-interrogatories, if any, request officers in other jurisdictions, having power and duties similar to those of a member of the board, to take depositions or testimony of persons or witnesses residing in such jurisdictions. On the return of any such deposition to the division it shall be forwarded to the appropriate member. A reasonable fee for services in connection with the taking of such depositions and the expenses thereof shall be assessed upon the requesting party.
The expenses for services in connection with the taking of depositions shall be paid by the party requesting that such witness be deposed or whose witness is ordered to be deposed; provided, however, that if the decision of the member or reviewing board is in favor of the employee, the cost of such proceeding shall be added to the amount awarded to the employee and be paid by the insurer under the provisions of this chapter.
The evidence at the hearing shall be taken by an employee of the department sworn to record the entire proceeding. The record of the hearing shall be transcribed verbatim or electronically recorded. Upon the request of a member or the reviewing board, or at the request of a party, a transcript or recording or both, whichever such party requests shall be forwarded to such party without charge. The original recording shall remain in the control of the department. Verbatim transcripts shall be made manually from the stenographic notes only if a certified copy of the proceedings is required by the reviewing board or a court of the commonwealth. Decisions of members of the board shall set forth the issues in controversy, the decision on each and a brief statement of the grounds for each such decision. Decisions shall issue no more than twenty-eight days following the close of testimony, unless further extension is authorized in writing by the director of dispute resolution.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 11c - Appeals to Reviewing Board

Section 11C. Any party aggrieved by a decision of an administrative judge after a hearing held pursuant to section eleven shall have thirty days from the filing date of such decision within which to file an appeal from said decision to the reviewing board. A party who has by mistake, accident, or other reasonable cause failed to appeal from a decision within the time limited herein may within one year of the filing of said decision petition the commissioner of the department who may permit such appeal if justice and equity require it, notwithstanding that a decree has previously been rendered on any decision filed, pursuant to section twelve. Appeals to the reviewing board must be accompanied by a fee of thirty per cent of the average weekly wage in the commonwealth, which shall be paid into the special fund pursuant to section sixty-five. Such fee may be waived by the reviewing board for indigent claimants. The reviewing board shall reverse the decision of an administrative judge only if it determines that such administrative judge's decision is beyond the scope of his authority, arbitrary or capricious, or contrary to law. The reviewing board may, when appropriate, recommit a case before it to an administrative judge for further findings of fact. Where the reviewing board affirms the decision of an administrative judge, it may do so in summary fashion and without discussion of the issues raised on appeal.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 11d - Earnings Reports by Employees; Recovery of Overpayments

Section 11D. (1) Any employee entitled to receive weekly compensation under this chapter shall have an affirmative duty to report to the insurer all earnings, including wages or salary earned from self-employment. Insurers shall notify employees of said duty on a form approved by the department. Such form shall indicate that failure to report any earnings may subject the employee to civil or criminal penalties, and shall further indicate that failure to file an earnings report on a form approved by the department within thirty days of an insurer's request for such filing may result in the insurer's suspension of the employee's weekly benefits; provided, however, that no employee shall be required to file an earnings report more often than once every six months.
(2) An insurer in receipt of an earnings report indicating that overpayments have been made shall be entitled to recover such overpayments by unilateral reduction of weekly benefits, by no more than thirty percent per week, of any remaining compensation owed the employee; provided, however, that the reported earnings are of a kind that could have been considered in the computation of the employee's compensation rate. Where overpayments have been made that cannot be recovered in this manner, recoupment may be ordered pursuant to the filing of a complaint under section ten or by bringing an action against the employee in superior court.
(3) An insurer that has paid compensation pursuant to a conference order, shall, upon receipt of a decision of an administrative judge or a court of the commonwealth which indicates that overpayments have been made be entitled to recover such overpayments by unilateral reduction of weekly benefits, by no more than thirty percent per week, of any remaining compensation owed the employee. Where overpayments have been made that cannot be recovered in this manner, recoupment may be ordered pursuant to the filing of a complaint pursuant to section ten or by bringing an action against the employee in superior court.
(4) Where an order of recoupment against an employee has not been fulfilled, and weekly benefits are owed to an employee under this chapter by an insurer other than that to which recoupment has been ordered, such insurer shall reduce by thirty percent said weekly benefits payable to the employee, and shall pay such thirty percent excess directly to the insurer to whom recoupment has been ordered, until full recovery has been made.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 12 - Enforcement of Orders; Appeals From Decisions of Reviewing Board; Costs; Reported Questions; Copies of Judgments

Section 12. (1) Whenever any party in interest presents a certified copy of an order or decision of a board member or of the reviewing board and any papers in connection therewith to the superior court department of the trial court for the county in which the injury occurred or for the county of Suffolk, the court shall enforce the order or decision, notwithstanding whether the matters at issue have been appealed and a decision on the merits of the appeal is pending. In the event that the order or decision is reversed on appeal, the enforcement order shall be deemed vacated and unenforceable from the date of such reversal. If the request for an enforcement order is presented to the superior court for the county of Suffolk, the court may, on motion of any party in interest, order the case removed to the superior court for the county in which the injury occurred.
(2) Any appeal from a decision by a reviewing board shall be taken pursuant to section fourteen of chapter thirty A, except that such appeal shall be filed with the appeals court of the commonwealth and provided further that clause (e) of paragraph seven of section fourteen of chapter thirty A shall not apply to such appeals.
(3) In rendering an order or judgement under this section or following a rescript of the supreme judicial court after an appeal from such an order or judgement the court shall award costs to the prevailing party, to be assessed as in actions at law. This paragraph shall not authorize the awarding of costs to or against the industrial accident board or reviewing board.
(4) In the event of a judgement of the appeals court, the court may, on motion of either party, by a brief statement of facts agreeable to the parties, report questions of law raised by the decree to the supreme judicial court for determination.
(5) Immediately after the entry of a judgement under this section, whether final or interlocutory, the clerk of the court shall prepare and forward to the department and to the parties an attested copy of such judgement. Upon the entry of an interlocutory judgement under this section recommitting a case to the board, counsel for the parties shall immediately notify said board by appropriate motion for action in accordance with the requirements of such judgement.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 12a - Award of Costs and Attorney's Fees

Section 12A. If on appeal to the appeals court or the supreme judicial court pursuant to section twelve the claimant prevails, the court shall allow the claimant, in addition to the award in the judgement, an amount equal to the reasonable cost of his attorney's fees, briefs and other necessary expenses that result from the appeal. When any party in interest obtains an enforcement order from the superior court department of the trial court pursuant to said section twelve, the court shall also allow the party the reasonable cost of attorney's fees, briefs and other expenses provided for by this section.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 14a - Employee Leasing Companies

Section 14A. (1) As used in this section, the following words shall have the following meanings:—
(a) ''Client company'', a person, association, partnership, corporation or other entity that utilizes workers provided by an employee leasing company pursuant to a contract.
(b) ''Commissioner'', the commissioner of insurance.
(c) ''Employee leasing company'', a sole proprietorship, partnership, corporation or other form of business entity whose business consists largely of leasing employees to one or more client companies under contractual arrangements that retain for such employee leasing companies a substantial portion of personnel management functions, such as payroll, direction and control of workers, and the right to hire and fire workers provided by the employee leasing company; provided, however, that the leasing arrangement is long term and not an arrangement to provide the client company temporary help services during seasonal or unusual conditions.
(2) The commissioner may establish by regulation the circumstances and conditions, if any, under which any employee leasing company may be the policyholder of a workers' compensation insurance policy providing coverage to employees leased to client companies, and the manner and method of determining the appropriate premiums of client companies and employee leasing companies.
(3) An employee leasing company that does not meet the requirements of this section shall be subject to the provisions of section twenty-five C and where applicable, section fourteen.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 15a - Controversy as to Which of Two or More Insurers Is Liable

Section 15A. If one or more claims are filed for an injury and two or more insurers, any one of which may be held to be liable to pay compensation therefor, agree that the injured employee would be entitled to receive such compensation but for the existence of a controversy as to which of said insurers is liable to pay the same, such one of said insurers as they may mutually agree upon or as may be selected by a single member of the board shall pay to the injured employee the compensation aforesaid, pending a final decision of the board as to the matter in controversy, and such decision shall require that the amount of compensation so paid shall be deducted from the award if made against another insurer and be paid by said other insurer to the insurer agreed upon or selected by the single member as aforesaid. If, however, said insurers cannot agree that such employee would be entitled to compensation irrespective of the existence of such controversy, then a hearing to determine the question of liability and the payment of compensation shall be held forthwith by the division, such hearing to take precedence over other pending matters.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 16 - Subsequent Findings Discontinuing Compensation; Finality

Section 16. When in any case before the department it appears that compensation has been paid or when in any such case there appears of record a finding that the employee is entitled to compensation, no subsequent finding by a member or the reviewing board discontinuing compensation on the ground that the employee's incapacity has ceased shall be considered final as a matter of fact or res adjudicata as a matter of law, and such employee or his dependents, in the event of his death, may have further hearings as to whether his incapacity or death is or was the result of the injury for which he received compensation; provided, however, that if the board shall determine that the petition for such rehearing is without merit or frivolous, the employee or his dependents shall not thereafter be entitled to file any subsequent petition thereof except for cause shown and in the discretion of the member to whom such subsequent petition may be referred; and, provided further, that, in the event of the death of the employee, such a petition for a rehearing shall be filed within three months from the time of his decease and within one year from the date of the finding terminating his compensation.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 17 - Enforcement of Orders or Decisions

Section 17. All orders or decisions issued in accordance with this chapter shall be enforceable under section twelve unless and until reversed by a decision of a member of the board or a reviewing board, or a judgement or decision of a court of the commonwealth; and payment of compensation, when ordered, shall commence immediately, with the first payment to be received by the employee within fourteen days of the issuance of any such order or decision, and shall cover all periods for which compensation is due under this chapter. No penalties shall be assessed during the pendency of any appeal.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 18 - Independent and Sub-Contractors; Liability of Insurer and Others

Section 18. If an insured person enters into a contract, written or oral, with an independent contractor to do such person's work, or if such a contractor enters into a contract with a sub-contractor to do all or any part of the work comprised in such contract with the insured, and the insurer would, if such work were executed by employees immediately employed by the insured, be liable to pay compensation under this chapter to those employees, the insurer shall pay to such employees any compensation which would be payable to them under this chapter if the independent or sub-contractors were insured persons. The insurer, however, shall be entitled to recover indemnity from any other person who would have been liable to such employees independently of this section; and if the insurer has paid compensation under this section, it may enforce, in the name of the employee or in its own name and for its benefit, the liability of such other person. The insurer shall also be entitled to recover from the uninsured independent contractor or the uninsured sub-contractor all compensation benefits and expenses, medical, hospital or otherwise, that it has paid or may become obligated to pay on account of any injury to the employee or employees of any such uninsured independent contractor or uninsured sub-contractor; provided, that this provision shall not authorize the insurer to recover from such a contractor or sub-contractor an amount which, together with any sum recovered under this chapter from any other person on account of the payment of compensation to such employee or employees, will exceed in the aggregate the amount of such compensation benefits and expenses. This section shall not apply to any contract of an independent or sub-contractor which is merely ancillary and incidental to, and is no part of or process in, the trade or business carried on by the insured, nor to any case where the injury occurred elsewhere than on, in or about the premises on which the contractor has undertaken to execute the work for the insured or which are under the control or management of the insured. The word ''premises'', as used in this section, shall include the public highways if the contract requires or necessitates the use of the public highways.
In any case where there shall exist with respect to an employee a general employer and a special employer relationship, as between the general employer and the special employer, the liability for the payment of compensation for the injury shall be borne by the general employer or its insurer, and the special employer or its insurer shall be liable for such payment if the parties have so agreed or if the general employer shall not be an insured or insured person under this chapter.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 19 - Agreements by Parties

Section 19. (1) Except as otherwise provided by section seven, any payment of compensation shall be by written agreement by the parties and subject to the approval of the department. Any other questions arising under this chapter may be so settled by agreement. Said agreements shall for all purposes be enforceable in the same manner as an order under section twelve.
(2) Any withdrawal of a complaint for discontinuance of compensation shall be made in writing and filed with the department and the employee. The parties shall be deemed to have agreed to all of the findings contained in a written decision of an arbitrator on a case forwarded to arbitration pursuant to the provisions of section ten. The department shall approve any agreement received on a prescribed form unless such agreement is deemed to be in violation of law. Any agreement not approved shall be returned to the party submitting it. Except as provided by section ten B, a party to any agreement under this chapter may file a complaint with the superior court to vacate or modify such agreement on grounds of law or equity.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 20 - Hospital Records as Evidence; Medical Records and Reports Open to Inspection

Section 20. Copies of hospital records kept in accordance with section seventy of chapter one hundred and eleven, certified by the persons in custody thereof to be true and complete, shall be admissible in evidence in proceedings before the division or any member thereof. The division or any member, before admitting any such copy in evidence, may require the party offering the same to produce the original record. All medical records and reports of hospitals, clinics and physicians of the insurer, employer, or of the employee shall be filed with and open to the inspection of the division so far as relevant to any matter before it. Such reports shall be open to the inspection of any party.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 20a - Copies of Reports of Medical Examinations Furnished Employees; Reports as Evidence

Section 20A. Any employer who maintains a clinic, dispensary or hospital for the treatment of injured employees and any insurer who maintains a clinic, dispensary or hospital for the treatment of injured employees of any insured shall, upon request of any injured employee attending such a clinic, dispensary or hospital, or of his attorney, furnish such employee or his attorney, at cost, with copies of reports of all medical examinations of the injured employee made while at such clinic, dispensary or hospital, showing the history obtained, the nature of the treatment given or prescribed, the diagnosis and the prognosis. No such medical report shall upon objection by the claimant be admissible in evidence in any proceeding under this chapter, unless a copy thereof has been furnished to the claimant, or a person acting in his behalf, or to his attorney, within twenty days after a written request therefor.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 20b - Medical Reports of Disabled or Deceased Physicians as Evidence

Section 20B. In proceedings before the industrial accident board, the medical report of an incapacitated, disabled or deceased physician who attended or examined the employee, including expressions of medical opinion, shall, at the discretion of the member, be admissible as evidence if the member finds that such medical report was made as the result of such physician's attendance or examination of the employee.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 21 - Notice by Insured to Employees

Section 21. Every insured person shall, as soon as he secures a policy, give written or printed notice to all persons under contract of hire with him that he has provided for payment to injured employees by the insurer, or by self-insurance, as provided by this chapter.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 22 - Notice by Insured to New Employees; Notice of Cessation of Insurance; Filing Copy

Section 22. Every insured person shall give written or printed notice to every person with whom he is about to enter into a contract of hire that he has provided for payment to injured employees by the insurer or by means of self-insurance as provided in this chapter. An employer ceasing to be insured by an insurance company shall, on or before the day on which his policy expires, give written or printed notice thereof to all persons under contract with him. In case of the renewal of the policy no notice shall be required. He shall file a copy of said notice with the department. The notices required by this and the preceding section may be given in the manner therein provided or in such other manner as may be approved by the department.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 23 - Release of Claims or Demands at Common Law

Section 23. If an employee files any claim or accepts payment of compensation on account of personal injury under this chapter, or submits to a proceeding before the department under sections ten to twelve, inclusive, such action shall constitute a release to the insurer of all claims or demands at common law, if any, arising from the injury. If an employee accepts payment of compensation under this chapter on account of personal injury or makes an agreement under section forty-eight, such action shall constitute a release to the insured of all claims or demands at common law, if any, arising from the injury.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 24 - Waiver of Right of Action for Injuries

Section 24. An employee shall be held to have waived his right of action at common law or under the law of any other jurisdiction in respect to an injury that is compensable under this chapter, to recover damages for personal injuries, if he shall not have given his employer, at the time of his contract of hire, written notice that he claimed such right, or, if the contract of hire was made before the employer became an insured person or self-insurer, if the employee shall not have given the said notice within thirty days of the time said employer became an insured person or self-insurer. An employee who has given notice to his employer that he claimed his right of action as aforesaid may waive such claim by a written notice, which shall take effect five days after it is delivered to the employer or his agent. The notices required by this section shall be given in such manner as the department may approve. If an employee has not given notice to his employer that he preserves his right of action at common law as provided by this section, the employee's spouse, children, parents and any other member of the employee's family or next of kin who is wholly or partly dependent upon the earnings of such employee at the time of injury or death, shall also be held to have waived any right created by statute, at common law, or under the law of any other jurisdiction against such employer, including, but not limited to claims for damages due to emotional distress, loss of consortium, parental guidance, companionship or the like, when such loss is a result of any injury to the employee that is compensable under this chapter.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25 - Insurer's Liability on Judgment for Employee

Section 25. If an insured person who has complied with the rules, regulations and demands of the insurer is required by a judgment of a court to pay to an employee any damages on account of personal injury sustained by such employee during the period covered by insurance, the insurer shall pay to the insured the full amount of such judgment and the cost assessed therewith if the insured shall have given the insurer written notice of the bringing of the action in which the judgment was recovered and an opportunity to appear and defend the same.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25b - Applicability of Statute Relating to Insurance and Self-Insurers; Employer Bringing Employees Within Statute

Section 25B. Section twenty-five A shall not apply to the commonwealth, the Massachusetts Turnpike Authority, the Massachusetts Bay Transportation Authority, the Massachusetts Port Authority or the various counties, cities, towns and districts provided for in sections sixty-nine to seventy-five, inclusive. Any employer may bring an employee or employees for whom he is not required by this chapter to provide for the payment of compensation within the coverage of this chapter by providing for the payment of compensation to such employee or employees as provided by this chapter.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25d - Service Companies; Investigation, Adjustment or Settlement of Claims for Self-Insurers

Section 25D. A self-insurer may engage a service company, third party administrator, or like organization to investigate, adjust or settle claims under this chapter. The insurance commissioner shall promulgate regulations governing the conduct and practices of service companies, third party administrators, or like organizations.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25h - Termination of Certificate

Section 25H. (1) The certificate of approval issued by the commissioner of insurance to a workers' compensation self-insurance group authorizes the group to provide workers' compensation benefits. The certificate of approval remains in effect until terminated at the request of the group or revoked by the commissioner of insurance pursuant to the provisions of section twenty-five U.
(2) The commissioner of insurance shall not grant the request of any group to terminate its certificate of approval unless the group has insured or reinsured all incurred workers' compensation obligations with an authorized insurer under an agreement filed with and approved in writing by said commissioner. Such obligations shall include both known claims and expenses associated therewith. Subject to the approval of the commissioner of insurance, a group may merge with another group engaged in the same or similar type of business only if the resulting group assumes in full all obligations of the merging groups. A public employer group may only merge with another public employer group. The commissioner of insurance may hold a hearing on the merger and shall do so if any party, including a member of either group, so requests.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25j - Boards of Trustees

Section 25J. (1) Each group shall be operated by a board of trustees which shall consist of not less than three persons whom the members of a group elect for stated terms of office. At least two of the trustees shall be employees, officers or directors of members of the group, except for public employer groups for whom the three trustees shall be elected officials or employees of public entities within this state. The administrator of a self-insurance group, if any, shall not serve on the board of trustees of the group, unless the group is a public employer group, in which case the administrator may serve as a trustee. All trustees shall be residents of the commonwealth or officer of corporations authorized to do business in the commonwealth.
(2) The board of trustees of each group shall ensure that all claims are paid promptly and shall take all necessary precautions to safeguard the assets of the group, including the following:
(a) Maintain responsibility for all monies collected or disbursed from the group and segregate all monies in a claims fund account and an administrative fund account. Net premium shall be placed in a designated depository in an amount equal to the aggregate retained workers' compensation liability of the group, and such deposits shall be called the claims fund account. The remaining net premium after any payments for reinsurance or excess insurance shall be placed in a designated depository for the payment of taxes, general regulatory fees and assessments and administrative costs and such deposits shall be called the administrative fund account.
(b) Maintain minutes of its meetings and make such minutes available to the commissioner of insurance; and
(c) Designate an administrator to carry out the policies of the board of trustees and to provide day to day management of the group. The board shall enter into a written agreement with the administrator, which shall include, but not be limited to, a description of the duties, responsibilities and compensation for the administrator, subject to the commissioner's approval. The group shall demonstrate to the commissioner's satisfaction that any administrator designated by the board of trustees is of good repute, is in sound financial condition and is experienced in the area of workers' compensation claims administration.
(3) Funds not needed for current obligations may be invested by the board of trustees in accordance with the provisions of section sixty-three of chapter one hundred and seventy-five.
(4) The board of trustees shall not:
(a) Extend credit to individual members for payment of a premium, except pursuant to payment plans approved by the commissioner of insurance.
(b) Borrow any monies from the group or in the name of the group except in the ordinary course of business, without first advising the commissioner of insurance of the nature and purpose of the loan and obtaining prior approval from the commissioner of insurance.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25l - Solicitation of Membership by Licensed Agents

Section 25L. Except for the trustees, officers, directors or salaried employees of a group or its administrator, any person soliciting membership in a workers' compensation self-insurance group must be a licensed agent as provided by section sixty-three of chapter one hundred and seventy-five.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25n - Performance Reports; Statements of Financial Condition

Section 25N. Each group shall submit to the commissioner of insurance thirty days prior to the end of its policy year a performance report estimating total outstanding liability, including incurred but not reported claims, for that policy year.
Each group shall submit to the commissioner of insurance a statement of financial condition audited by an independent certified public accountant on or before the last day of the sixth month following the end of the group's fiscal year. Said financial statement shall be on a form prescribed by said commissioner and shall include, but not be limited to, actuarially appropriate reserves for known claims and expenses associated therewith, claims incurred but not reported and expenses associated therewith, reinsurance in force, unearned premiums, and bad debts, which reserves shall be known as liabilities.
The commissioner of insurance may prescribe the format and frequency of other reports which may include, but shall not be limited to, payroll audit reports, summary loss reports and quarterly financial statements.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25o - Uniform Classification System; Premium Contributions; Application to Make Own Rates; Audits

Section 25O. (1) Every workers' compensation self-insurance group shall adhere to the uniform classification system, uniform experience rating plan, and manual rules filed with the commissioner of insurance by an advisory organization designated by said commissioner.
(2) Premium contributions to the group shall be determined by applying the manual rates and rules to the appropriate classification of each member which shall be adjusted by each member's experience credit or debit. Subject to approval by the commissioner of insurance, premium contributions may also be reduced by an advance premium discount reflecting the group's expense levels and loss experience.
(3) Notwithstanding the provisions of subsection (2), a group may apply to the commissioner of insurance for authority to make its own rates. Such rates shall be based on at least two years of the group's experience. Public employer safety groups in operation for at least two consecutive years prior to their application as a public employer self insurance group may apply to the commissioner of insurance to make its own rates effective the first year of operation as a self insured group. Any self-insured group which is composed of more than 1,000 members and has been in existence for a period of five consecutive years as of December 31, 1999 and which remains in compliance with the requirements of subsection (2) of section 25G shall not be required to have its members experience rated pursuant to the uniform experience rating plan filed with and approved by the commissioner, unless its by-laws or similar rules require otherwise.
(4) Each group shall be audited at least annually by an auditor approved by the commissioner of insurance to verify proper classifications, experience rating, payroll and rates. A report of the audit shall be filed with said commissioner of insurance in a form acceptable to him. A group or any member thereof may request a hearing on any objections to the classifications. If the commissioner of insurance determines that, as a result of an improper classification, a member's premium contribution is insufficient, he shall order the group to assess that member an amount equal to the deficiency. If said commissioner determines that as a result of an improper classification a member's premium is excessive, he shall order the group to refund to the member the excess collected. The audit shall be at the expense of the group.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25p - Refunds

Section 25P. Any monies for a fund year in excess of the amount necessary to fund all obligations for such fund year may be declared to be refundable by the board of trustees not less than six months after the end of the fund year.
Each member shall be given a written description of the refund plan at the time of application for membership. A refund for any fund year shall be paid only to those employers who remain participants in the group for the entire fund year. Payment of a refund based on a previous fund year shall not be contingent on continued membership in the group after that fund year.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25q - Premium Payment Plans; Loss Reserves; Bad Debt Reserves

Section 25Q. (1) Each group shall establish with the approval of the commissioner of insurance a premium payment plan which shall include an initial payment by each member of at least twenty-five per cent of that member's annual premium before the start of the group's fund year and payment of the balance of each member's annual premium within the first eight months of that fund year in monthly or quarterly installments.
(2) Each group shall establish and maintain actuarially appropriate loss reserves which shall include reserves for known claims and expenses associated therewith and claims incurred but not reported and expenses associated therewith.
(3) Each group shall establish and maintain bad debt reserves based on the historical experience of the group or other groups.
(4) Subsections (1) and (3) shall not apply to public employer groups; provided, however, that public employer groups shall establish a premium payment plan acceptable to the commissioner.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25r - Deficiencies; Assessments; Liquidation of Groups

Section 25R. If the assets of a group are at any time insufficient to enable the group to discharge its legal liabilities and other obligations and to maintain the reserves required of it under this chapter, it shall forthwith make up the deficiency or levy an assessment on its members for the amount needed to make up the deficiency.
In the event of a deficiency in any fund year, such deficiency shall be made up immediately, either from surplus from a fund year other than the current fund year, administrative funds, assessment of the membership, if ordered by the group or, such alternate method as the commissioner of insurance may approve of direct. Said commissioner shall be notified prior to any transfer of surplus funds from one fund year to another.
If the group fails to assess its members or to otherwise make up such deficit within thirty days the commissioner of insurance shall order it to do so.
If the group fails to make the required assessment of its members within thirty days after the commissioner of insurance orders it to do so, or if the deficiency is not fully made up within sixty days after the date on which such assessment is made, then after such longer period of time as may be specified by said commissioner, the group shall be deemed to be insolvent.
The commissioner of insurance shall proceed against an insolvent group in the same manner as said commissioner would proceed against in insolvent domestic insurer in the commonwealth pursuant to section six of chapter one hundred and seventy-five. Said commissioner shall have the same powers and limitations in such proceedings as are provided under said section six, except as otherwise provided in this chapter.
In the event of the liquidation of a group, the commissioner of insurance shall levy an assessment on its members for such an amount as he determines to be necessary to discharge all liabilities of the group, including the reasonable cost of liquidation.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25s - Penalties

Section 25S. After notice and opportunity for a hearing, the commissioner of insurance may impose a monetary penalty on any person or group found to be in violation of any of the provisions of sections twenty-five E to twenty-five U, inclusive, or of any rules or regulations promulgated thereunder. The monetary penalty shall not exceed one thousand dollars for each act or violation, not to exceed an aggregate monetary penalty of ten thousand dollars. The amount of any such monetary penalty shall be paid to said commissioner for the use of the department of insurance.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25t - Cease and Desist Orders

Section 25T. After notice and opportunity for a hearing, the commissioner of insurance may issue an order requiring a person or group to cease and desist from engaging in an act or practice found to be in violation of any provision of sections twenty-five E to twenty-five U, inclusive, or of any rules or regulations promulgated thereunder.
Upon a finding, after notice and opportunity for a hearing, that any person or group has violated any cease and desist order, the commissioner of insurance may: impose a monetary penalty of not more than ten thousand dollars for each act or violation of such order not to exceed an aggregate monetary penalty of one hundred thousand dollars and may revoke the group's certificate of approval.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25u - Revocation of Certificates of Approval

Section 25U. After notice and opportunity for a hearing, the commissioner of insurance may revoke a group's certificate of approval if it is found to be insolvent, fails to pay any regulatory fee or assessment, or special fund or trust fund contribution imposed on it, or fails to comply with any of the applicable provisions of sections twenty-five E to twenty-five U, inclusive, with any rules lawfully promulgated, or with any lawful order of said commissioner within the time prescribed. In addition, said commissioner of insurance may revoke a group's certificate of approval if, after notice and opportunity for hearing, the commissioner finds that any certificate of approval that was issued to the group was obtained by fraud; that there was a material misrepresentation in the application for the certificate of approval; or that the group or its administrator has misappropriated, converted, illegally withheld, or refused to pay over on proper demand any monies that belong to a member, an employee of a member, or a person otherwise entitled thereto and that have been entrusted to the group or its administrator in its fiduciary capacities.
This section shall apply to public employer groups; provided, however, that the failure of a public employer group to pay a premium tax shall not be grounds for revocation of the public employer group's certificate of approval.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25v - Applicability of Chapter 176v to Groups Governed by Secs. 25e to 25u

Section 25V. Notwithstanding any general or special law to the contrary, chapter 176V shall apply to groups governed by sections 25E to 25U of this chapter.
2023 Massachusetts General Laws › Part I - Administration of the Government › Title XXI - Labor and Industries › Chapter 152 - Workers' Compensation › Section 25w - Applicability of Chapter 176w to Workers' Compensation Self-Insurance Groups Governed by Secs. 25e to 25u

Section 25W. Notwithstanding any general or special law to the contrary, chapter 176W shall apply to groups governed by sections 25E to 25U, inclusive.