reglab/statecodes huggingface dataset:
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-187 - PROFESSIONAL LIABILITY SELF-INSURANCE TRUST FUNDS › Section 69O-187.003 - Approval of Service Agent Required

Current through Reg. 50, No. 138; July 16, 2024
Any Service Agent shall be approved by the Office prior to
				  use by the Fund. The Service Agent shall provide proof that it meets the
				  following conditions before approval may be granted:
(1) The owner(s) of the Service Agent,
				including members of a copartnership, the officers of a corporation, and any
				person exercising control or influence over the affairs of the Service Agent,
				must not have been convicted of a felony or of any crime involving fraud,
				embezzlement, or theft nor have been an officer, Trustee or Service Agent or
				Administrator in a self-insurance funded plan that has become
				insolvent.
(2) The Service Agent
				shall certify that it either employs or contracts with a sufficient number of
				experienced and qualified claims personnel to meet the needs of the
				self-insurance trust fund with which it intends to contract.
(3) The Service Agent shall certify that it
				employs or contracts with a sufficient number of personnel experienced and
				qualified in the area of underwriting to meet the needs of the self-insurance
				trust fund with which it intends to contract or to provide the contractual
				arrangement made to have such service provided. In this context, the term
				"underwriting" includes, but is not limited to, the overall planning and
				coordinating of the self-insurance trust fund, the ability to procure excess
				insurance, the ability to provide summary data regarding the cost of claims,
				including the frequency and distribution of claims by type and cause, and the
				skill to make recommendations to individual members regarding the correction of
				any deficiencies that arise in the self-insurance trust fund.
(4) The Service Agent shall submit
				information concerning its organization and staff sufficient to establish
				fulfillment of the requirements of this section.
(5) The Service Agent shall certify that it
				has the recordkeeping capabilities specified before any approval may be
				granted.
(6) The Service Agent
				shall submit biographical statements on the form entitled "Biographical
				Statement," which is included in the "Application for Approval as a Medical
				Malpractice Self-Insurance Trust Fund," Form OIR-370; and fingerprint cards for
				all persons who have first line responsibility for the operation or management
				of all or part of the Fund, including but not limited to the principal
				executive and operating officers of the Service Agent. Form OIR-370 is hereby
				incorporated by reference and shall become effective on May 10, 1989. Form
				OIR-370 may be obtained from the Office of Insurance Regulation, Bureau of
				Property and Casualty Forms and Rates, Larson Building, Tallahassee, Florida
				32399-0300.
Rulemaking Authority 627.357(6), 624.308(1) FS. Law
					 Implemented 624.307(1), 627.357 FS.
New 5-10-89, Formerly 4-39.0021,
					 4-187.003.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-187 - PROFESSIONAL LIABILITY SELF-INSURANCE TRUST FUNDS › Section 69O-187.006 - Deficit Assessments and Surplus Funds

Current through Reg. 50, No. 138; July 16, 2024
(1) In the event of a deficit in any fund
				year, such deficit shall be made up, either from unencumbered surplus from a
				fund year or years other than the current fund year; or, upon approval by the
				Office, by assessment of the membership, if necessary and consistent with sound
				actuarial principles, or by such alternate method as the Office may approve.
				The Office shall be notified prior to any transfer of unencumbered surplus
				funds.
(2) If necessary and
				consistent with sound actuarial principles, the Fund may issue dividends or
				refunds to its members as approved by the Office.
(3) All filings shall be submitted
				electronically to http://www.floir.com/iportal.
Rulemaking Authority 627.357(6), 624.308(1) FS. Law
					 Implemented 624.307(1), 624.424, 627.357
					 FS.
New 10-7-75, Formerly 4-39.05, Amended 5-10-89, Formerly
					 4-39.005, 4-187.006, Amended 7-30-17.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-187 - PROFESSIONAL LIABILITY SELF-INSURANCE TRUST FUNDS › Section 69O-187.008 - Contracts for Excess Insurance

Current through Reg. 50, No. 138; July 16, 2024
Specific excess and aggregate excess insurance may be
				  required as a condition of approval or continuing operation of the Fund.
The Fund shall not voluntarily reduce its specific excess or
				  aggregate excess insurance without the prior approval of the Office. The Fund
				  shall notify the Office of any involuntary changes in such coverages as soon as
				  the Fund receives notice of any such change in coverage. The Office may approve
				  the continued operations of the Fund with the reduced coverage taking into
				  consideration the availability of such excess insurance, the financial
				  condition of the Fund and the cost of any such excess insurance. All filings
				  shall be submitted electronically to
				  http://www.floir.com/iportal.
Rulemaking Authority 627.357(6), 624.308(1) FS. Law
					 Implemented 624.307(1), 624.424, 627.357
					 FS.
New 10-7-75, Formerly 4-39.07, Amended 5-10-89, Formerly
					 4-39.007, 4-187.008, Amended 7-30-17.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-187 - PROFESSIONAL LIABILITY SELF-INSURANCE TRUST FUNDS › Section 69O-187.011 - Exemptions

Current through Reg. 50, No. 138; July 16, 2024
Rule 69O-187, F.A.C., as amended on May 10, 1989, shall allow
				  any Fund established prior to this date an exemption from Rules
				  69O-187.003 and
				  69O-187.010, F.A.C. At such time
				  as any of the Fund documents filed pursuant to the application process are
				  amended, the amended document(s) shall comply with Rule
				  69O-187.010, F.A.C. In the event
				  the management of the Fund is changed, the Fund shall adhere to Rule
				  69O-187.003,
				  F.A.C.
Rulemaking Authority 627.357(6), 624.308(1) FS. Law
					 Implemented 624.307(1), 627.357 FS.
New 5-10-89, Formerly 4-39.0082,
					 4-187.011.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-187 - PROFESSIONAL LIABILITY SELF-INSURANCE TRUST FUNDS › Section 69O-187.012 - Withdrawal of Self-Insurance Privilege

Current through Reg. 50, No. 138; July 16, 2024
Failure to comply with any of the foregoing rules or with any
				  order of the Office within the time prescribed shall be considered good cause
				  for revocation, suspension, or refusal of the self-insurance privilege as
				  previously indicated.
Rulemaking Authority 627.357(6), 624.308(1) FS. Law
					 Implemented 624.307(1), 627.357 FS.
New 10-7-75, Formerly 4-39.09, Amended 5-10-89, Formerly
					 4-39.009, 4-187.012.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-188 - COMMERCIAL SELF-INSURANCE FUNDS › Section 69O-188.001 - Purpose

Current through Reg. 50, No. 138; July 16, 2024
The purpose of this chapter is to establish a procedure by
				  which notice is acknowledged by applicants for commercial self-insurance funds
				  of the assessability of membership in the self-insurance fund and that it may
				  be necessary to contribute additional monies to meet unfilled obligations of
				  the Fund.
Rulemaking Authority 624.308(1) FS. Law Implemented
					 624.307(1), 624.462, 624.472 FS.
New 3-28-89, Formerly 4-78.001,
					 4-188.001.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-188 - COMMERCIAL SELF-INSURANCE FUNDS › Section 69O-188.002 - Scope

Current through Reg. 50, No. 138; July 16, 2024
This chapter shall apply to all self-insurance funds
				  authorized to do business in Florida pursuant to Section
				  624.462, F.S.
Rulemaking Authority 624.308(1) FS. Law Implemented
					 624.307(1), 624.462, 624.472 FS.
New 3-28-89, Formerly 4-78.002,
					 4-188.002.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-188 - COMMERCIAL SELF-INSURANCE FUNDS › Section 69O-188.010 - Rating Plan: Discounts, Credits, Surcharges

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule applies to all commercial
				property and casualty insurance which is written by a commercial self-insurance
				fund, as defined in Section 624.460-.488, F.S., in accordance with a rating
				plan. It is intended to establish guidelines and procedures for determining
				whether discounts, credits or surcharges applied under a rating plan are
				producing rates that are not excessive, inadequate or unfairly discriminatory.
				This part does not apply to workers' compensation or employer's liability
				insurance.
(2) As used in this
				rule:
(a) "Rating plan" means the rate manual
				and any schedule rating plan, experience rating plan, individual risk premium
				modification plan, rule, procedure, plan, underwriting rule, schedule or other
				such device for modifying manual rates.
(b) "Subjective discount, credit or surcharge
				plan" means any part of the rating plan that (i) applies to a specific policy
				at the discretion of the fund or the insured, or (ii) uses subjective
				non-quantifiable standards for determining the rate modification, or (iii) does
				not specify the exact amount of the modification. Also called rate modification
				plans, these plans usually provide various risk characteristics or conditions
				and a range of modification factors which may be applied to the manual rate of
				a particular insurance risk in recognition of such characteristics or
				conditions. The effect of the modification factor is to increase (debit) or
				decrease (credit) the rate to be charged. These plans include, but are not
				limited to, plans commonly called Schedule Rating Plans and Individual Risk
				Premium Modification Plans.
(c)
				"Manual rate" means the rate developed from the rating plan prior to the
				application of any subjective discount, credit or surcharge plan. Generally,
				the manual rate is designed to apply on a generic basis to similar risks and is
				published in a rate manual by a fund or rating organization. Package rates
				produced by application of package modification factors to monoline rates are
				considered to be manual rates.
(d)
				"Experience rating plan" means any part of a rating plan used to modify an
				otherwise applicable rate based on the past loss experience of the individual
				insured.
(e) "Fund" means a
				commercial self-insurance fund authorized to write one or more property or
				casualty lines of business in the State of Florida under Sections 624.460-.488,
				F.S.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-188 - COMMERCIAL SELF-INSURANCE FUNDS › Section 69O-188.020 - Purpose

Current through Reg. 50, No. 138; July 16, 2024
The purpose of the rules in this part is to specify the
				  manner in which each commercial self-insurance fund as defined in Sections
				  624.460-.488, F.S., shall for assessment and financial reporting purposes,
				  report its experience to the Office, and the manner in which the trustees shall
				  levy an assessment upon the members for the amount needed to make up any
				  deficiency.
Rulemaking Authority 624.308 FS. Law Implemented
					 624.307(1), 624.470, 624.474, 624.488
					 FS.
New 12-17-90, Formerly 4-78.020,
					 4-188.020.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-188 - COMMERCIAL SELF-INSURANCE FUNDS › Section 69O-188.021 - Definitions

Current through Reg. 50, No. 138; July 16, 2024
As used herein and for purposes of Forms OIR-EX and OIR-IA,
				  the following definitions shall apply. For purposes of reporting on a
				  calendar-accident year basis, references to "policy year" in the rules in this
				  part shall mean "calendar-accident year" as the context may require.
(1) "Office" means the Office of Insurance
				Regulation.
(2) "Policy Year" means
				an aggregate record of all transactions for policies becoming effective during
				a given twelve (12) month period ending on December 31.
(3) "Calendar-Accident Year" means premiums
				earned during a twelve (12) month period ending December 31 and losses incurred
				from accidents which occur during the same period.
(4) "Calendar-Year" means the twelve (12)
				month period ending December 31 for which all policies of a particular policy
				year were effective. This definition is not applicable to funds reporting on a
				calendar-accident year basis.
(5)
				"Earned Premium" means:
(a) For a policy year,
				all earned premiums collected or due for each policy year including endorsement
				premiums, post-year audit adjustments, and retro rating plan adjustments less
				reinsurance expenses associated with such policies and less contributions to
				aggregate excess funds.
(b) For a
				calendar-accident year, all earned premiums collected or due for each
				calendar-accident year less reinsurance expenses associated with such premiums
				and less contributions to aggregate excess funds. Endorsement premiums,
				post-year audit adjustments, and retro rating plan adjustments shall be
				included in the calendar-accident year in which such adjustments are
				made.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-188 - COMMERCIAL SELF-INSURANCE FUNDS › Section 69O-188.022 - Filing of the Commercial Self-Insurance Fund Experience Reporting Form

Current through Reg. 50, No. 138; July 16, 2024
(1) On or before March 31 of each year or a
				later date if approved by the Office Department for good cause, each commercial
				self insurance fund shall complete for the preceding policy years, excluding
				closed policy years, evaluated as of the preceding December 31, and submit to
				the Office Department Form OIR-EX, "Commercial Self-Insurance Fund Experience
				Reporting Form," rev. 8/90, and Form OIR-IA, "Commercial Self-Insurance Fund
				Policy Year Investment Income Allocation Schedule (Schedule "A")," rev. 8/90,
				in accordance with this rule. Forms OIR-EX and OIR-IA, and the accompanying
				instructions are hereby adopted and incorporated by reference. Forms are
				available at http://www.floir.com/iportal.
(2) Each fund shall, upon filing its initial
				Form OIR-EX and Form OIR-IA, elect to report on either a policy year or
				calendar-accident year basis. Thereafter, the reporting shall be on a
				consistent basis from year to year. Any changes in accounting or actuarial
				technique used in developing data shall be approved by the Office. All filings
				shall be submitted electronically to
				http://www.floir.com/iportal.
Rulemaking Authority 624.308 FS. Law Implemented
					 624.307(1), 624.424, 624.470, 624.474, 624.488
					 FS.
New 12-17-90, Formerly 4-78.022, 4-188.022, Amended
					 7-30-17.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-188 - COMMERCIAL SELF-INSURANCE FUNDS › Section 69O-188.023 - Filing of the Annual Statement by Commercial Self-Insurance Funds

Current through Reg. 50, No. 138; July 16, 2024
(1) Each commercial self-insurance fund shall
				submit electronically to http://www.floir.com/iportal. For the purpose of
				complying with rule Chapter 69O-137, F.A.C., a commercial self-insurance fund
				shall be considered an authorized insurer, except that the fund's annual
				statement shall be due on or before April 1 of each year.
(2) As an aggregate write-in on the balance
				sheet of the Annual Statement for assets and policyholders' surplus, an entry
				for future investment income on losses and allocated loss adjustment expense
				reserves and unallocated loss adjustment expense reserves shall be reflected.
				Future investment income shall be calculated as follows:
A + B + C - D
A
=
Losses and Allocated Loss Adjustment Expense
							 Reserves
B
=
Unallocated Loss Adjustment Expense Reserves
C
=
Excess of Statutory Reserves over Statement
							 Reserves
D
=
Present Value of A + B + C
(3)
				If a commercial self-insurance fund elects to report on a policy year basis
				under Rule 69O-188.022, F.A.C., then the
				commercial self-insurance fund shall file a supplemental schedule on a policy
				year basis of Schedule P of the NAIC Annual Statement Form for Fire and
				Casualty Insurers.
Rulemaking Authority 624.308 FS. Law Implemented
					 624.307(1), 624.424, 624.470, 624.474, 624.488
					 FS.
New 12-17-90, Formerly 4-78.023, 4-188.023, Amended
					 7-30-17.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-188 - COMMERCIAL SELF-INSURANCE FUNDS › Section 69O-188.024 - Deficiency/Assessment Procedure

Current through Reg. 50, No. 138; July 16, 2024
(1) After four (4)
				completed policy years, the commercial self-insurance fund trustees shall,
				within sixty (60) days of filing Forms OIR-EX and OIR-IA with the Office, make
				up any deficiencies identified in each policy year on Form OIR-EX, line 13., or
				shall levy an assessment upon the members for the amount needed to make up said
				deficiencies.
(2) Prior to a fund
				reporting four (4) complete policy years, the Office shall order the trustees
				of a fund to make up a deficiency or assess its members who participated in a
				policy year in which a deficiency is reported unless the fund can present an
				actuarially sound plan to amortize the deficiency. The Office may require that
				such plan be certified by an actuary who is a member of the American Academy of
				Actuaries.
(3) If needed, the
				trustees shall levy an assessment by sending a notice of assessment by
				certified mail to the address of record of each member of the fund from whom an
				assessment is due. The trustees shall take all steps necessary and reasonable
				to collect the assessment as soon as is reasonably possible. The trustees shall
				not be required to pursue assessments against a member if to do so would not be
				cost-effective.
(4) The fund may
				petition the Office within thirty (30) days of filing Forms OIR-EX and OIR-IA,
				to delay levying an assessment if it believes to do so is prudent. The Office
				shall grant the petition if the fund demonstrates to the satisfaction of the
				Office that the deficiency indicated on Form OIR-EX is likely to be resolved
				without an assessment. While such petition is under consideration by the
				Office, the sixty (60) day requirement in subsection
				69O-188.024(1),
				F.A.C., shall not be applicable. However, if such petition is denied by the
				Office, the fund shall levy the assessment within sixty (60) days of such
				denial. All forms shall be submitted electronically to
				http://www.floir.com/iportal.
Rulemaking Authority 624.308 FS. Law Implemented
					 624.307(1), 624.424, 624.470, 624.474, 624.488
					 FS.
New 12-17-90, Formerly 4-78.024, 4-188.024, Amended
					 7-30-17.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-188 - COMMERCIAL SELF-INSURANCE FUNDS › Section 69O-188.025 - Assessment Calculation

Current through Reg. 50, No. 138; July 16, 2024
(1) Assessments
				shall be made only against members having a policy during a policy year
				reporting a deficiency on Form OIR-EX, line 13. The assessment for each policy
				year shall be prorated among all policyholders for that policy year as follows:
X/Y x A = B
X
=
Assessment needed for a specific policy year.
Y
=
Total earned premium for the policy year being
							 assessed.
A
=
Each member's earned premium for the policy year
							 being assessed.
B
=
Assessment due from the member.
(2)
				For funds reporting on a calendar-accident year basis earned premiums shall
				include endorsement premiums, post-year audit adjustments and retro rating plan
				adjustments. For any reassessment necessary, eliminate from the total premiums
				earned during the policy year (Y) earned premiums of members who fail to pay
				the assessment. In calculating the amount of assessment necessary, reasonable
				estimates of the amount of the assessment that will not be collectible may be
				utilized.
Rulemaking Authority 624.308 FS. Law Implemented
					 624.307(1), 624.470, 624.474, 624.488
					 FS.
New 12-17-90, Formerly 4-78.025,
					 4-188.025.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-188 - COMMERCIAL SELF-INSURANCE FUNDS › Section 69O-188.026 - Notice Requirement

Current through Reg. 50, No. 138; July 16, 2024
If after reviewing any form filed pursuant to this part, the
				  Office preliminarily determines that the numbers contained thereon are
				  inaccurate or that justification for the numbers is necessary, it shall issue a
				  notice to the fund requesting that a corrected form be filed or that additional
				  information or justification be submitted to support the form. The notice shall
				  specify those parts of the form which the Office believes to be inaccurate and
				  the nature of the additional information or justification to be filed. The fund
				  shall, within thirty (30) days from the date it receives the notice, file with
				  the Office all information or data which it contends supports or justifies the
				  form. If such information is not so filed, the Office may require the fund to
				  immediately cease accepting any premiums for new (non-renewal) insurance
				  coverage. While the corrected form or additional information or justification
				  is under review by the Office, the sixty (60) day requirement in subsection
				  69O-188.024(1),
				  F.A.C., shall not be applicable; however, should a determination be made that
				  an assessment is in order, the fund shall levy the assessment within sixty (60)
				  days of such notification by the Office.
Rulemaking Authority 624.308 FS. Law Implemented
					 624.307(1), 624.470, 624.474, 624.488
					 FS.
New 12-17-90, Formerly 4-78.026,
					 4-188.026.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-188 - COMMERCIAL SELF-INSURANCE FUNDS › Section 69O-188.027 - Excess Funds

Current through Reg. 50, No. 138; July 16, 2024
(1) Once a policy
				year is closed, any excess funds must be:
(a)
				Distributed as dividends to members subject to the approval of the Office;
				or
(b) Transferred to any open fund
				year or years. Such transfer must be formally approved by the
				trustees.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-188 - COMMERCIAL SELF-INSURANCE FUNDS › Section 69O-188.028 - Additional Provisions

Current through Reg. 50, No. 138; July 16, 2024
(1) Nothing in this
				part shall preclude a fund's trustees from levying an assessment to its members
				under the terms of their policies or shall be used as the basis for a member
				not to pay such an assessment.
(2)
				Failure of the trustees to make up deficiencies or assess the members in
				compliance with Rule 69O-188.024, F.A.C., will result
				in Office action under Section
				624.476,
				F.S.
Rulemaking Authority 624.308 FS. Law Implemented
					 624.307(1), 624.470, 624.474, 624.488
					 FS.
New 12-17-90, Formerly 4-78.028,
					 4-188.028.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-189 - WORKERS' COMPENSATION › Section 69O-189.001 - General Reporting Requirements (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 624.308(1) FS. Law Implemented
					 624.307(1), 627.914(5)(b), 627.918(1) FS.
New 6-4-92, Formerly 4-189.001, Repealed
					 3-29-05.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-189 - WORKERS' COMPENSATION › Section 69O-189.004 - Deviation Filing Information

Current through Reg. 50, No. 138; July 16, 2024
F.S., authorize the filing of premium deviations which
				  automatically expire after a period of one year unless refiled and reapproved.
				  Any such premium deviation filing shall include the following information:
(1) Proposed effective date of
				deviation.
(2) Proposed deviation
				percentage.
(3) The basis for the
				proposed deviation including all relevant factors to explain the justification
				for the deviation request.
(4)
				Calendar year earned premium, accident year incurred losses, accident year loss
				adjustment expense, and loss ratios of the preceding three years. Show the
				ratio of accident year loss adjustment expense to accident year incurred losses
				for each year, including Florida experience for the company filing for the
				deviation. If no Florida experience is available for part of the experience
				period requested, so state and show the experience in the group as a
				whole.
(5) Provide an exhibit
				showing anticipated expenses for the period of the deviation. This exhibit
				should show production expenses and general expenses. All companies are
				generally expected to have the same taxes and profit and contingencies as
				included in National Council on Compensation Insurance (hereinafter referred to
				as NCCI) filings. Do not include taxes or profit and contingencies unless
				justification for such factors is provided.
(6) As support for expense exhibits, show
				actual expenses for the latest three years for production and general
				expenses.
(7) Pursuant to section
				627.211(3),
				F.S., the Office shall consider the following areas when evaluating each
				company requesting a deviation:
(a) Applicable
				principles for ratemaking as set forth in sections
				627.062 and
				627.072, F.S.;
(b) The financial condition of the
				insurer.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-189 - WORKERS' COMPENSATION › Section 69O-189.0055 - Records and Reports of Information by Workers' Compensation Insurers Required

Current through Reg. 50, No. 138; July 16, 2024
(1) The Office shall
				use one or more designated workers' compensation and employers' liability
				insurance statistical agents as designated by the Office through the contract
				solicitation process.
(2) Each
				insurer and self-insurance fund as defined in section
				624.461, F.S., shall utilize the
				rules and statistical plans of the Office's designated statistical agents in
				the recording and reporting of loss, expense, and claims experience for
				workers' compensation insurance.
(3) Any changes or amendments to the
				statistical plans and rules of the Office's designated statistical agents are
				subject to approval by the Office prior to use by insurers and self-insurance
				funds for Florida experience. Changes or amendments are made when there are
				economically justifiable reasons made by the industry or the
				Office.
Rulemaking Authority 624.308(1), 627.914 FS. Law
					 Implemented 624.307(1), 627.914 FS.
New 12-24-03, Formerly
					 4-189.0055.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-189 - WORKERS' COMPENSATION › Section 69O-189.006 - Guidelines for Large Deductible Workers' Compensation Filings

Current through Reg. 50, No. 138; July 16, 2024
If a workers' compensation insurer wishes to file for a large
				  deductible, such filing shall be governed by the following guidelines:
(1) Eligibility: Minimum standard premium of
				$500,000; Minimum deductible of $100,000.
(2) Insurer must be clearly obligated to pay
				first dollar of loss just like any other workers' compensation policy without a
				deductible.
(3) Reimbursement of
				deductible by insured does not affect insurer obligation to pay
				losses.
(4) Insurer must continue
				all filing requirements with Department of Financial Services in compliance
				with chapter 440, F.S., for all losses including those below the deductible
				limits.
(5) Insurer must file unit
				statistical reports with the NCCI which show all losses including those below
				the deductible limit.
(6) Unit
				statistical reports are to be completed and filed with the NCCI so that an
				experience modification factor can be calculated for the insured.
(7) Data must be maintained to allow for
				reporting on financial calls of Standard Premium at NCCI Level together with
				all losses including those below the deductible limit.
(8) Insurers must comply with NCCI Aggregate
				Financial Calls, Detail Claim Information Calls, Unit Statistical Reporting,
				and other required calls.
(9)
				Insurer must have an established program to evaluate financial ability of
				insured to pay losses within the deductible. Insurers are required to use
				various financial mechanisms to insure that funds are available from the
				insured to pay deductible portion of losses.
Rulemaking Authority 624.308(1) FS. Law Implemented
					 624.307(1), 627.091(1) FS.
New 6-4-92, Formerly
					 4-189.006.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-189 - WORKERS' COMPENSATION › Section 69O-189.007 - Insurer Experience Reporting - Excessive Profits, Workers' Compensation Insurance (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 624.308(1), 627.215 FS. Law
					 Implemented 624.307(1), 624.424(1)(c), 627.215
					 FS.
New 6-14-84, Amended 7-1-85, Formerly 4-59.061, Amended
					 6-1-88, Formerly 4-59.0061, Amended 12-20-00, Formerly 4-189.007, Amended
					 3-29-05, Repealed 7-30-17.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-189 - WORKERS' COMPENSATION › Section 69O-189.010 - Workers' Compensation Insurance Dividend Plans Defined

Current through Reg. 50, No. 138; July 16, 2024
(1) An insurer, in order to avoid policy and
				advertising misrepresentation as set forth in section
				626.9541(1),
				F.S., shall not include an estimated amount of dividend which may be received,
				in the calculation of premium on proposals for workers' compensation insurance
				in the State of Florida.
(2)
				Insurers may, in connection with such proposals, advise and disclose actual
				dividends which have been paid by said insurer on policies which expired prior
				to the date of the proposal, and on which dividends were declared. In all
				cases, the proposal must include a statement that dividends are declared only
				at the option of the company's board of directors and cannot be
				guaranteed.
(3) Any favor or
				advantage in paying or allowing dividends or other benefits as an inducement to
				an insurance contract is defined as an unfair method of competition under
				section 626.9541(8)(a)2., F.S.
(4)
				A retention plan may be a rating plan or a dividend plan depending on the
				method by which the return is made to the policyholder. If any return of
				premium to the policyholder is subject to the decision of the board of
				directors of the insurer and is returned in the form of a dividend, then the
				plan under which the premium is returned is not construed to be a rating
				plan.
(5) If any return of premium
				to the insured is not subject to the decision of the board of directors, then
				the plan under which the premium is returned to the insured is construed to be
				a rating plan and must be filed by the carrier or a designated rating
				organization.
Rulemaking Authority 624.308(1) FS. Law Implemented
					 624.307(1), 626.9541(1), (8)(a)2.,
					 628.361,
					 628.371,
					 628.391
					 FS.
New 6-4-92, Formerly
					 4-189.010.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-189 - WORKERS' COMPENSATION › Section 69O-189.013 - Workers' Compensation Excess Insurance Rates

Current through Reg. 50, No. 138; July 16, 2024
The filing of workers' compensation excess insurance rates
				  may take the form of rating guidelines and parameters in lieu of specific
				  rates.
Rulemaking Authority 624.308(1) FS. Law Implemented
					 624.307(1), 627.091 FS.
New 6-4-92, Formerly
					 4-189.013.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-189 - WORKERS' COMPENSATION › Section 69O-189.016 - Filing Procedures for Workers' Compensation Classifications, Rules, Rates, Rating Plans, Deviations and Forms

Current through Reg. 50, No. 138; July 16, 2024
(1) Purpose: To establish the procedures to
				be utilized by insurers in the filing of workers' compensation classifications,
				rules, rates, rating plans, deviations and forms pursuant to sections
				627.091,
				627.211 and
				627.410, F.S.
(2) Any insurer authorized to transact
				workers' compensation and employer's liability insurance in Florida shall file
				with the Office every manual of classifications, rules, rates, rating plans,
				deviations and every modification of any of the foregoing, which it proposes to
				use. An insurer may satisfy its obligation to make such filings by becoming a
				member of, or a subscriber to, a licensed rating organization which makes such
				filings and by authorizing the Office to accept such filings in its behalf. No
				insurer shall use any workers' compensation and employer's liability
				classification, rule, rate or rating plan unless it has been filed with the
				Office and the filing has been affirmatively approved.
(3) Any insurer authorized to transact
				workers' compensation and employer's liability insurance in Florida shall file
				with the Office all policy forms and endorsements as defined in section
				627.402, F.S., which it proposes
				to use. An insurer may satisfy its obligation to make such filings in part, by
				becoming a member of, or a subscriber to, a licensed rating organization which
				makes such filings and by authorizing the Office to accept such filings in its
				behalf. However, each individual insurer must file with the Office its own
				unique policy jacket, policy information page, participating language if
				applicable, and any other insurer specific form or endorsement. No insurer
				shall use any workers' compensation and employer's liability policy form or
				endorsement unless the form has been filed with the Office and the filing has
				been affirmatively approved.
(4)
				All filings referenced in this rule shall be submitted to the Office in
				accordance with the requirements outlined in subsections (5) and (6), below.
				The procedures in this rule supersede any other procedures relating to filing
				requirements. All material submitted shall be legible.
(5) Filing Submittal Requirements.
(a) Complete classification, rule, rate,
				rating plan, deviation and form filings shall be submitted with the following
				information at a minimum:
1. Form OIR-B1-582,
				which is adopted and incorporated pursuant to rule
				69O-170.0155, F.A.C.;
2. Cover letter; and,
3. Explanatory
				memorandum.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-190 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69O-190.057 - Evaluation of Application for Self-Insurers Fund

Current through Reg. 50, No. 138; July 16, 2024
(1) The application will be evaluated and a
				determination will be made of:
(a) Whether
				the fund application, individual member applications and indemnity agreement
				are properly completed and that all required information is supplied.
(b) Whether the combined financial condition
				of the membership meets the criteria established in Rule
				69O-190.056, F.A.C.
(c) Whether or not the servicing program
				satisfied Rule 69O-190.031, F.A.C.
(d) Whether the fidelity bonds or insurance
				policies for the administrator, service company, fiscal agent, and other
				individuals pursuant to subsection
				69O-190.064(5),
				F.A.C., are properly executed and in amounts sufficient to protect the fund
				against loss.
(e) Whether a
				sufficient amount of premium has been deposited pursuant to subsection
				69O-190.056(5),
				F.A.C.
(f) Whether the by-laws or
				trust agreement and written policies contain the items specified in subsections
				69O-190.064(17), (18), and
				(19), F.A.C.
(g) Whether the surety bond is properly
				executed or the cash securities properly assigned and if they are in the proper
				amounts pursuant to Rules
				69O-190.060, 69O-190.032 and
				69O-190.033, F.A.C.
(h) Whether the
				excess contracts have proper endorsements and provide suitable coverage to the
				fund pursuant to Rules 69O-190.035 and 69O-190.036, F.A.C.
(i) Whether the excess coverages have limits
				and retentions pursuant to Rule
				69O-190.061, F.A.C.
(j) Whether the combined annual normal
				premiums meet the criteria contained in subsection
				69O-190.056(5),
				F.A.C.
(k) Whether the proforma
				required in paragraph
				69O-190.056(3)(m),
				F.A.C., provides that the fund complies with all requirement of Chapter 440,
				F.S., and this rule for the period covered.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-190 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69O-190.058 - Conditions for Retaining the Self-Insurance Privilege of Self-Insurers Funds

Current through Reg. 50, No. 138; July 16, 2024
(1) The
				self-insurance privilege of a self-insurers fund is granted continuously until
				revoked.
(2) A review of all
				self-insurers fund programs will be made annually. As a result of such reviews,
				changes in the prior requirements to self-insure or the imposition of
				additional requirements in order to continue to be self-insured may be made
				pursuant to Rules 69O-190.060 and
				69O-190.061, F.A.C.
(3) In addition to complying with the
				continuing requirements for self-insurance, all self-insurers funds shall be
				required to submit the following documents and reports on a continuing basis:
(a) Annual financial statements, audited
				financial statements, and actuarial reports pursuant to Rule
				69O-190.059, F.A.C.
(b) Annual Summary Loss Reports on each
				member pursuant to paragraph
				69O-190.062(1)(a),
				F.A.C.
(c) Annual Payroll Reports
				on each member pursuant to paragraph
				69O-190.062(1)(b),
				F.A.C.
(d) Quarterly Financial
				Statements pursuant to Rule
				69O-190.059, F.A.C., and Status
				Reports pursuant to paragraph
				69O-190.062(1)(c),
				F.A.C.
(e) Proof of servicing
				pursuant to Rule 69O-190.031, F.A.C.
(f) Proof of excess coverage pursuant to
				Rules 69O-190.061 and 69O-190.035,
				F.A.C.
(g) Copies of endorsements
				to excess policies pursuant to Rule 69O-190.036, F.A.C.
(h) Copies of surety bonds or riders pursuant
				to Rules 69O-190.060 and 69O-190.032,
				F.A.C.
(i) Proof of cash securities
				pursuant to Rule 69O-190.032, F.A.C.
(j) Reporting changes in coverage of the
				membership pursuant to subsection
				69O-190.062(3),
				F.A.C.
(k) Changes in by-laws or
				trust agreement and written policies pursuant to subsection
				69O-190.064(20),
				F.A.C.
(l) Fidelity bonds, riders,
				insurance policies or endorsements pursuant to subsection
				69O-190.064(5),
				F.A.C.
(m) Copies of new member
				applications pursuant to subsection
				69O-190.062(2),
				F.A.C.
(n) Estimated Breakdown of
				Policy Year Expenses pursuant to subsection
				69O-190.059(6),
				F.A.C.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-190 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69O-190.059 - Financial and Actuarial Reports for Self-Insurers Funds

Current through Reg. 50, No. 138; July 16, 2024
(1) Each fund shall file with the Office
				quarterly financial statements on OIR Form BSI-28 or the 1992 National
				Association of Insurance Commissioners (NAIC) Quarterly Statement, Fire and
				Casualty Companies Association Edition in its entirety.
(2) Each fund shall file with the Office an
				annual financial statement on OIR Form BSI-29 or the following portions of the
				1992 National Association of Insurance Commissioners Annual Statement, Fire and
				Casualty Companies Association Edition: Jurat Page; Statutory Balance Sheet;
				Underwriting and Investment Exhibit - Income Statement; Cash Flow; Underwriting
				and Investment Exhibit Part 1, Part 1A, Part 2, Part 2A, Part 3, Part 3A, and
				Part 4; Exhibit 1 - Analysis of Assets; Exhibit 2 - Analysis of Non-Admitted
				Assets; Notes to Financial Statements; Five Year Historical Data (NOTE: funds
				shall complete this form on a going forward basis); Schedule of Special
				Deposits; Schedule A Part 1; Schedule B; Schedule BA; Schedule C; Schedule D
				Part 1, Part 1A, Part 3, Part 4 and Part 5 (NOTE: only 4th quarter transactions
				need to be reported); Schedule DA Part 1; Schedule F - Part 1A (NOTE: any
				amounts in dispute must be disclosed); Schedule M; Schedule N; Schedule P, Part
				1 Summary, Part 2 Summary, Part 3 Summary, Part 5 Summary, interrogatories;
				Schedule X; Schedule Y.
(a) As part of its
				annual financial statement each fund shall file with the Office an Estimated
				Breakdown of Policy Year Expenses on OIR Form BSI-21 within 60 days after the
				beginning of each policy year. The projection of its anticipated income and
				expenses, shall also include the comparable, actual results for the immediate
				preceding year.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-190 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69O-190.060 - Security Deposits or Bonds for Self-Insurers Fund

Current through Reg. 50, No. 138; July 16, 2024
(1) Pursuant to Section
				624.4621, F.S., each
				self-insurers fund shall deposit with the Office acceptable securities or post
				a surety bond issued by a corporate surety authorized to do business in the
				State of Florida or make provisions as otherwise provided in these
				rules.
(2) The security deposit or
				bond required of a self-insurers fund providing coverage under Section
				624.4621, F.S., shall be equal
				to the greater of:
(a) $250,000;
(b) 10% of the normal premium; and,
(c) 10% of the total loss reserves.
The amount of the security deposit or bond shall be
				  determined at least annually based on data submitted by the self-insurers fund
				  to the Office for the previous fiscal year end. Documents assigning investment
				  assets to the division shall be filed with the division within 90 days of the
				  effective date of these rules. Extensions may be granted for good
				  cause.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-190 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69O-190.061 - Excess Insurance Requirements - Self-Insurers Funds

Current through Reg. 50, No. 138; July 16, 2024
(1) When used in this rule, the following
				words or terms shall have the meaning as described herein:
(a) Loss fund - the retention under the terms
				of an aggregate excess contract, or if no aggregate excess is purchased, the
				amount remaining from normal premium in each fund year after all necessary
				expenses are paid. For the purposes of paragraphs
				69O-190.061(8)(b) and
				(c), F.A.C., no loss fund shall be less than
				70 percent of earned normal premium without the approval of the
				Office.
(b) Aggregate loss - the
				amount of all claims incurred, including reserves for loss development and
				IBNR, which exceeds the loss fund.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-190 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69O-190.062 - Filing Reports - Self-Insurers Funds

Current through Reg. 50, No. 138; July 16, 2024
(1) Reports as to payroll records, coverage,
				accident experience and compensation payment and such periodic reports as are
				required to be filed with the Office shall be made as follows:
(a) Summary loss data shall be filed with the
				Office on each fund member within 60 days after the evaluation date of the
				losses being reported on OIR Form BSI-17. Procedures for reporting losses as
				specified in subsection 69O-190.050(3), F.A.C., shall apply.
(b) Properly classified and audited payrolls
				on each fund member shall be submitted to the Office on OIR Form BSI-5 within
				60 days after the evaluation date of the summary loss information required in
				paragraph (a) above. The classification and audit procedures specified in
				subsection 69O-190.050(1), F.A.C., shall apply.
(c) Quarterly Status Reports submitted on OIR
				Form BSI-24 (Revised 3-11-87), which accurately reflect the financial condition
				of each open fund year shall be filed with the Office within thirty (30) days
				after the close of each fund year quarter and signed by the chairman of the
				board of trustees or authorized self-insurers fund administrator. A fund year
				is considered open as long as one claim from that fund year remains
				unsettled.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-190 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69O-190.064 - Trustees' Responsibilities

Current through Reg. 50, No. 138; July 16, 2024
(1) The
				board of trustees shall have complete authority over and shall retain ultimate
				control of the assets of the fund and shall be responsible for all operations
				of the fund.
(2) The trustees shall
				have the authority to approve applications for membership in the fund. The
				trustees may delegate this authority to the administrator.
(3) The composition of the board of trustees
				shall be as follows:
(a) A majority of the
				board shall be owners, officers, directors, partners or employees of one or
				more members of the fund.
(b) A
				trustee, or relative of the trustee, shall not be an owner, officer, director,
				partner or employee of the fund's service company. This does not apply to
				employment of a relative of the trustee in which the relative's duties are of a
				clerical, or non-managerial nature. Non-managerial being a position which
				cannot affect the financial standing of a self-insurer, or the benefits to
				which an injured employee is entitled under Chapter 440,
				F.S.