Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-189 - WORKERS' COMPENSATION › Section 69O-189.015 - Workers' Compensation Insurer Reporting of Significant Underwriting Change

Current through Reg. 50, No. 138; July 16, 2024
(1) Purpose: To
				administer the requirements of section
				624.4315, F.S.
(2) Definitions:
(a) "Insurer Group" means two or more
				affiliated insurers that are under common ownership and/or
				management.
(b) "Underwriting" is
				defined as the insurer selection of policyholders through hazard recognition
				and evaluation.
(c) "Underwriting
				Change" is any deliberately planned change in the insurer's administrative
				policies or procedures that will affect the insurer's acceptance or rejection
				of applicants for workers' compensation coverage or will affect the insurer's
				acceptance or rejection of renewal policies or will result in the mid-term
				cancellation of policies in Florida. An insurer that transfers policyholders to
				another insurer in the "Insurer Group", with no lapse in coverage occurring for
				the policyholder, has not made an "Underwriting Change" for purposes of this
				rule.
(d) "Significant Underwriting
				Change that materially limits or restricts the number of workers' compensation
				policies or premiums written in Florida" means an Underwriting Change that is
				reasonably expected to result in any of the following:
1. For an "Insurer Group" with more than one
				insurer licensed in Florida for workers' compensation:
a. Will reduce the number of in-force
				policies in Florida for the "Insurer Group" by at least 750 policies over the
				12 months following the change.
b.
				Will reduce the number of in-force policies in Florida for the "Insurer Group"
				by at least 250 and will reduce the number of in-force policies in Florida for
				the "Insurer Group" at the end of the previous calendar year by more than 33%
				over the 12 months following the change.
c. Will reduce the direct premiums written in
				Florida by at least $3 million and the direct written premiums for the "Insurer
				Group" in Florida for the 12 months following the change will be reduced by
				more than 33% of the prior calendar year, excluding the impact of rate changes
				and payroll changes.
d. Will result
				in the complete elimination of all workers' compensation policies in Florida
				for any insurer in the group.
2. For an individual insurer with no
				affiliated insurers licensed in Florida for workers' compensation:
a. Will reduce the number of in-force
				policies in Florida for the insurer by at least 750 policies over the 12 months
				following the change.
b. Will
				reduce the number of in-force policies in Florida for the insurer by at least
				250 and will reduce the number of in-force policies in Florida for the insurer
				at the end of the previous calendar year by more than 33% over the 12 months
				following the change.
c. Will
				reduce the direct premiums written in Florida by at least $3 million and the
				direct written premiums for the insurer in Florida for the 12 months following
				the change will be reduced by more than 33% of the prior calendar year,
				excluding the impact of rate changes and payroll changes.
d. Will result in the complete elimination of
				all workers' compensation policies in Florida for the
				insurer.
(e)
				Notwithstanding any other provision herein, a Significant Underwriting Change
				does not occur in the following situations:
1.
				A reduction in the number of policies or premium results for reasons other than
				an "Underwriting Change."
2. The
				reduction in premium results solely from conversion to a large deductible
				policy unless there has been an "Underwriting Change" such that the
				policyholder can only purchase a large deductible.
3. The reduction in premium results solely
				from conversion to a policy written under a retrospective rating plan unless
				there has been an "Underwriting Change" such that the policyholder can only
				purchase a retrospectively rated policy.