reglab/statecodes huggingface dataset:
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.206 - Maintenance of Loss Data Records, Review and Audit

Current through Reg. 50, No. 138; July 16, 2024
(1) All records supporting the submitted Form
				DFS-F2-SI-17 (Unit Statistical Report), effective 08/09, as previously
				incorporated by reference in Rule
				 69L-5.205, F.A.C., or its
				electronic equivalent shall be open for inspection and audit by the Department
				or its Authorized Representative, during regular business hours. Copies of this
				form are available at the Division of Workers' Compensation, Bureau of
				Monitoring and Audit, Self-Insurance Section, 1579 Summit Lake Drive,
				Tallahassee, FL 32317. Self-insurers are required to maintain loss records that
				reflect a true and accurate division by the classification codes, status type,
				and injury codes contained in the NCCI Workers' Compensation Statistical Plan
				Manual and the NCCI Basic Manual for Workers' Compensation and Employers
				Liability Insurance so the proper classification code, status type, and injury
				code for each accident may be determined. The Workers' Compensation Statistical
				Plan Manual, 2008 Edition, including updates through April 1, 2009 is hereby
				incorporated by reference. A copy of the Manual may be obtained from the
				National Council on Compensation Insurance, Inc., Customer Service Center, 901
				Peninsula Corporate Circle, Boca Raton, FL 33487, telephone 1(800)622-4123. A
				copy of the manual is also available for viewing at the Division of Workers'
				Compensation, Bureau of Monitoring and Audit, Self-Insurance Section, 1579
				Summit Lake Drive, Tallahassee, FL 32317. The NCCI Basic Manual for Workers'
				Compensation and Employers Liability Insurance, 2001 Edition, including updates
				through June 1, 2009, is previously incorporated by reference into Rule
				 69L-5.201, F.A.C.
To ensure their availability for audit purposes, the records
				  shall be retained for five (5) years from the last date the claims data was
				  used for calculation of the experience modification. The location of these
				  records shall be provided to the Department upon submission of the application
				  for self-insurance and updated within fifteen (15) days of any
				  relocation.
(2) At the
				conclusion of the audit conducted by the Department or its Authorized
				Representative, a preliminary report shall be prepared and sent to the
				self-insurer. The preliminary report shall identify any payroll, loss, or
				classification deficiencies. The self-insurer shall have thirty (30) days from
				the date of receipt to review and respond to the Department's preliminary
				report. The Department shall review the response and issue a final
				report.
Rulemaking Authority
					  440.38(1), (2),
					 (3),
					 440.385(6),
					 440.525(2),
					 440.591 FS. Law Implemented
					 440.38(1), (2),
					 (3),
					  440.385(1), (3),
					 (6),
					  440.525 FS.
New 3-9-10.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.207 - Outstanding Liabilities Reporting

Current through Reg. 50, No. 138; July 16, 2024
(1)
				Current Self-Insurers and Former Self-Insurers, other than Governmental
				Entities, shall report their outstanding self-insured workers' compensation
				liabilities for all entities covered under the self-insurance authorization on
				Form DFS-F2-SI-20 (Report of Outstanding Workers' Compensation Liabilities),
				effective 08/09, as incorporated by reference. Copies of this form are
				available at the Division of Workers' Compensation, Bureau of Monitoring and
				Audit, Self-Insurance Section, 1579 Summit Lake Drive, Tallahassee, FL 32317.
				This includes all outstanding liabilities of Former Self-Insurers for which the
				Current Self-Insurer is the Successor Entity. Form DFS-F2-SI-20 (Report of
				Outstanding Workers' Compensation Liabilities), effective 08/09, shall be
				accompanied by a loss run substantiating all amounts reported on the form, be
				signed by an Authorized Representative of the Self-Insurer or its Qualified
				Servicing Entity, and be submitted no later than 120 days after the end of the
				self-insurer's fiscal year. Copies of this form are available at the Division
				of Workers' Compensation, Bureau of Monitoring and Audit, Self-Insurance
				Section, 1579 Summit Lake Drive, Tallahassee, FL 32317. The evaluation date
				shall not be prior to the end of the self-insurer's latest fiscal year. Failure
				to submit the required Form DFS-F2-SI-20 (Report of Outstanding Workers'
				Compensation Liabilities), effective 08/09, or material understatement or
				concealment of loss reserves, shall constitute good cause for revocation of the
				self-insurance authorization in addition to civil penalties specified in Rule
				 69L-5.217, F.A.C.
(2) FSIGA Members shall submit Form
				DFS-F2-SI-20 (Report of Outstanding Workers' Compensation Liabilities),
				effective 08/09, to the:
Florida Self-Insurers Guaranty Association, Inc.
1427 E. Piedmont Dr., 2nd Floor
Tallahassee, Florida 32308
Rulemaking Authority
					  440.38(1), (2),
					 (3),
					 440.385(6),
					 440.525(2),
					 440.591 FS. Law Implemented
					 440.38(1), (2),
					 (3),
					  440.385(1), (3),
					 (6),
					  440.525 FS.
New 3-9-10.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.208 - Maintenance of Outstanding Liabilities Records, Review and Audit

Current through Reg. 50, No. 138; July 16, 2024
(1) All records supporting Form DFS-F2-SI-20,
				(Report of Outstanding Workers' Compensation Liabilities), effective 08/09,
				shall be open for inspection and audit by the Department, the Association, or
				their Authorized Representative, during regular business hours. Each
				self-insurer is required to maintain all records supporting Form DFS-F2-SI-20
				(Report of Outstanding Workers' Compensation Liabilities), effective 08/09. To
				ensure their availability for audit purposes, the records shall be retained for
				five (5) years after closing of a claims file.
(2) The location of these records shall be
				provided to the Department or Association upon submission of the application
				for self-insurance and updated within fifteen (15) days of any
				relocation.
Rulemaking Authority
					  440.38(1), (2),
					 (3),
					 440.385(6),
					 440.525(2),
					 440.591 FS. Law Implemented
					 440.38(1), (2),
					 (3),
					  440.385(1), (3),
					 (6),
					  440.525 FS.
New 3-9-10.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.209 - Financial Statements Reporting

Current through Reg. 50, No. 138; July 16, 2024
Current Self-Insurers and Former Self-Insurers, other than
				  Governmental Entities, shall submit their Financial Statements no later than
				  120 days after the end of their fiscal year. Failure to submit the required
				  Financial Statements shall constitute good cause for revocation of the
				  self-insurance authorization in addition to civil penalties specified in Rule
				   69L-5.217, F.A.C.
(1) The Financial Statements shall meet the
				following requirements:
(a) The Financial
				Statements shall be in the name of the entity holding the self-insurance
				authorization;
(b) The Financial
				Statements shall demonstrate that the self-insurer has the financial strength
				necessary to ensure the timely payment of all current and future
				claims;
(c) The Financial
				Statements shall be audited in accordance with Generally Accepted Auditing
				Standards;
(d) Financial statements
				submitted for Current Self Insurers and Former Self Insurers under an
				authorization granted prior to January 1, 1997, are not required to be audited
				in accordance with Generally Accepted Auditing Standards.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.210 - Actuarial Reports

Current through Reg. 50, No. 138; July 16, 2024
(1) Current
				Self-Insurers and Former Self-Insurers, other than Governmental Entities, that
				do not have Investment Grade Credit Ratings shall be required to submit
				Actuarial Reports within 120 days after the end of their fiscal year or within
				90 days of the date requested by the Department or the Association.
(a) Actuarial Reports shall have a valuation
				date not more than 180 days prior to the date submitted to the Department or
				the Association.
(b) If requested
				by the Department or the Association in order to determine the value of the
				current loss reserves, any Current Self-Insurer or Former Self-Insurer, other
				than a Governmental Entity, shall be required to submit an Actuarial
				Report.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.211 - Changes in Anniversary Rating Date

Current through Reg. 50, No. 138; July 16, 2024
(1)
				Any Current Self-Insurer desiring to change its Anniversary Rating Date shall
				submit a request in writing.
(a) Governmental
				Entities shall submit requests to the:
Department of Financial Services
Division of Workers' Compensation
Bureau of Monitoring and Audit/Self-Insurance
1579 Summit Lake Drive
Tallahassee, FL 32317
(b) FSIGA Members shall submit requests to
				the:
Florida Self-Insurers Guaranty Association, Inc.
1427 E. Piedmont Dr., 2nd Floor
Tallahassee, Florida 32308
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.212 - Contact Information Reporting

Current through Reg. 50, No. 138; July 16, 2024
Current Self-Insurers and Former Self-Insurers shall provide
				  written notification of changes in their contact information within thirty (30)
				  days of the effective date of the change. Notification shall be submitted as
				  follows:
(1) Governmental Entities
				shall submit contact information to the:
Department of Financial Services
Division of Workers' Compensation
Bureau of Monitoring and Audit/Self-Insurance
1579 Summit Lake Drive
Tallahassee, FL 32317
(2) FSIGA Members shall submit contact
				information to the:
Florida Self-Insurers Guaranty Association, Inc.
1427 E. Piedmont Dr., 2nd Floor
Tallahassee, Florida 32308
Rulemaking Authority
					  440.38(1), (2),
					 (3),
					 440.385(6),
					 440.591 FS. Law Implemented
					 440.38(1), (2),
					 (3),
					  440.385(1), (3),
					 (6) 
					 FS.
New 3-9-10.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.213 - Subsidiary, Affiliate and Location Reporting

Current through Reg. 50, No. 138; July 16, 2024
(1) Current Self-Insurers shall provide
				written notification of changes in the names and addresses, as well as changes
				in the structure, of the self-insurer, its affiliates and their wholly or
				majority owned subsidiaries, along with the Federal Employer Identification
				Number (FEIN), fictitious names, and percentage of ownership for each legal
				entity included under the self-insurance authorization within thirty (30) days
				of the effective date of the change. Current Self-Insurers shall also provide
				written notification of changes in the addresses of all operating locations
				with employees within the State of Florida, which are included under the
				self-insurance authorization within thirty (30) days of the effective date of
				the change.
(2) Current
				Self-Insurers shall annually provide a written statement of the accuracy of
				their subsidiary, affiliate and location information. Such statement shall be
				signed by an officer of the Current Self-Insurer.
(3) Notifications of changes and annual
				certifications shall be submitted as follows:
(a) Governmental Entities shall submit
				location information to the:
Department of Financial Services
Division of Workers' Compensation
Bureau of Monitoring and Audit/Self-Insurance
1579 Summit Lake Drive
Tallahassee, FL 32317
(b) FSIGA Members shall submit location
				information to the:
Florida Self-Insurers Guaranty Association, Inc.
1427 E. Piedmont Dr., 2nd Floor
Tallahassee, Florida
				  32308
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.214 - Indemnity Agreements for Affiliated Self-Insurers

Current through Reg. 50, No. 138; July 16, 2024
Affiliated Self-Insurers must execute a new Form DFS-F2-SI-11
				  (Indemnity Agreement), effective 08/09, as incorporated by reference, within
				  thirty (30) days of changes in the affiliates included under the self-insurance
				  authorization. Copies of this form are available at the Division of Workers'
				  Compensation, Bureau of Monitoring and Audit, Self-Insurance Section, 1579
				  Summit Lake Drive, Tallahassee, FL 32317. Form DFS-F2-SI-11 (Indemnity
				  Agreement), effective 08/09, shall be executed by an officer of each affiliated
				  entity to be included under the self-insurance authorization. The executed form
				  shall be submitted to the:
Florida Self-Insurers Guaranty Association, Inc.
1427 E. Piedmont Dr., 2nd Floor
Tallahassee, Florida 32308
Rulemaking Authority
					  440.38(1), (2),
					 (3),
					 440.385(6),
					 440.591 FS. Law Implemented
					 440.38(1), (2),
					 (3),
					  440.385(1), (3),
					 (6) 
					 FS.
New 3-9-10.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.215 - Parental Guaranty

Current through Reg. 50, No. 138; July 16, 2024
Notwithstanding any other provisions of these Rules to the
				  contrary, if a parent company that directly or indirectly owns 100% of a
				  Current Self-Insurer, Former Self-Insurer or applicant for self-insurance
				  elects to execute Form DFS-F2-SI-10 (Parental Guaranty and Corporate Resolution
				  for Self-Insured Subsidiary Entity), effective 08/09, as incorporated by
				  reference, then:
(1) The Financial
				Statements of the parent company shall be used to apply the financial statement
				requirements of subsections
				 69L-5.209(1) 
				and  69L-5.225(1),
				F.A.C.;
(2) The Credit Rating of
				the parent company shall be used to determine the amount of the Security
				Deposit in accordance with Rule
				 69L-5.218, F.A.C.;
(3) The Net Worth of the parent company shall
				be used to determine the excess insurance requirements in accordance with
				paragraph  69L-5.219(1)(a),
				F.A.C.;
(4) The Net Worth of the
				parent company shall be used to apply the Net Worth requirements in subsection
				 69L-5.225(1),
				F.A.C.; and,
(5) The Credit Rating
				of the parent company shall be used to apply the minimum requirements in
				paragraph  69L-5.225(1)(b),
				F.A.C., and the initial security deposit requirements of paragraph
				 69L-5.225(1)(e),
				F.A.C.
(6) Copies of Form
				DFS-F2-SI-10 (Parental Guaranty and Corporate Resolution for Self-Insured
				Subsidiary Entity), effective 08/09, are available at the Division of Workers'
				Compensation, Bureau of Monitoring and Audit, Self-Insurance Section, 1579
				Summit Lake Drive, Tallahassee, FL 32317.
Rulemaking Authority
					  440.38(1), (2),
					 (3),
					 440.385(6),
					 440.591 FS. Law Implemented
					 440.38(1), (2),
					 (3),
					  440.385(1), (3),
					 (6) 
					 FS.
New 3-9-10, Amended
					 5-13-14.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.216 - Provision of Benefits and Safe Working Environment by Self-Insurers

Current through Reg. 50, No. 138; July 16, 2024
(1) It shall be the sole responsibility of
				Current Self-Insurers and Former Self-Insurers to provide for competent persons
				to service their self-insurance program in the areas of claims adjusting,
				safety engineering and loss control. This shall be done through either the use
				of their own employees, who are determined by the Department to have experience
				in these areas, or by contracting with a Qualified Servicing Entity approved by
				the Department to provide these services. A list of Qualified Servicing
				Entities may be obtained by contacting the Department at:
Department of Financial Services
Division of Workers' Compensation
Bureau of Monitoring and Audit/Self-Insurance
1579 Summit Lake Drive
Tallahassee, FL 32317
(2) Current Self-Insurers and Former
				Self-Insurers choosing to use their own employees to provide these services
				must obtain prior approval from the Department and shall submit Form
				DFS-F2-SI-19 (Certification of Servicing for Self-Insurers), effective 08/09,
				as incorporated by reference, within thirty (30) days of a change in servicing
				arrangement and at least every three (3) years thereafter. Resumes of employees
				with experience in these areas must be provided for approval.
(3) Current Self-Insurers and Former
				Self-Insurers contracting with a Qualified Servicing Entity must submit a
				completed Form DFS-F2-SI-19 (Certification of Servicing for Self-Insurers),
				effective 08/09, within thirty (30) days of entering into a servicing contract.
				For expiring contracts renewed with the same Qualified Servicing Entity, a
				completed Form DFS-F2-SI-19 must be submitted within thirty (30) days after the
				expiration date of the contract being renewed. For contracts that are
				continuous or have terms greater than three (3) years, Form DFS-F2-SI-19 must
				be submitted no later than three (3) years and thirty (30) days from the date
				of submission of the prior Form DFS-F2-SI-19.
(a) For Governmental Entities, Form
				DFS-F2-SI-19 (Certification of Servicing for Self-Insurers), effective 08/09,
				shall be obtained from and submitted to the:
Department of Financial Services
Division of Workers' Compensation
Bureau of Monitoring and Audit/Self-Insurance
1579 Summit Lake Drive
Tallahassee, FL 32317
(b) For FSIGA Members, Form DFS-F2-SI-19
				(Certification of Servicing for Self-Insurers), effective 08/09, shall be
				obtained from and submitted to the:
Florida Self-Insurers Guaranty Association, Inc.
1427 E. Piedmont Dr., 2nd Floor
Tallahassee, Florida 32308
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.217 - Civil Penalties and Fines

Current through Reg. 50, No. 138; July 16, 2024
(1) Civil
				Penalties for Delinquent Reports - Failure to timely file legible and complete
				forms, reports or documents as required by Section
				 440.38(2)(b),
				F.S., or these rules, shall subject the party required to file such form,
				report, or document to assessment by the Department of a civil penalty. For
				purposes of this rule, a form, report or document is considered timely filed if
				postmarked on or before the due date prescribed in this rule. Reports submitted
				by a Qualified Servicing Entity on behalf of the self-insurer shall be treated
				as if they were submitted by the self-insurer directly.
(a) Late filed forms, reports, and documents
				required pursuant to this rule shall be penalized as follows:
1. $100 for filings 1 to 14 days
				late.
2. $500 for filings 15 to 30
				days late.
3. $1,000 for filings 31
				to 60 days late.
4. For periods
				greater than sixty (60) days, $50.00 per day from the required filing date.
				Total penalties assessed under this rule for a single late filed form, report,
				or document shall not exceed $5,000.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.219 - Excess Insurance

Current through Reg. 50, No. 138; July 16, 2024
(1) Current
				Self-Insurers, other than Governmental Entities, shall maintain a Specific
				Excess Insurance Policy. Such policy shall have a workers' compensation limit
				of not less than $50,000,000.
(a) The
				self-insured retention of Specific Excess Insurance Policies shall be as
				follows:
1. The self-insurer's per occurrence
				retention shall be no more than $600,000 or 1.5% of the self-insurer's Net
				Worth as shown on the self-insurer's latest audited Financial Statements,
				whichever is greater. The self-insured retention shall be rounded to the
				nearest $50,000.
2. A higher
				self-insured retention shall be allowed, if approved by the Department. The
				Department shall consider the Current Self-Insurer's financial strength,
				including but not limited to its Net Worth, and its Net Worth in relation to
				the requested self-insured retention, in its review of the requested
				self-insured retention.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.220 - Drug-Free Workplace Premium Credit Program

Current through Reg. 50, No. 138; July 16, 2024
(1) In order for self-insurers to receive up
				to a five percent (5%) credit on the computation of premiums used in the
				determination of the assessments for the Workers' Compensation Administration
				Trust Fund, the Special Disability Trust Fund and the Florida Self-Insurers
				Guaranty Association, Inc., they must state that they have established a
				drug-free workplace in accordance with Sections
				 440.101 and
				 440.102, F.S.
(2) The application must be completed using
				Form DFS-F2-SI-8 (Self-Insured Employer Application for Drug-Free Workplace
				Premium Credit Program), effective 08/09, as incorporated by reference, and
				shall be filed annually, sixty (60) days prior to their Anniversary Rating
				Date. Copies of this form are available at the Division of Workers'
				Compensation, Bureau of Monitoring and Audit, Self-Insurance Section, 1579
				Summit Lake Drive, Tallahassee, FL 32317. The completed Form DFS-F2-SI-8
				(Self-Insured Employer Application for Drug-Free Workplace Premium Credit
				Program), effective 08/09, shall be mailed to the:
Department of Financial Services
Division of Workers' Compensation
Assessments Unit
1579 Summit Lake Drive
Tallahassee, FL 32317
(3) Applications not received prior to the
				Anniversary Rating Date shall be applied pro rata as of the date the
				certification is received at the Division.
Rulemaking Authority
					 440.38(1), (2),
					 (3),
					 440.385(6),
					 440.591 FS. Law Implemented
					  440.101,
					  440.102,
					  440.38(1), (2),
					 (3),
					  440.385(1), (3),
					 (6) 
					 FS.
New 3-9-10.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.221 - Safety Program Premium Credit

Current through Reg. 50, No. 138; July 16, 2024
(1)
				In order for self-insurers to receive up to a two percent (2%) credit on the
				computation of premiums used in the determination of the assessments for the
				Workers' Compensation Administration Trust Fund, the Special Disability Trust
				Fund and the Florida Self-Insurers Guaranty Association, Inc., they must state
				that they have established a workplace safety program in accordance with
				Section  440.1025, F.S.
(2) The statement must be completed using
				Form DFS-F2-SI-9 (Self-Insurer Certification of Workplace Safety Program
				Premium Credit) effective 08/09, as incorporated by reference, and shall be
				filed annually sixty (60) days prior to their Anniversary Rating Date. Copies
				of this form are available at the Division of Workers' Compensation, Bureau of
				Monitoring and Audit, Self-Insurance Section, 1579 Summit Lake Drive,
				Tallahassee, FL 32317. The completed Form DFS-F2-SI-9 (Self-Insurer
				Certification of Employer Workplace Safety Program Premium Credit) effective
				08/09, shall be mailed to the:
Department of Financial Services
Division of Workers' Compensation
Assessments Unit
1579 Summit Lake Drive
Tallahassee, FL 32317
(3) Certifications not received prior to the
				Anniversary Rating Date shall be applied pro rata as of the date the
				certification is received at the Division.
Rulemaking Authority
					  440.1025,
					  440.38(1), (2),
					 (3),
					 440.385(6),
					 440.591 FS. Law Implemented
					 440.1025,
					 440.38(1), (2),
					 (3),
					  440.385(1), (3),
					 (6) 
					 FS.
New 3-9-10.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.222 - Revocation and Employer Compliance

Current through Reg. 50, No. 138; July 16, 2024
(1)
				Failure to comply with any of the rules herein or with any order of the
				Department or court of competent jurisdiction within the time prescribed shall
				be considered good cause for revocation of the self-insurance authorization,
				within the meaning of Section
				 440.38(3), F.S.
				Noncompliance with any of the provisions of the Workers' Compensation Law,
				Chapter 440, F.S., particularly those relating to time and method of
				compensation payments, the furnishing of medical treatment and filing of
				accident and compensation reports, or failure to pay any assessment or penalty,
				shall likewise be deemed good cause.
(2) Material understatement or concealment of
				payroll, and material misrepresentation or concealment of employee duties, so
				as to avoid proper classification shall be considered good cause for revocation
				of the self-insurance authorization, within the meaning of Section
				 440.38(3), F.S.
				and/or action by the Department under Section
				 440.107, F.S. Material
				understatement or concealment of data pertinent to the computation and
				application of an experience modification factor shall be considered good cause
				for revocation of the self-insurance authorization, within the meaning of
				Section  440.38(3), F.S.
				and/or action by the Department under Section
				 440.107,
				F.S.
Rulemaking Authority
					  440.38(1), (2),
					 (3),
					 440.385(6),
					 440.525(2),
					 440.591 FS. Law Implemented
					 440.38(1), (2),
					 (3),
					  440.385(1), (3),
					 (6),
					  440.525 FS.
New 3-9-10.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.223 - Election Process

Current through Reg. 50, No. 138; July 16, 2024
(1) The state and
				its boards, bureaus, departments, and agencies and all of its political
				subdivisions which employ labor, and the state universities that are electing
				to self-insure pursuant to Section
				 440.38(6),
				F.S., shall submit to the Division for review at least ninety (90) days prior
				to the preferred effective date of self-insured status, the following
				information:
(a) Copy of document(s) through
				which the entity is organized or authorized to operate as a Governmental
				Entity, including articles of incorporation, grant of authority, or charter, if
				applicable;
(b) Application for
				Governmental Self-Insurance, Form DFS-F2-SI-1G, effective 08/09, as
				incorporated by reference;
(c)
				Application for Governmental Self-Insurance Estimated Payroll, Form
				DFS-F2-SI-GEP, effective 08/09, as incorporated by reference;
(d) Certification of Servicing for
				Self-Insurers, Form DFS-F2-SI-19, effective 08/09, as previously incorporated
				by reference in Rule  69L-5.216, F.A.C.;
				and,
(e) NCCI Workers' Compensation
				Experience Modification Promulgation Worksheet for the current and two (2)
				preceding years, as set forth in the National Council on Compensation Insurance
				(NCCI) Experience Rating Plan Manual for Workers' Compensation and Employers
				Liability Insurance. The NCCI Experience Rating Plan Manual for Workers'
				Compensation and Employers Liability Insurance, 2003 Edition, including updates
				through October 2008, is previously incorporated by reference into Rule
				 69L-5.201, F.A.C.
The notification, forms and supporting documentation can be
				  obtained from and shall be submitted to the:
Department of Financial Services
Division of Workers' Compensation
Bureau of Monitoring and Audit/Self-Insurance
1579 Summit Lake Drive
Tallahassee, FL 32317
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.224 - Termination

Current through Reg. 50, No. 138; July 16, 2024
A Governmental Entity who ceases self-insurance shall notify
				  the Division of such withdrawal and shall continue to file all reports required
				  by this rule with the Division upon withdrawal and thereafter until such time
				  as the employer has satisfied the Division that there is no remaining value to
				  the claims incurred while the employer was self-insured.
Rulemaking Authority
					  440.38(1), (2),
					 (3),
					 440.385(6),
					 440.591 FS. Law Implemented
					 440.38(1), (2),
					 (3),
					  440.385(1), (3),
					 (6) 
					 FS.
New 3-9-10.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.227 - Alien Corporations Additional Requirements

Current through Reg. 50, No. 138; July 16, 2024
An Alien Corporation applying for self-insurance must submit
				  the following documentation in duplicate at the time of application in addition
				  to the application requirements outlined in Rule
				   69L-5.225, F.A.C.:
(1) An opinion from an attorney, with a
				minimum of three years experience in international law, that states that the
				Alien Corporation's country of domicile has substantially similar laws with
				respect to the jurisdiction of the Department and the Courts of the State of
				Florida for the purpose of securing timely payment of all current and future
				workers' compensation claims of the Alien Corporation.
(2) A stipulation that, notwithstanding other
				rights, all matters related to the self-insurance authorization and to workers'
				compensation claims under Chapter 440, F.S., will be resolved in Florida Courts
				under Florida law.
(3) Designation
				of a general agent for service of process in Florida.
Rulemaking Authority
					  440.38(1), (2),
					 (3),
					 440.385(6),
					 440.591 FS. Law Implemented
					 440.38(1), (2),
					 (3),
					  440.385(1), (3),
					 (6) 
					 FS.
New 3-9-10.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.228 - Termination

Current through Reg. 50, No. 138; July 16, 2024
(1) A FSIGA Member who obtains replacement
				coverage and desires to terminate its self-insurance authorization shall advise
				the Association in writing within thirty (30) days of the desired termination
				date and shall provide proof of replacement coverage in the form of a
				certificate of insurance effective as of the desired termination date. If a
				certificate of insurance effective as of the desired termination date cannot be
				provided, then:
(a) If the certificate of
				insurance indicates an effective date prior to the desired termination date,
				the certificate must be amended to show Florida being endorsed onto the policy
				effective as of the desired termination date or a copy of the endorsement
				itself must be attached.
(b) If the
				certificate of insurance indicates an effective date subsequent to the desired
				termination date, the self-insurance authorization shall be terminated as of
				the effective date of the certificate of insurance.
(c) If a FSIGA Member no longer has employees
				in the State of Florida and desires to terminate its self-insurance
				authorization, the FSIGA Member shall so advise the Association in writing
				within thirty (30) days of the desired termination date and shall provide proof
				that it no longer has employees in the State of Florida.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.229 - Application Process

Current through Reg. 50, No. 138; July 16, 2024
(1) Application to
				become a Qualified Servicing Entity shall be made on Form DFS-F2-SI-22
				(Qualified Servicing Entity Application), effective 08/09, incorporated by
				reference. Entities may apply to become a Qualified Servicing Entity in any or
				all of the following: claims-adjusting, loss control or safety engineering. The
				application shall be submitted to the Division at least ninety (90) days prior
				to the desired effective date. The application may be obtained at:
Department of Financial Services
Division of Workers' Compensation
Bureau of Monitoring and Audit/Self-Insurance
1579 Summit Lake Drive
Tallahassee, FL 32317
(a) Entities that are not insurance companies
				licensed to write workers' compensation insurance by the Florida Office of
				Insurance Regulation shall include the following in the application package:
1. A completed Form DFS-F2-SI-22 (Qualified
				Servicing Entity Application), effective 08/09, as incorporated by
				reference.
2. Proof that the
				management and ownership of the Qualified Servicing Entity is competent,
				trustworthy and possesses managerial experience that would make the proposed
				operation beneficial to the workers covered. In determining competency the
				Department shall consider the applicant's claims-handling history. If the
				applicant's history contains any of the following it shall be considered a
				demonstration of a lack of competency:
a. A
				repeated pattern or practice of questionable claims-handling techniques
				pursuant to Section  440.525 or
				 440.20, F.S.;
b. A repeated pattern or practice of
				unreasonably controverting claims;
c. A repeated pattern or practice of failing
				to pay compensation orders as required by statute; or
d. A repeated pattern or practice of
				arbitrarily or unreasonably disallowing or reducing payments to healthcare
				providers pursuant to Section
				 440.13(7)(f),
				F.S.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-5 - RULES FOR SELF-INSURERS UNDER THE WORKERS' COMPENSATION ACT › Section 69L-5.230 - Contracting with a Qualified Servicing Entity

Current through Reg. 50, No. 138; July 16, 2024
(1) Each Qualified Servicing Entity shall
				file Form DFS-F2-SI-19 (Certification of Servicing for Self-Insurers),
				effective 08/09, as previously incorporated by reference in Rule
				 69L-5.216, F.A.C., within thirty
				(30) days of entering into a contract for servicing.
(a) For Governmental Entities, Form
				DFS-F2-SI-19 (Certification of Servicing for Self-Insurers), effective 08/09,
				shall be obtained from and submitted to the:
Department of Financial Services
Division of Workers' Compensation
Bureau of Monitoring and Audit/Self-Insurance
1579 Summit Lake Drive
Tallahassee, FL 32317
(b) For FSIGA Members, Form DFS-F2-SI-19
				(Certification of Servicing for Self-Insurers), effective 08/09, shall be
				obtained from and submitted to the:
Florida Self-Insurers Guaranty Association, Inc.
1427 E. Piedmont Drive, 2nd Floor
Tallahassee, FL 32308
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-6 - WORKERS' COMPENSATION COMPLIANCE › Section 69L-6.007 - Compensation Notice

Current through Reg. 50, No. 138; July 16, 2024
(1)
(a) Upon issuance of an insurance policy or
				certificate of membership in a self-insurance fund or a renewal certificate
				thereof, the insurer or self-insurance servicing agent shall electronically
				send the compensation notice to the employer or furnish the employer with a
				sufficient number of typewritten or printed compensation notices, commonly
				referred to as the "broken arm poster." The compensation notice shall be
				printed on paper or cardboard stock 11 inches by 17 inches, and have the same
				form and content as Form DFS-F4-1548, "Workers' Comp Works For You" Poster,
				(Rev 3/10), or Form DFS-F4-2026, "Compensación por accidentes de trabajo
				labora para usted" Poster, (Rev. 03/10), which are incorporated herein by
				reference. Form DFS-F4-1548 can be found at the following link:
https://www.flrules.org/Gateway/reference.asp?No=Ref-13906
;
				or on the Division's website at:
https://www.myfloridacfo.com/Division/WC/PublicationsFormsManualsReports/Brochures/Broken_Arm_Eng.pdf
.
				Form DFS-F4-2026 can be found at the following link:
https://www.flrules.org/Gateway/reference.asp?No=Ref-13907
;
				or on the Division's website at:
https://www.myfloridacfo.com/Division/WC/PublicationsFormsManualsReports/Brochures/Broken_Arm_Span.pdf
.
				The compensation notice may be posted separately or may be included as a part
				of a Florida and federal labor law poster.
(b) As an alternative to having the
				Anti-Fraud Reward Program language in the poster itself, the employer may elect
				to attach the Anti-Fraud Reward Program Notice to the poster on a separate
				piece of paper, with the same form and content as Form DFS-F4-1603, "Anti-Fraud
				Reward Program" Notice, (Eff. 2/2022), or Form DFS-F4-1604, "Programa de
				Recompesa en contra del Fraude," (Eff. 2/2022), which are incorporated herein
				by reference. Form DFS-F4-1603 can be found at the following link:
https://www.flrules.org/Gateway/reference.asp?No=Ref-14431
;
				or on the Division's website at:
https://www.myfloridacfo.com/Division/WC/pdf/Anti-FraudNotice.pdf
.
				Form DFS-F4-1604 can be found at the following link:
https://www.flrules.org/Gateway/reference.asp?No=Ref-14432
;
				or on the Division's website at:
https://www.myfloridacfo.com/Division/WC/pdf/Anti-FraudNotice-Spanish.pdf
.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-6 - WORKERS' COMPENSATION COMPLIANCE › Section 69L-6.009 - Forms and Instructions (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 440.05(9),
					 440.591 FS. Law Implemented
					 440.05
					 FS.
New 11-20-79, Amended 4-15-81, 1-2-86, Formerly 38F-6.09,
					 Amended 5-28-91, 2-15-94, 2-2-00, 3-5-02, Formerly 38F-6.009, 4L-6.009, Amended
					 2-19-07, 1-7-08, 12-31-08, Repealed
					 9-4-13.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-6 - WORKERS' COMPENSATION COMPLIANCE › Section 69L-6.015 - Record Maintenance and Production Requirements for Employers

Current through Reg. 50, No. 138; July 16, 2024
(1) Employers must at all times maintain the
				records required by this rule and must produce the records when requested by
				the division pursuant to Section
				 440.107, F.S.
(2) Identity, organizational, and
				occupational records. Every employer shall maintain the notice that assigns to
				the employer its Federal Employer Identification Number (IRS Form 575A);
				records that identify its business name, such as fictitious name registration;
				records that identify its business form, such as corporation, limited liability
				company, or partnership; and a copy of its articles of incorporation or
				organization, occupational licenses, trade licenses or certifications, and
				competency cards.
(3) Employment
				records. Every employer shall maintain employment records pertaining to every
				person to whom the employer paid or owes remuneration for the performance of
				any work or service in connection with any employment under any appointment or
				contract for hire or apprenticeship.
(a) The
				employment records required by this subsection shall indicate with regard to
				every such person:
1. Name of the
				person.
2. Social Security Number,
				Federal Employer Identification Number, or IRS Tax Identification Number of the
				person.
3. Each day, month, and
				year or pay period when the employer engaged the person in
				employment.
4. Amount of
				remuneration paid or owed by the employer for work or service performed by the
				person. Where remuneration is paid or owed on an hourly basis, the record shall
				indicate the day, month, and year of work or service and the number of hours
				worked by the person during each pay period. Where remuneration is paid or owed
				on any basis other than hourly, the record shall specify the basis, such as
				competitive bid, piece rate, or task, and indicate the day, month, and year,
				when remuneration was earned.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-6 - WORKERS' COMPENSATION COMPLIANCE › Section 69L-6.018 - Misclassification of Employees as Independent Contractors

Current through Reg. 50, No. 138; July 16, 2024
(1) An employer who fails to secure
				compensation as required by Sections
				 440.10(1)  and
				 440.38(1),
				F.S., for each employee classified by the employer as an independent contractor
				but who does not meet the criteria of an independent contractor specified in
				Section  440.02, F.S., shall be assessed
				a penalty in the following amount:
(a) $2500
				per misclassified employee for the first two misclassified employees per site;
				and,
(b) $5,000 per misclassified
				employee after the first two misclassified employees per
				site.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-6 - WORKERS' COMPENSATION COMPLIANCE › Section 69L-6.019 - Policies and Endorsements Covering Employees Engaged in Work in Florida

Current through Reg. 50, No. 138; July 16, 2024
(1) Every employer who is required to provide
				workers' compensation coverage for employees engaged in work in this state
				shall obtain a Florida policy or endorsement for such employees that utilizes
				Florida class codes, rates, rules and manuals that are in compliance with and
				approved under the provisions of chapter 440, F.S., and the Florida Insurance
				Code, pursuant to Sections
				 440.10(1)(g) 
				and  440.38(7),
				F.S.
(2) In order to comply with
				Sections  440.10(1)(g) 
				and  440.38(7),
				F.S., any policy or endorsement presented by an employer as proof of workers'
				compensation coverage for employees engaged in work in this state must be
				issued by an insurer that holds a valid Certificate of Authority in the State
				of Florida.
(3) In order to comply
				with Sections  440.10(1)(g) 
				and  440.38(7),
				F.S., for any workers' compensation policy or endorsement presented by an
				employer as proof of workers' compensation coverage for employees engaged in
				work in this state:
(a) The policy
				information page (NCCI form number WC 00 00 01 A) must list "Florida" in Item
				3.A., and use Florida approved classification codes, rates, and estimated
				payroll in Item 4.
(b) The policy
				information page endorsement (NCCI form number WC 89 06 00 B) must list
				"Florida" in Item 3.A., and use Florida approved classification codes, rates,
				and estimated payroll in Item 4.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-6 - WORKERS' COMPENSATION COMPLIANCE › Section 69L-6.022 - Confidentiality of Records Produced by the Division (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority
					 440.185(10),
					 440.591 FS. Law Implemented
					 440.125,
					 440.185(11)
					 FS.
New 3-27-03, Formerly 4L-6.022, Repealed
					 2-15-16.
Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-6 - WORKERS' COMPENSATION COMPLIANCE › Section 69L-6.024 - Subcontractors Requirement Regarding Proof of Coverage

Current through Reg. 50, No. 138; July 16, 2024
Under Section
				   440.05(14),
				  F.S., an officer of a corporation who elects to be exempt from Chapter 440,
				  F.S., may not recover benefits or compensation under Chapter 440, F.S., and a
				  carrier may not consider any officer of a corporation who holds a valid
				  certificate of election to be exempt for purposes of determining the
				  appropriate premium for workers' compensation coverage. In order to be
				  consistent with the provisions of Section
				   440.05(14),
				  F.S., in instances where a subcontractor is a corporation and has an officer or
				  officers who elect to be exempt, and the subcontractor provides a copy of the
				  officer's or officers' certificate of election to be exempt to a contractor
				  pursuant to Section  440.10(1)(c),
				  F.S., the subcontractor is not required to also provide evidence of workers'
				  compensation insurance to the contractor if the subcontractor has no employees
				  who may recover benefits under Chapter 440, F.S., at any time during the life
				  of the contract or project for which evidence of exemption or coverage is
				  required. If a subcontractor hires one or more employees at any time during the
				  life of a contract, that subcontractor must provide the contractor with
				  evidence of workers' compensation insurance before any such employee or
				  employees can perform any work related to that contract.
Rulemaking Authority
					 440.05(9),
					 440.591 FS. Law Implemented
					 440.02(15),
					 440.05(14),
					 440.10(1)(c)
					 FS.
New 7-21-04.