reglab/statecodes huggingface dataset:
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 11 - Hearing and Appeal Procedures › Section 15435 - Decision

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The hearing
					 officer shall conduct the hearing and provide a written recommendation to the
					 Director and make available the entire record of the hearing. A matter is
					 deemed submitted to the Director either at the close of the hearing, or, at the
					 discretion of the hearing officer, upon the submission of any post-hearing
					 briefs or arguments requested or allowed by the hearing officer.
(b) The decision of the Director shall
					 reflect a summary of evidence, findings of fact and conclusions of law,
					 together with citations to the controlling statutes applied in rendering the
					 decision, and any determinations made by the Director.
(c) The decision shall be mailed within
					 ninety (90) days of the date of submission, with copies of all parties of
					 record. Issuance of a decision may be delayed to allow settlement, or as the
					 interests of justice may require, in which case the Director shall give all
					 parties of record written notice of such delay.
(d) The Director shall make determinations,
					 as required, as to whether there was at the time of the notice of intention or
					 at the time of the decision, good cause to revoke or deny a certificate or
					 certificate to administer.
(e) If
					 the Director determines that an appellant's application was not processed
					 within the time limits which the Director has adopted in these Regulations
					 pursuant to Government Code section
					 15378, the
					 decision shall include a refund of the fees paid by that appellant for that
					 application.
(f) The decision of
					 the Director shall be final, unless reconsideration pursuant to section
					 15436 of these regulations is
					 requested.
1.
						Amendment filed 12-17-90; operative 1-16-91 (Register 91, No.
						6).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  59,
						  3700,
						  3701,
						  3701.5,
						  3702,
						  3702.1,
						  3702.5,
						  3702.6,
						  3702.7,
						  3702.9,
						  3702.10,
						  3705,
						  3740-
						  3747, Labor
						  Code; Sections
						  11181-
						  11188,
						  15378,
						  Government Code; Sections
						  1985-
						  2031,
						  2033-
						  2036,
						  Code of Civil Procedures.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 11 - Hearing and Appeal Procedures › Section 15436 - Reconsideration

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The Director
					 has the discretion to reconsider and take whatever action is appropriate and
					 necessary to support and facilitate a decision or determination. The Director,
					 in his/her discretion, may grant a stay of enforcement in any proceeding where
					 reconsideration or appeal is initiated.
(b) The employer, surety, custodian of a
					 security deposit, the SISF, or an aggrieved party, upon receipt of the
					 decision, shall have ten (10) calendar days to request reconsideration of the
					 decision by the Director. The request must be in writing and shall be limited
					 to the grounds specified in Labor Code section
					 5903.
(c) Upon receipt of a request for
					 reconsideration, the Director may:
(1) Decline
					 reconsideration;
(2) Grant
					 reconsideration and issue an amended decision or determination after
					 reconsideration based only upon the record and additional argument and evidence
					 offered in the request for reconsideration and any response thereto;
					 or,
(3) If the Director deems that,
					 based upon the request for reconsideration and any response, further hearing is
					 merited, grant reconsideration and hold further hearing pursuant to these
					 regulations, and issue a decision or determination after
					 reconsideration.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 11 - Hearing and Appeal Procedures › Section 15438 - Severability

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
If any provisions of these regulations or the application
						thereof to any party or circumstances is held invalid, such invalidity shall
						not affect other provisions or applications of these regulations which can be
						given effect without the invalid provision or applications and to this end the
						provisions of the regulations are severable.
1.
						Renumbering and amendment of former section
						15437 to section
						15438 filed 12-17-90; operative
						1-16-91 (Register 91, No. 6).
2. Editorial correction of NOTE
						(Register 91, No. 46).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  59,
						  3700,
						  3701,
						  3701.5,
						  3702,
						  3702.1,
						  3702.5,
						  3702.6,
						  3702.7,
						  3702.9,
						  3702.10,
						  3705 and
						  3740-
						  3747, Labor
						  Code; Sections
						  11181-
						  11188 and
						  15378,
						  Government Code; Sections
						  1985-
						  2031
						  and
						  2033-
						  2036,
						  Code of Civil Procedure.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 12 - Claims Administration › Section 15450 - Certificate to Administer

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A valid Certificate to Administer issued
					 by the Manager shall be in the possession of each claims administrator, whether
					 a person, firm, corporation, joint powers authority or self insured employer,
					 to administer or adjust workers' compensation self insurance claims.
EXCEPTION 1: An insurer admitted to transact workers'
						compensation insurance in California is exempt from this requirement pursuant
						to Labor Code Section
						3702.1(a);
NOTE: An insurance company subsidiary not admitted to
						transact workers' compensation insurance in California and engaged in the
						administration or adjustment of claims for a self insured employer is not
						exempt.
EXCEPTION 2: A private self insurer that administers its
						own claims and/or the claims of other private self insurers with common
						ownership or which are in the same Master Certificate file is exempt from this
						requirement.
EXCEPTION 3: A joint powers authority that holds a Master
						Certificate of Consent to Self Insure and administers its own claims; and/or
						the claims of other public self insurers which have an affiliate Certificate
						under the same Master Certificate file number held by the joint powers
						authority; and/or the claims of a former member of the joint powers authority
						is exempt from this requirement.
EXCEPTION 4: A public self insurer that administers its
						own agency's claims is exempt from this requirement.
(b) Application for a Certificate to
					 Administer shall be made on forms provided by Self-Insurance Plans (Form A4-50
					 (Rev. 4/91)). A complete application shall include the application form, and
					 fees in accordance with Section
					 15454.
NOTE: The current application form is contained in Plate
						L of the Appendix following the last Article of these Group 2
						regulations.
(1) The applicant will be
					 notified in writing within 14 days of receipt if the application is
					 deficient.
(2) A certificate to
					 administer will be issued within 30 days of receipt of a complete
					 application.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 12 - Claims Administration › Section 15450.1 - Third Party Claims Administration for New Private Self Insurers

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Each private
					 self insurer granted an initial, individual Certificate to Self Insure workers'
					 compensation liabilities that has not been self insured or previously self
					 insured for a total of three full years shall contract with a third party
					 claims administrator for the first three (3) full calendar years of self
					 insurance. The self insured employer's third party claims administrator shall
					 hold a Certificate to Administer pursuant to Section
					 15450 of these
					 regulations.
(b) Each private group
					 self insurer granted its initial Certificate to Self Insure workers'
					 compensation liabilities shall contract with a third party administrator for
					 the first five (5) full calendar years of self insurance. The group self
					 insurer's third party claims administrator shall hold a Certificate to
					 Administer pursuant to Section
					 15450 of these
					 regulations.
1. New
						section filed 6-30-94; operative 6-30-94 (Register 94, No. 26). For prior
						history, see Register 92, No. 13.
2. Amendment of subsections (a)
						and (b) and repealer of subsection (c) filed 2-9-2006; operative 3-11-2006
						(Register 2006, No. 6).
Note: Authority cited: Sections
						  54,
						  55,
						  59 and
						  3702.10, Labor
						  Code. Reference: Sections
						  3700,
						  3701,
						  3701.5,
						  3702,
						  3702.1,
						  3702.2 and
						  3702.3, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 12 - Claims Administration › Section 15454 - Certificate to Administer: Fees

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The certificate fee shall be paid no
					 later than June 1 in the year of application and shall be sufficient to cover
					 the 1 to 3 year period of the application submitted, and shall accompany the
					 application form. The fee is not prorated in the initial year of each
					 application cycle and is not refundable for any portion of the current fiscal
					 year.
(b) The minimum fee for each
					 private certificate to administer the first adjusting location is $1,000 per
					 year. There is an additional charge of $200 per year for each additional claims
					 adjusting location.
(c) Public
					 applicants are exempt from the payment of a fee for the Certificate to
					 Administer provided all claims administered are for public self insurers. A
					 public administrator for private sector self insurers shall pay the certificate
					 fees due for a private Certificate to Administer.
1.
						Amendment filed 2-19-92; operative 3-20-92 (Register 92, No. 13).
2.
						Amendment of subsection (b) filed 2-9-2006; operative 3-11-2006 (Register 2006,
						No. 6).
Note: Authority cited: Sections
						  54,
						  55,
						  59, and
						  3702.10, Labor
						  Code. Reference: Sections
						  59,
						  3702.1,
						  3702.5 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 12 - Claims Administration › Section 15456 - Exempt. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Repealer filed 2-19-92; operative 3-20-92 (Register 92, No.
						13).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code Reference: Sections
						  59,
						  3702.1 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 12 - Claims Administration › Section 15458 - Claims Administration and Recordkeeping

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Workers' compensation claims and claim files shall be
						administered and maintained in accordance with the provisions of Articles 6 and
						9 of these regulations.
1.
						Amendment filed 2-19-92; operative 3-20-92 (Register 92, No.
						13).
Note: Authority cited: Sections
						  54,
						  55,
						  59 and
						  3702.7, Labor
						  Code. Reference: Sections
						  129,
						  3700,
						  3701,
						  3702,
						  3702.1 and
						  3702.7, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 12 - Claims Administration › Section 15459 - Notification of Willful Failure to Pay Benefits

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The claims administrator shall notify the Manager in
						writing within three days of a self insured employer's willful failure to
						provide adequate funding for the timely payment of workers' compensation
						benefits in accordance with provisions of the Labor Code.
1.
						Amendment filed 2-19-92; operative 3-20-92 (Register 92, No.
						13).
Note: Authority cited: Sections
						  54,
						  55,
						  59 and
						  3702.10, Labor
						  Code. Reference: Sections
						  59,
						  129,
						  3700,
						  3701,
						  3702 and
						  3702.1, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 12 - Claims Administration › Section 15461 - Examination. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1.
						Repealer filed 2-19-92; operative 3-20-92 (Register 92, No.
						13).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  59,
						  3702,
						  3702.1 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 12 - Claims Administration › Section 15463 - Revocation of Certificate

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The Manager may issue a Notice of Intent
					 to Revoke to any holder of a Certificate to Administer. The notice shall
					 indicate the cause for the revocation action and advise the holder of the
					 Certificate of the right to a hearing.
(b) The procedure for revocation of a
					 Certificate of Consent to Administer shall be in accordance with Article 11 of
					 these regulations.
1.
						Amendment and new forms filed 2-19-92; operative 3-20-92 (Register 92, No.
						13).
2. New Appendix plates D, E, F1-F6, G and I filed 12-22-92;
						operative 1-21-93 (Register 93, No. 2).
3. Amendment of Plate F-6
						filed 8-12-93; operative 9-13-93 (Register 93, No. 33).
4. Change
						without regulatory effect relocating Appendix Plates A-1, A-2, B, C, and H from
						section 15204 to section
						15463 filed 9-14-93 pursuant to
						title 1, section
						100, California Code of Regulations
						(Register 93, No. 38).
5. Amendment of forms filed 6-30-94;
						operative 6-30-94 (Register 94, No. 26).
6. Amendment of Appendix
						Plate I filed 12-1-94; operative 1-2-95 (Register 94, No. 48).
7.
						Change without regulatory effect renumbering a portion of Form A4-3 (Agreement
						of Assumption and Guarantee of Workers' Compensation Liabilities) to new Form
						A4-6, including amendments, filed 2-17-98 pursuant to section
						100, title 1, California Code of
						Regulations (Register 98, No. 8).
8. Amendment adding new form A4-5
						filed 6-4-98; operative 7-4-98 (Register 98, No. 23).
9. Amendment
						filed 2-9-2006; operative 3-11-2006 (Register 2006, No. 6).
10.
						Amendment adding new forms A4-7, A4-40a and A4-40b filed 3-2-2009; operative
						3-2-2009 pursuant to Government Code section
						11343.4
						(Register 2009, No. 10).
11. Amendment of Appendix repealing forms
						A4-1, A4-2, A4-3, A4-3G, A4-3M, A4-5, A4-6, A4-7, A4-8, A4-32, A4-40a, A4-40b
						and A4-GAU and adopting forms A-1, A-2, A-3B, A-4, A-5, A-6, S-1, S-2A, S-2B,
						S-4, S-5 and S-6 filed 12-14-2016; operative 1-1-2017 pursuant to Government
						Code section
						11343.4(b)(3)
						(Register 2016, No. 51).
Note: Authority cited: Sections
						  54,
						  55,
						  59 and
						  3702.10, Labor
						  Code. Reference: Sections
						  59,
						  3702.1,
						  3702.7 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 12 - Claims Administration › Appendix - Appendix

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
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California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 13 - Group Self-Insurance › Section 15471 - Initial Feasibility Study

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Included with each group self-insurer's initial
						application for a Certificate To Self-Insure required by Section
						15482 of these regulations shall be
						a feasibility study report prepared by the prospective Group Administrator or
						an independent risk management individual or firm, consisting of the
						following:
(a) An analysis of the
					 advantages and disadvantages of group self-insurance for the proposed group
					 members as compared to the options of individual self-insurance or coverage
					 under a policy issued by a carrier(s);
(b) Identification of all of the initial
					 proposed group members and the combined total payroll for the proposed group
					 self-insurer;
(c) A consolidated
					 summary of the historical workers' compensation claims loss experience and the
					 allocated loss expenses of the proposed group members for a minimum of the
					 three most recent, full policy years, as well as the current policy year
					 through the last completed quarter under the current policy at the time the
					 application is submitted;
(d) A
					 five (5) year pro forma financial statement including, but not limited to, an
					 income statement, balance sheet, projected cash flows, and claims payout
					 projections. The pro forma financial statement must include a detailed
					 separation of assets, liabilities, retained earnings, taxes, and accrual and
					 distribution of excess contributions. If any claims costs are discounted, the
					 interest rate assumptions and payout patterns must be described and must be
					 based on reasonable assumptions.
(e) A summary of the specific details of the
					 group self-insurer's operating plan or the plan itself, including, but not
					 limited to, descriptions of:
(1) The group
					 self-insurer's legal and organizational structure;
(2) Method of governance;
(3) General management of the group
					 self-insurer, including underwriting policies, insurance coverage, billing,
					 commissions, fees, and all other expenses.
(4) Rating or contribution plans, or other
					 means by which group funding during the first five years of operation will
					 generated and the amounts to be generated by the methods proposed for each of
					 the first 5 years of operation.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 13 - Group Self-Insurance › Section 15472 - Minimum Financial Requirements for a Group Self-Insurer

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) In addition to
					 other requirements specified in this Article 13, no private group shall
					 continue as a group self-insurer, unless it meets the funding and solvency
					 requirements specified in section
					 15484(e) as
					 demonstrated in independently audited financial statements meeting the
					 requirements specified in section
					 15484(a)
					 and
(b) of this chapter. (Exception:
					 A group self-insurer may continue if it is operating under a corrective action
					 plan approved by the Chief.)
1. New
						section filed 6-30-94; operative 6-30-94 (Register 94, No. 26).
2.
						Amendment of section heading and section filed 3-2-2009; operative 3-2-2009
						pursuant to Government Code section
						11343.4
						(Register 2009, No. 10).
3. Amendment of section heading and section
						filed 12-14-2016; operative 1-1-2017 pursuant to Government Code section
						11343.4(b)(3)
						(Register 2016, No. 51).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  3700,
						  3701,
						  3701.5,
						  3702,
						  3702.2 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 13 - Group Self-Insurance › Section 15473 - Homogeneity of Group Members

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Each private group self insurer shall
					 demonstrate and maintain homogeneity of its group members by one of the
					 following methods:
(1) Each group member
					 shall share the same, predominant three-digit North American Industry
					 Classification System (NAICS) Code; or
(2) Each group member shall share the same
					 governing class code as established by the Workers' Compensation Insurance
					 Rating Bureau (WCIRB) definition.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 13 - Group Self-Insurance › Section 15474 - Reporting Periods

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Regardless of the date that self insurance begins or the
						term of the program year of a group self insurer, the group self insurer shall
						file a Self Insurer's Annual Report by March 1 of each year as required by
						Section 15251. While the filing of the
						group self insurer's first Self Insurer's Annual Report may be for a period
						shorter than a year, the duration of the initial program year of the group self
						insurer, may be shorter or longer than twelve months.
1. New
						section filed 6-30-94; operative 6-30-94 (Register 94, No. 26).
2.
						Amendment filed 3-2-2009; operative 3-2-2009 pursuant to Government Code
						section
						11343.4
						(Register 2009, No. 10).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  3700,
						  3702.1,
						  3702.2 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 13 - Group Self-Insurance › Section 15475.2 - Restriction on Use of Funds

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The group self-insurer, its trustees,
					 group members, Group Administrator, claims administrator, or other agents or
					 vendors of the group self-insurer shall not utilize funds collected from group
					 members or from other parties conducting business with the group self-insurer,
					 and/or funds earned by the group self-insurer through investments for any
					 purpose not directly related to the payment of claims, the payment of fees
					 related to funding the group, including the posting of a security deposit,
					 penalties, excess insurance premiums, or for any other reasonable obligations
					 or costs of operation of the group self-insurer as determined and authorized by
					 the Board, including the refunding of surplus funds authorized pursuant to
					 Section 15477.
(b) The group self-insurer shall not lend any
					 money to any trustee, core member or affiliate member of the private group
					 self-insurer, or to the Group Administrator, the claims administrator, and/or
					 any other agent, vendor, or service provider. The group self-insurer shall not
					 lend or issue any debt instruments incur other encumbrances or obligations, or
					 extend credit to any group member for the payment of contributions or
					 assessments. Notwithstanding this section, the group self-insurer may:
(1) permit fixed installment plans not to
					 exceed twelve (12) months to collect contributions for the payment of current
					 group members;
(2) permit fixed
					 installment plans approved by the Chief for the payment of special assessments
					 to make up a funding insufficiency pursuant to Section
					 15477.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 13 - Group Self-Insurance › Section 15475.3 - Investment of Funds

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 Subject to the limitations set forth in Section
					 15475.2, the Board of Trustees of a
					 group self-insurer may invest excess funds not immediately needed for the
					 payment of the group insurer's liabilities in any of the following:
(1) United States Treasury Bills, Notes, and
					 Bonds for which the full faith and credit of the United States are pledged for
					 the payment of interest and principal.
(2) Federal agency or United States
					 government-sponsored enterprise obligations, participations, or other
					 instruments, including those issued by or fully guaranteed as to principal and
					 interest by federal agencies or United States government sponsored
					 enterprises.
(3) Certificates of
					 Deposit that are FDIC or NCUA insured or collateralized by the issuing
					 institution. Investments in eligible certificates of deposit, that are brokered
					 into various FDIC and/or NCUA insured institutions, shall have a maximum
					 maturity of no more than five (5) years, and shall not exceed fifty percent
					 (50%) of the total portfolio as measured at the date of purchase.
(4) Money market accounts and savings
					 accounts offered by financial institutions whose deposits are insured by a
					 federal agency. Such deposit accounts in financial institutions shall be
					 limited to offices or branches of the financial institutions located in the
					 State of California. Should the amount deposited in any single account exceed
					 the federally insured amount for any one account, the financial institution
					 shall also meet the credit rating requirements as set forth in Section
					 15215(e).
(5) Bonds, notes, warrants, or other evidence
					 of indebtedness of any local agency or State agency within the United States of
					 America, including bonds payable solely out of the revenues from a
					 revenue-producing property owned, controlled, or operated by the State or local
					 agency, or by the department, board, agency, or authority of the State or local
					 agency, provided the credit worthiness of the security meets the same
					 requirements of securities posted with the Director as security deposit in
					 Section 15213(a)(1).
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 13 - Group Self-Insurance › Section 15476 - Advanced Contribution Discounts

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The Board of Trustees of a group self-insurer using a
						contribution plan shall not authorize discounts to any member. Additionally, if
						any factors reflecting loss histories, such as experience modification
						calculations, are utilized to modify group self-insurer or individual member
						contributions, the contributions for the funding of the group self-insurer's
						program year[s] shall be no less than the funding required under Section
						15484(e).
1. New
						section filed 6-30-94; operative 6-30-94 (Register 94, No. 26).
2.
						Amendment of section heading and section filed 3-2-2009; operative 3-2-2009
						pursuant to Government Code section
						11343.4
						(Register 2009, No. 10).
3. Amendment of section heading and section
						filed 12-14-2016; operative 1-1-2017 pursuant to Government Code section
						11343.4(b)(3)
						(Register 2016, No. 51).
Note: Authority cited: Sections
						  54,
						  55 and
						  3702.10, Labor
						  Code. Reference: Sections
						  3700,
						  3701 and
						  3702.10, Labor
						  Code.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 13 - Group Self-Insurance › Section 15477 - Surplus or Insufficient Funding

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The Board of Trustees of a group self
					 insurer shall not declare that surplus contributions collected in excess of the
					 amount necessary to fund all obligations for any given program year will be
					 refunded to group members unless the group self insurer's most recent annual
					 certified, independently audited financial statement indicates that the group
					 self insurer's assets exceed its liabilities and unless the group self
					 insurer's current actuarial report indicates a surplus of group funds for each
					 program year as indicated in subsections (a)(1) and (a)(2) below.
(1) The group self insurer may transfer
					 excess funds to an escrow account at any time, but shall not declare surplus
					 fund amounts or distribute any surplus funds to group members for any given
					 program year sooner than 23 months after the close of the program year without
					 express written consent from the Chief. Any such disbursements made without
					 written consent from the Chief, including any subsequent disbursements from the
					 same program year or disbursements from a subsequent program year, shall only
					 be from a program year that remains funded as required by Section
					 15484, subdivision (e). Approval
					 from the Chief is not required as long as the group self insurer's current
					 actuarial report and current financial statement support the determination of
					 the surplus amount, and as long as claim funding for each program year meets or
					 exceeds the funding required by Section
					 15484, subdivision (e).
(2) Notwithstanding subsection (a)(1) of this
					 section, the group self insurer may request the Chief to allow that funds be
					 released sooner than 23 months after the end of a program year and/or that the
					 determination of a program year's surplus be based upon the actuarial study
					 conducted with a confidence factor of less than the funding required by Section
					 15484, subdivision (e), and the
					 Chief may allow such a release of surplus funds upon a showing of good cause by
					 the group self insurer. The Chief may require that a special audit be
					 conducted, an independent actuarial study be completed at the group self
					 insurer's expense, and/or other documentation be submitted to support the
					 request from the group self insurer. In no event shall surplus funds be
					 distributed sooner than 23 months after the completion of a program year
					 without express written consent of the Chief.
(3) No reduction in contribution rates for
					 group members shall be authorized unless supported by an actuarial study less
					 than one year old conducted pursuant to Section
					 15481 of these
					 regulations.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 13 - Group Self-Insurance › Section 15478 - Excess Insurance

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Each group self insurer shall have and
					 maintain in full force one or more specific excess workers' compensation
					 insurance policies issued by an admitted casualty insurance carrier or carriers
					 authorized to transact such business in the State of California by the
					 California Department of Insurance. The specific excess policy shall not have a
					 retention level above $500,000 nor an upper limit of less than twenty-five
					 million dollars ($25,000,000) without express written consent of the Manager
					 pursuant to subsection (b). The policy may not lapse, be canceled or otherwise
					 terminated without prior written notice to the Manager and the group self
					 insurer no later than 30 days prior to the date of cancellation or termination
					 by the carrier. On the policy issuance date and on any subsequent renewal date
					 of the policy, the excess carrier or its parent company shall have an adjusted
					 policyholders' surplus of no less than twenty-five million dollars
					 ($25,000,000) and an acceptable credit rating as set forth below:
(1) Standard and Poor's Insurer Financial
					 Strength Rating of A or better rating, or
(2) A.M. Best Company, Financial Strength
					 Rating of B+ or better rating.
If the group self insurer's specific excess carrier's
						credit rating falls below a B rating as rated by either rating agency specified
						in subsections (a)(1) or (a)(2), the group self insurer shall replace the
						policy or obtain new coverage for the remainder of the unused prior policy
						period and for future coverage through a specific excess carrier that meets the
						requirements of this section.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 13 - Group Self-Insurance › Section 15479 - Indemnity Agreement and Power of Attorney

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Each member of a group self-insurer shall
					 execute an Indemnity Agreement and Power of Attorney Form S-4
					 (1-2016).
(b) The Indemnity
					 Agreement and Power of Attorney shall contain, in substance, the following
					 provisions:
(1) An agreement under which each
					 member of a group self-insurer agrees to assume and discharge, jointly and
					 severally, any compensation liability under Labor Code Section
					 3700-
					 3705 of any and
					 all other employers that are parties to the group self-insurer indemnity
					 agreement;
(2) The agreement
					 provides that, in addition to the rights of the group self-insurer to enforce
					 the indemnity agreement in the event of a failure of the group self-insurer to
					 enforce such rights after reasonable notice to the group self-insurer, the
					 Director of Industrial Relations independently shall have the right to enforce
					 the indemnity agreement on behalf of the group self-insurer including the joint
					 and several liability of group members for payment of all compensation
					 liabilities under the indemnity agreement and the liability of group members
					 for any unpaid contributions and assessments;
(3) Provisions requiring that the Board of
					 Trustees of the group self-insurer designate and appoint a Group Administrator
					 empowered to accept the service of process on behalf of the group members and
					 authorized to act for and bind the group self-insurer and all group members in
					 all transactions relating to or arising out of the operation of the group
					 self-insurer;
(4) Provisions for
					 the right of the Director of Industrial Relations to substitute an outside
					 Conservator for the Group Administrator;
(5) A provision granting full power of
					 attorney and signature authority to the Group Administrator of the group
					 self-insurer to execute documents, enter contracts, accept service of process
					 on behalf of the group self-insurer, and conduct the general business of the
					 group self-insurer, and, that said signature of the Group Administrator shall
					 bind each and every group member jointly and severally. Note: A copy of S-4
					 (1-2016), Indemnity Agreement and Power of Attorney is available from the Chief
					 and is available at
http://www.dir.ca.gov/osip
and is
					 contained in the Appendix following Article 12 of Chapter 8, Subchapter
					 2.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 13 - Group Self-Insurance › Section 15480 - Termination of Membership in a Group Self-Insurer

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) No member of a group self-insurer may be
					 involuntarily canceled or terminated from group membership by the group
					 self-insurer unless at least 45 days advance written notice has been provided
					 to the group member and to the Chief. Notice to a broker or other third party
					 shall not be deemed as notice to the group member.
(b) In the case of cancellation or
					 termination of coverage of a group member, whether voluntary or involuntary,
					 the group self-insurer shall remain liable for all compensation liabilities of
					 the group member resulting from any claim with a date of injury during the
					 period of membership in the group self-insurer up to the effective date of the
					 termination and revocation of the group member's Affiliate Certificate of
					 Consent to Self-Insure, including the 45 day notice period in the event of
					 involuntary termination. The group member shall remain responsible for all
					 contributions and assessments for the period of membership in the private group
					 self-insurer, including the 45 day notice period and/or any period during which
					 the termination and revocation of the group member's Affiliate Certificate of
					 Consent to Self-Insure was under appeal.
(c) Notwithstanding subsection (b), the
					 following provisions apply in the case of the cancellation or termination of
					 membership of a member in a group self-insured group, whether voluntary or
					 involuntary:
(1) The group self-insurer shall
					 not incur liability for any claim of a member incurred on or after the date a
					 member obtains coverage through a standard workers' compensation policy issued
					 by an admitted carrier.
(2)
					 Liabilities of a group member may be transferred pursuant to Labor Code Section
					 3702.8 and/or
					 Article 8, Section
					 15360 of these
					 regulations.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 13 - Group Self-Insurance › Section 15482 - Private Group Application

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Each private group of employers desiring
					 to procure a private group Certificate of Consent to Self-Insure as provided in
					 Section 15470 of these regulations shall
					 submit to the Chief a complete Application For A Certificate Of Consent To
					 Self-Insure By A Group Of Employers for the group and a complete Application
					 For An Affiliate Certificate Of Consent To Self-Insure As A Member Of A Group
					 Self-Insurer for each initial member of the group no less than 30 days before
					 the requested effective date of self-insurance. Applications shall be made on:
(1) Form S-1 (1-2016) for a private group
					 seeking a group Certificate of Consent to Self-Insure;
(2) Form S-2B (1-2016) for each member of a
					 group seeking an Affiliate Certificate of Consent to Self-Insure. The
					 Application for an Affiliate Certificate of Consent to Self-Insure shall be
					 completed as provided in Section
					 15482.1 of these
					 regulations.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 13 - Group Self-Insurance › Section 15482.1 - Private Group Member Application

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A complete group member application to
					 self-insure on Form S-2B (1-2016) by each member of a group self-insurer shall
					 include all the attachments requested in the application form itself, and, as
					 applicable, the following:
(1) The Board of
					 Trustees, or the Group Administrator if authorized by the group bylaws, shall
					 evaluate potential new members by reviewing their financial statements, tax
					 returns, credit reports, or other appropriate documentation as specified in the
					 bylaws of the group self-insurer;
(2) A duly executed Resolution authorizing
					 completion of the application to become self-insured as a member of the group
					 self-insurer;
(3) A duly executed
					 Indemnity Agreement and Power of Attorney (Form S-4 (1-2016)), as required by
					 Section 15479 of these
					 regulations.
California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 8 - Office of the Director › Subchapter 2 - Administration of Self-Insurance Plans › Article 13 - Group Self-Insurance › Section 15482.2 - Interim Certificates to Group Members

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The Chief may issue an Interim
					 Certificate of Consent to Self-Insure to a new member of an existing private
					 group self-insurer upon receipt of a qualifying Request for Interim Certificate
					 and the filing fee as provided in Section
					 15491(a)(3). The
					 Interim Certificate of Consent to Self-Insure will be issued for a period not
					 to exceed 180 days. A Certificate of Consent to Self-Insure to replace the
					 Interim Certificate shall not be issued unless a completed application and
					 accompanying documents required by Section
					 15482.1 and the application fee
					 required by Section
					 15491 are submitted to the Chief
					 within 180 days of the effective date of the Interim Certificate.
(b) To qualify for issuance of an Interim
					 Certificate to its group members, the existing private group self-insurer
					 holding the Master Certificate of Consent to Self-Insure must be a group
					 self-insurer in good standing, and shall not be prohibited from adding new
					 members pursuant to Section
					 15477(b)(5).
(c) A Group Affiliate Members Interim
					 Application (Form S-2A (1-2016)) on behalf of the new group member shall be
					 submitted by the Group Administrator to the Chief. The request shall be in
					 writing and shall include the following information regarding the proposed new
					 group member:
(1) The proposed group member's
					 full legal name, state of incorporation, and Federal Tax Identification
					 Number;
(2) The requested effective
					 date of the Interim Certificate;
(3) The annual payroll of the proposed group
					 member during the last 12-months;
(4) The proposed member's three digit NAICS
					 code or two digit SIC Code, experience modification, and a description of the
					 type of business it conducts; and
(5) A signed statement from the Group
					 Administrator certifying that the proposed group member meets the homogeneity
					 and underwriting requirements of the group self-insurer and that the group
					 self-insurer shall be financially responsible to pay all workers' compensation
					 claims arising out of the period of time of the Interim
					 Certificate.